Complementary And Alternative Medicine Practitioners Research Articles

Strengthening the traditional medicine regulation, education and practice in Nigeria

Background: Despite tremendous advances in medical sciences still a large section of the population in rural areas is heavily dependent on indigenous and Traditional Medicine (TM) for treatment. Moreover, there has been a resurgence of interest in the use of Complementary and Alternative Medicine (CAM), globally. Objective: To review the overall regulator structure for the control of TM and the course curriculum for TM education in Nigeria. Method: Information on CAM and TM was collected via online search. Results: Responding to this unprecedented situation government of many countries have taken proactive steps to streamline and regulate the practitioners of CAM and TM in their countries as mandated by WHO. In many African countries because of the availability of research and training programs many traditional herbal medicines are now being sold over the counter. However, the situation is different in Nigeria, even though TM is very popular across the country, structured institutionalized teaching and research activity on TM are inadequate. Conclusion: Health is a key component in determining the Human Development Index (HDI) of a country. CAM and TM practitioner may play an important role in improving the HDI score of the country. Government-sponsored education & training program for TM practitioners is crucial.

Use of Complementary and Alternative Therapies in People with Inflammatory Bowel Disease.

Complementary and alternative medicines (CAMs) are frequently discussed by people with Inflammatory Bowel Disease (IBD). The aim of this study is to explore CAM use in Australians with IBD. This cross-sectional study was conducted via an anonymous online survey, predominantly distributed through IBD-specific social media accounts. Data collection occurred over a three-month period in 2021. Descriptive statistics, Chi-Square tests, and binary logistic regression were used to analyse quantitative data. A simple thematic analysis was conducted for qualitative free-text responses. Of the 123 responses, acupuncture (12.2%) and chiropractors (8.9%) were common CAM practitioners accessed. CAM practitioners were perceived to be 'very helpful' compared to mainstream health practitioners. The most common CAM products reported were vitamins (51.2%), probiotics (43.9%), and herbal medicine (30.9%). Common reasons for use were improved perceived improvements to wellbeing or for long-term management of IBD. Females were more likely to access CAM practitioners (OR 12.6, 95% CI 1.62-98.1, p = 0.02). Doctors were the participants' primary source of information (64.2%), although many expressed dissatisfaction with conventional therapy and the desire for a more holistic approach to care. The use of CAMs in this sample was high. Limited research into the efficacy and safety of these therapies may prevent health professionals from discussing their use with patients. Improved communication with health professionals will allow patients to be active partners in their healthcare plans and can heighten patient satisfaction with conventional therapy.

What natural therapeutics are Australians using to relieve feelings of anxiousness?

IntroductionFeelings of anxiousness are experienced in the absence of diagnosed anxiety in Australia with prevalence and management of anxiousness not well understood within the population. Anxiety statistics represent the closest statistical comparison to anxiousness affecting 13 % of the Australian population. This figure is estimated to be much higher post pandemic based on global prevalence increasing. MethodsThe overall aim of this research is to identify natural ingestive and lifestyle therapeutics used by Australian adults to address their anxiousness. 115 provided consent. A cross sectional survey of the Australian adult population was conducted. The survey included enquiry about the impact of the COVID-19 pandemic, concomitant or isolated pharmaceutical use, demographic factors, potential barriers of access to natural therapeutics, types of practitioners commonly sought, exacerbating factors and manifestations of anxiousness. ResultsOne hundred and fifteen (n=115) respondents completed the survey. The survey allowed respondents to select more than one lifestyle option. The survey found that of the natural therapeutic options, 90.32 % (n=84) used lifestyle medicine (deep breathing, time in nature and meditation), 55.9 % (n=52) used herbal medicine (Passionflower, Lemon balm, Withania and St John’s wort) and 53.2 % (n=49) used nutrients (Magnesium, B Vitamins and Theanine and SAMe). The survey identified that complementary and alternative medicine (CAM) practitioners were the most common type of practitioner sought for information with naturopaths the preferred CAM practitioners. ConclusionNatural therapeutics as a strategy for managing anxiety has potential therapeutic application for Australian’s experiencing anxiousness, particularly post COVID-19 pandemic. Lifestyle medicine was the most common strategy utilized. There was a significant openness to trialing natural therapies.

