High prevalence but limited evidence in complementary and alternative medicine: guidelines for future research.

Felix H Fischer,Klaus Linde,George Lewith,Bettina Reiter,Claudia M Witt,Klaus Von Ammon,Helle Johannessen,Bernhard Uehleke,Benno Brinkhaus,Torkel Falkenberg,Vinjar Fønnebø,Wolfgang Weidenhammer,Francesco Cardini

doi:10.1186/1472-6882-14-46

Abstract

The use of complementary and alternative Medicine (CAM) has increased over the past two decades in Europe. Nonetheless, research investigating the evidence to support its use remains limited. The CAMbrella project funded by the European Commission aimed to develop a strategic research agenda starting by systematically evaluating the state of CAM in the EU. CAMbrella involved 9 work packages covering issues such as the definition of CAM; its legal status, provision and use in the EU; and a synthesis of international research perspectives. Based on the work package reports, we developed a strategic and methodologically robust research roadmap based on expert workshops, a systematic Delphi-based process and a final consensus conference. The CAMbrella project suggests six core areas for research to examine the potential contribution of CAM to the health care challenges faced by the EU. These areas include evaluating the prevalence of CAM use in Europe; the EU cititzens’ needs and attitudes regarding CAM; the safety of CAM; the comparative effectiveness of CAM; the effects of meaning and context on CAM outcomes; and different models for integrating CAM into existing health care systems. CAM research should use methods generally accepted in the evaluation of health services, including comparative effectiveness studies and mixed-methods designs. A research strategy is urgently needed, ideally led by a European CAM coordinating research office dedicated to fostering systematic communication between EU governments, the public, charitable and industry funders, researchers and other stakeholders. A European Centre for CAM should also be established to monitor and further a coordinated research strategy with sufficient funds to commission and promote high quality, independent research focusing on the public’s health needs and pan-European collaboration. There is a disparity between highly prevalent use of CAM in Europe and solid knowledge about it. A strategic approach on CAM research should be established to investigate the identified gaps of knowledge and to address upcoming health care challenges.

Highlights

Complementary and alternative medicine (CAM) in the European Union (EU) includes practices such as acupuncture, anthroposophic medicine, aromatherapy, herbal medicine, homeopathy, kinesiology, massage, naturopathy, shiatsu, traditional Chinese medicine, and yoga
The CAMbrella vision for the year 2020 is that research into CAM will provide a broad but relevant and comprehensive evidence base, enabling the EU public and health care providers to make informed decisions about CAM use, both for individuals and for society as a whole
The CAMbrella roadmap puts forward a research agenda for CAM that is designed to address future health care challenges in the EU

Summary

Introduction

Complementary and alternative medicine (CAM) in the European Union (EU) includes practices such as acupuncture, anthroposophic medicine, aromatherapy, herbal medicine, homeopathy, kinesiology, massage, naturopathy, shiatsu, traditional Chinese medicine, and yoga. Over the last 25 years, the use of CAM has risen in Western industrialized countries [1,2,3,4] and CAM has been used often by patients with chronic conditions, such as cancer or chronic pain, or in situations where conventional treatment options have been limited [5]. The new EU framework programme ‘Horizon 2020’ emphasizes the consequences of demographic change in the EU, focusing in particular on elderly patients, who often experience multiple, chronic conditions. CAM may have an important role to play in improving health and well-being in an ageing EU population, including the management of chronic conditions, the prevention of illness, and the promotion of health. The coordination project CAMbrella included 16 institutions from 12 European countries (Figure 1) and was funded by the 7th Framework Programme to address these issues in a systematic manner [6]

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