Abstract
BackgroundPatients currently integrate complementary medicine (CM) and allopathic, choosing a combination of therapies rather than a single therapy in isolation. Understanding integrative healthcare (IHC) extends beyond evaluation of specific therapies to encompass evaluations of multidisciplinary complex interventions. IHC is defined as a therapeutic strategy integrating conventional and complementary medical practices and practitioners in a shared care setting to administer an individualized treatment plan. We sought to review the outcomes of recent clinical trials, explore the design of the interventions and to discuss the methodological approaches and issues that arise when investigating a complex mix of interventions in order to guide future research.MethodFive databases were searched from inception to 30 March 2013. We included randomized and quasi-experimental clinical trials of IHC. Data elements covering process of care (initial assessment, treatment planning and review, means for integration) were extracted.ResultsSix thousand two hundred fifty six papers were screened, 5772 were excluded and 484 full text articles retrieved. Five studies met the inclusion criteria. There are few experimental studies of IHC. Of the five studies conducted, four were in people with lower back pain. The positive findings of these studies indicate that it is feasible to conduct a rigorous clinical trial of an integrative intervention involving allopathic and CM treatment. Further, such interventions may improve patient outcomes.ConclusionsThe trials in our review provide a small yet critical base from which to refine and develop larger studies. Future studies need to be adequately powered to address efficacy, safety and include data on cost effectiveness.
Highlights
Patients currently integrate complementary medicine (CM) and allopathic, choosing a combination of therapies rather than a single therapy in isolation
We sought to review the outcomes of recent clinical trials, explore the structure of the interventions and to discuss the methodological approaches and issues that arise when investigating a complex mix of interventions in order to guide future research
We excluded the six clinical trials that had been included in the previous review [19] as they did not meet our criteria of integrative management or were hospital-based programs
Summary
Patients currently integrate complementary medicine (CM) and allopathic, choosing a combination of therapies rather than a single therapy in isolation. Patients are integrating complementary medicine (CM) and allopathic medicine in a variety of ways depending on their health status and health beliefs [2, 3]. They frequently use “bundles” of therapies rather than just one therapy in isolation [4, 5]. IHC may refer to the process of patient care where allopathic and CM clinicians work as a team. Further confusion is added to the typology of this field by regional variations, where “integrated” is used in the United Kingdom (UK) and parts of Europe, in the same way in which “integrative” is used in the United States (US) and Australia
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