Knowledge, perception, attitude, and practice of complementary and alternative medicine by health care workers in Garki hospital Abuja, Nigeria

BackgroundHealthcare workers are currently making efforts to offer services that cater to the holistic care needs of their patients. Previous studies have shown that some healthcare workers encounter challenges when advising patients about Complementary and Alternative Medicine (CAM), even though its use is widespread. Many health care workers may not have received formal education or training in CAM and consequently are unable to address their patients’ questions about it. This study explored the knowledge, perception, attitude and practice of CAM by healthcare workers in Garki Hospital, Abuja, Nigeria.MethodsThis was an institution-based cross-sectional study, design and a convergent parallel, mixed methods design was used for data collection. Five (5) healthcare workers were purposively selected as participants for the key informant interviews, while two hundred and fifty (250) selected using a simple random sampling method completed the questionnaire. The data collection instruments used were a key informant interview guide and a 35-item self-administered questionnaire. Knowledge was assessed with a 4-item scale with a maximum score of 8. Perceptions and attitudes were assessed using Likert scales with a maximum score of 45 and 20, respectively. Practice was assessed with a 6-item scale with a maximum score of 18. Qualitative data was analysed using framework analysis. Quantitative data was analysed using descriptive and inferential statistics. Data acquired from both methods were integrated to form the findings.ResultsThe average age of respondents for the quantitative study was 34.0 ± 7.8 years, and they were predominantly females (61.2%) with one to ten years of work experience (68.8%). The mean knowledge, perception and attitude scores were 1.94 ± 1.39, 13.08 ± 2.34 and 32.68 ± 6.28, respectively. Multiple linear regression result showed that knowledge (t = 2.025, p = 0.044) and attitude (t = 5.961, p = 0.000) had statistically significant effects on the practice of CAM. Qualitative data revealed that the majority of the participants perceive CAM favourably, provided it is properly introduced into mainstream medicine with evidence of safety and research to prove its efficacy.ConclusionThe study has shown the gaps in knowledge and the practices of CAM by conventional medical practitioners. This has implications for their ability to counsel and refer patients who may require CAM therapies. Policy, research and programmatic initiatives that seek to enhance their knowledge of CAM, and improve collaboration with CAM practitioners are recommended.

Management of Polycystic Ovarian Syndrome: A Qualitative Inquiry among Complementary and Alternative Medicine Practitioners in South Africa.

Polycystic ovarian syndrome (PCOS) is a complex reproductive endocrinopathy affecting 4-20% of females of reproductive age. PCOS and its consequent complications such as infertility, diabetes mellitus and cardiovascular disease significantly impact clinical management. Complementary and alternative medicine (CAM), including homeopathy, is gaining recognition in PCOS management. There remains a paucity of formal protocols for managing PCOS within homeopathy and other CAM systems. This study aimed to explore and document existing therapeutic practices in the management of PCOS from diagnosis to treatment used by practitioners within various disciplines of CAM: viz., homeopathy, ayurveda, unani tibb, traditional Chinese medicine (TCM) and naturopathy, in the context of their unique philosophical background. In this explorative, descriptive study, data were collected from CAM practitioners in eThekwini Municipality, KwaZulu Natal, South Africa, using semi-structured interviews and analysed using Tesch's and Creswell's methods for qualitative analysis. Four themes emerged from the data, namely: CAM philosophical perspectives on PCOS, contributing factors, diagnosis of PCOS, and management of PCOS. Five sub-themes emerged: clinical diagnosis of PCOS, CAM-specific characterisation of PCOS, CAM-specific treatment of PCOS, adjunctive therapies, and lifestyle interventions. Homeopathic management comprised several prescribing methods, the most common ones being miasmatic/constitutional, keynote and clinical, alongside adjunctive therapies and lifestyle interventions. Other CAM modalities adopted similar holistic approaches. This paper offers a comprehensive exploration of the perceptions, clinical investigations and management practices in PCOS by homeopaths and four other CAM modalities - ayurveda, unani tibb, TCM and naturopathy - as documented in the study. Homeopaths and other CAM practitioners employed CAM-specific therapies, along with adjunctive therapies and lifestyle interventions, adopting holistic approaches. Enhancing the quality of life through emotional counselling, stress reduction and lifestyle improvements emerged as shared objectives across modalities. Our findings underscore the need to further explore inter-disciplinary collaboration in PCOS management among registered CAM practitioners, with the potential to expand the scope of comprehensive care for PCOS patients.

The salutogenic gaze: Theorising the practitioner role in complementary and alternative medicine consultations.

Research on why people use complementary and alternative medicine (CAM) shows clients value the CAM consultation, where they feel listened to and empowered to control their own health. Such 'empowerment' through CAM use is often theorised as reflecting wider neoliberal imperatives of self-responsibility. CAM users' perspectives are well studied, but there has been little sociological analysis of interactions within the CAM consultation. Specifically, it is unclear how user empowerment/self-knowledge relates to the CAM practitioner's power and expert knowledge. We address this using audio-recorded consultations and interviews with CAM practitioners to explore knowledge use in client-practitioner interactions and its meaning for practitioners. Based on our analysis and drawing on Foucault (1973), The Birth of the Clinic: an archaeology of medical perception and Antonovsky (1979), Health, Stress and Coping, we theorise the operation of power/knowledge in the CAM practitioner-client dyad by introducing the concept of the 'salutogenic gaze'. This gaze operates in the CAM consultation with disciplining and productive effects that are oriented towards health promotion. Practitioners listen to and value clients' stories, but their gaze also incorporates surveillance and normalisation, aided by technologies that may or may not be shared with clients. Because the salutogenic gaze is ultimately transferred from practitioner to client, it empowers CAM users while simultaneously reinforcing the practitioner's power as a health expert.

Translation and Cross-Cultural Adaptation of the International Questionnaire to Measure the Use of Complementary and Alternative Medicine (I-CAM-Q) for the Polish and Cross-Sectional Study.

According to the World Health Organization (WHO), complementary and alternative medicine (CAM) encompasses a broad set of health care practices that are not part of a country's traditional or conventional medicine and are not fully integrated into the prevailing health care system. The aim of this study is the linguistic and cross-cultural adaptation of the Polish version of the International Questionnaire to Measure Use of Complementary and Alternative Medicine (I-CAM-Q) and the assessment of the occurrence and factors related to CAM among patients in Poland. A methodological model of translation and cross-cultural adaptation of research tools according to Beaton et al. with a Delphi-Technique was used for the linguistic and cultural adaptation of the Polish version of I-CAM-Q. The Delphi consensus was achieved in the scale assessment between the experts in two rounds (with a score of above 80% of expert agreement). Data was collected using an online survey within 38 thematically different groups on Facebook, among 524 participants. Over half (59.7%, n = 313) of the respondents used the services of at least one CAM practitioner. On the other hand, 50.8% (n = 266) of the respondents declared using physician's advice. The use of herbs and plant products was reported by 84.7% (n = 444), and vitamins and minerals by 88.4% (n = 463) of respondents. The most commonly used self-help practices among the respondents were relaxation techniques (49.6%), praying for one's health (43.3%) and meditation (41.2%). The consensual methodology of validating the Polish version of the I-CAM-Q scale allowed for creation of a conceptually and linguistically equivalent tool with the original international instrument. A high frequency of CAM use was found among the respondents. Therefore, strategies should be implemented to improve patient-physician communication on the use of CAM in Poland.

Application of Virtual Reality Technology in Clinical Practice, Teaching, and Research in Complementary and Alternative Medicine.

Background The application of virtual reality (VR) in clinical settings is growing rapidly, with encouraging results. As VR has been introduced into complementary and alternative medicine (CAM), a systematic review must be undertaken to understand its current status. Aim This review aims to evaluate and summarize the current applications of VR in CAM, as well as to explore potential directions for future research and development. Methods After a brief description of VR technology, we discuss the past 20 years of clinical VR applications in the medical field. Then, we discuss the theoretical basis of the combination of VR technology and CAM, the research thus far, and practical factors regarding usability, etc., from the following three main aspects: clinical application, teaching, and scientific research. Finally, we summarize and propose hypotheses on the application of VR in CAM and its limitations. Results Our review of the theoretical underpinnings and research findings to date leads to the prediction that VR and CAM will have a significant impact on future research and practice. Conclusion Although there is still much research needed to advance the science in this area, we strongly believe that VR applications will become indispensable tools in the toolbox of CAM researchers and practitioners and will only grow in relevance and popularity in the era of digital health.

Knowledge, attitude, and practices of complementary and alternative medicine: a survey of physicians and nurses at an academic medical center in Beirut

ABSTRACT The aim of this study is to assess the knowledge, attitudes, and practices of complementary and alternative medicine (CAM) among physicians and nurses at the American University of Beirut Medical Center (AUBMC) in Beirut, Lebanon. A web-based survey was emailed to 518 physicians and 423 registered nurses in all medical departments at AUBMC. Of the 94 physicians responding to the survey, 61% have never referred a patient to a CAM practitioner yet 33% reported that they would refer if available. Sixty-two percent of physicians believed that incorporating evidence-based CAM therapies will increase patient satisfaction and 66% thought that offering CAM would attract more patients. Of the 80 nurses who responded, 78.7% have never referred a patient to a CAM practitioner, yet half reported that they would likely refer if a CAM practitioner was available. Fifty-seven percent of nurses surveyed believed that offering CAM would attract more patients while 59% thought that it would increase patient satisfaction. Most nurses were uncomfortable counseling patients about CAM modalities. Favorable attitudes towards CAM were reflected by the physicians and nurses as signified by the above-average attitude means towards CAM (M = 4.01, SD = .16 and M = 3.25, SD = .59, respectively). The study findings demonstrate that despite the physicians’ and nurses’ limited knowledge and their discomfort in counseling on CAM, they expressed acceptability and willingness in using and incorporating CAM therapies into clinical practice at AUBMC. This is the first study conducted in Lebanon that assesses both nurses’ and physicians’ perspectives on the use of all CAM domains in general within the same healthcare setting. This study not only provides baseline data but also highlights the knowledge gap and learning needs among physicians and nurses with regards to CAM.

Medical Pluralism in East and West Europe: A Comparison of People Visiting Healthcare Practitioners Specializing in Complementary and Alternative Medicine

Background: Interest in various forms of complementary and alternative medicine (CAM) (e.g., naturopathy, homeopathy, traditional Chinese medicine, osteopathy, and chiropractic) is continuing to grow throughout Europe. Very little is known as to whether the prevalence and patterns of CAM usage are another cross-cutting phenomenon, dividing Europe, or whether they indicate homogenous healthcare settings throughout the continent. By examining data from the general population, the main objective of the study is to conduct a cross-country comparison of medical pluralism in Eastern and Western European countries. Methods: The cross-country comparison was conducted using data obtained through the International Social Survey Programme (ISSP). Data addressing healthcare issues were last collected for the ISSP in 2011. By analysing existing similarities and/or differences in the prevalence of sociodemographic and socioeconomic determinants, which could encourage visits to complementary and alternative practitioners, data from 21 European societies only were included. In addition, the aim was to investigate whether individuals’ scarcity of trust in physicians, as well as a lack of confidence in healthcare systems, may explain visits to CAM practitioners across Europe. Results: While in Eastern countries, a total of 531 (5.5%) respondents reported a visit to/by a CAM healthcare practitioner during the preceding 12 months, in Western Europe, a visit to/by a CAM healthcare practitioner was reported by 11.6% of individuals. In Western Europe, the use of CAM is most prevalent among younger generations of women, those of a lower socioeconomic position and/or with a low level of trust in conventional doctors. In Eastern Europe, CAM practitioners are mainly visited by older generations, city dwellers of a higher socioeconomic position and with a relatively high level of trust in physicians. Conclusion: After collating data from 21 societies, the study concludes that more than three decades after the collapse of the socialist experiment in Eastern Europe, there is evidence that the European continent remains divided in relation to the alternative healthcare sector. The field of non-conventional healthcare represents an indicator supporting the existence of a dividing line between Eastern and Western Europe.

An exploration of barriers and enablers to the conduct and application of research among complementary and alternative medicine stakeholders in Australia and New Zealand: A qualitative descriptive study.

BackgroundMost studies examining complementary and alternative medicine (CAM) stakeholder engagement with evidence-based practice have relied on quantitative research methods, which often fail to capture the nuances of this phenomena. Using qualitative methods, this study aimed to explore the experiences of CAM stakeholders regarding the barriers and enablers to the conduct and application of research.MethodsThis research was guided by a qualitative descriptive framework. CAM practitioners and researchers of multiple CAM disciplines from across Australia and New Zealand were invited to share their personal perspectives of the study phenomena. Semi-structured interviews were conducted via Zoom, which were audio-recorded and transcribed verbatim. Rigour strategies were applied to ensure the credibility of results. The transcript was analysed using thematic analysis.ResultsCAM stakeholders identified an array of barriers and enablers to the conduct and application of research within their disciplines. The barriers and enablers that emerged were found to be inter-connected with two similar constructs: capacity and culture. Captured within the construct of capacity were five themes—lack of resources, inadequate governance/leadership, lack of competency, bias directed from outside and within CAM, and lack of time for research. Within the construct of culture were two themes—intrinsic perceptions in CAM, and lack of communication within and outside CAM.ConclusionsPromoting evidence-based practice and engaging with research in CAM continues to face challenges. This study, for the first time, has highlighted the multitude of interlinked barriers that confront CAM stakeholders when engaging with research. These findings highlight the need for a concerted and targeted approach to tackle these challenges.

Occurrence and relevance of orthorexic eating behaviour in clients of complementary and alternative medicine

Orthorexia is put forward as a new variant of disordered eating behavior, characterized by a fixation on only eating food that is considered to be healthy. First studies evaluating its clinical relevance revealed that orthorexic individuals seek help from health professionals and nutritionists. However, practitioners of complementary and alternative medicine (CAM) have not been considered yet. Hence, the aim of this study was to survey German CAM practitioners regarding the relevance and occurrence of orthorexic eating behavior in their clients. Two hundred and seventy-six participants filled in an online questionnaire that included questions on (1) level of awareness and participants’ evaluation of orthorexia, (2) prevalence, symptoms and comorbidities of orthorexia among their clients and (3) diagnostic assessment and treatment approaches. The results revealed that CAM practitioners considered orthorexia nervosa to be of clinical relevance. Seventy percent of the participants had been consulted by individuals with orthorexic eating behavior. However, only 20% of the participants reported that orthorexic eating behavior was the main symptom of the clients. It can be concluded that orthorexic eating behavior is a relevant condition in complementary and alternative medicine and that more research is needed in order to provide health care professionals with profound information regarding its symptomatic features and recommendations regarding its treatment. Key words: Orthorexia nervosa, orthorexic eating behavior, eating disorders, disordered eating behavior, complementary and alternative medicine.

Low back pain patients' perceived effectiveness of utilizing complementary and alternative medicine: a systematic review of qualitative studies.

The purpose of this systematic review of qualitative studies is to explore patients' perceived effectiveness of utilizing complementary and alternative medicine (CAM) for the treatment and/or management of low back pain (LBP). MEDLINE, EMBASE, AMED, and CINAHL were systematically searched from database inception until May 2020. Eligible articles included qualitative data about LBP patients' perceptions of using CAM. Of 1,567 items, 1,542 items were excluded; the remaining 25 articles were included in this review. Three themes emerged as follows: physical benefits; mental health benefits; and negative or no perceived effectiveness of CAM on patients with LBP. This study explores perceptions of CAM effectiveness among patients with LBP. These findings provide valuable information to CAM and non-CAM practitioners regarding the importance of individualized patient care based on their preferences, values, needs, and perspectives. Further exploration could include practitioners' perceptions of CAM and their impact on the patient-practitioner relationship.

The role of spirituality and spiritual care in complementary and alternative medicine: A scoping review

Background: Spirituality has become more prevalent in health professions other than complementary and alternative medicine (CAM). In CAM, spirituality appears to be part of a foundational component of the clinical practice, which is valued by many patients. Spirituality has gained popularity in healthcare education and practice; however, the contribution made by CAM remains minimal evidenced by the paucity of studies on the topic of spirituality in CAM. Therefore, there is need for a scoping review to: 1) to explore the focus and nature of research on spirituality in CAM; 2) to provide recommendations based on the relational aspects between spirituality and CAM.
 Methods: A scoping review was performed of all relevant articles found in Ebscohost (Academic Search Complete), Science Direct, and Scopus published between 2000 and 2019. This scoping review included two hundred and six studies, of these, twentytwo articles focussed on the role of spirituality in CAM.
 Results: These four themes were reported in the results: spirituality as a modality of CAM; patient perceptions of the role of spirituality and CAM; practitioner perceptions of the role of spirituality and CAM; and the role of spirituality and CAM in education and practice. Spirituality was considered an important component and was linked to culture, traditions and/or religious beliefs. The use of spirituality in CAM was especially linked to patients living with chronic disease such as diabetes, cardiac conditions and cancer. Spirituality seemingly facilitated health care and while patients expected spirituality healthcare advice from CAM practitioners most CAM practitioners felt ill equipped to deal with the topic appropriately.
 Conclusions: Overall, this scoping review highlights that the role of spirituality in CAM seem to be of value for both practitioners and clients within the CAM clinical setting. However, only a few practitioners include spiritual healthcare advice without clear guidelines. Consequently, this may compromise the holistic treatment, which so many patients expect within the CAM domain. Therefore, there is a need for the inclusion of spirituality in the CAM curriculum and guidelines for CAM practitioners.
 Bangladesh Journal of Medical Science Vol.20(4) 2021 p.714-724

Barriers to the conduct and application of research among complementary and alternative medicine professions in Australia and New Zealand: A cross-sectional survey

IntroductionDespite the growing international popularity and use of complementary and alternative medicine (CAM), the uptake of evidence-based practice (EBP) in CAM has been slow. This cross-sectional survey aimed to further our understanding of the factors impacting EBP uptake in CAM. MethodsThe 32-item oBSTACLES instrument was administered online using the SurveyMonkey™platform. The survey evaluated barriers to both the conduct and application of research among CAM practitioners and researchers, from multiple CAM disciplines across Australia and New Zealand. Participants were recruited via practice-based research networks, professional associations, CAM educational institutions, CAM research centres, pertinent product manufacturers and social media platforms. Data were analysed using descriptive statistics. ResultsSix hundred and eighty-two CAM stakeholders responded to the survey. Barrier items were divided into two interlinked constructs, “capacity” and “culture”. Capacity related to issues regarding access, competency, bias, incentives, and time, whereas culture related to values and complex systems. Under capacity, the greatest proportion of participants (>70 %) agreed that access was a barrier to the conduct and application of research, including lack of funding, institutional support, research training and collaborations. In terms of culture, the majority of participants (>60 %) agreed that values were a barrier to research conduct and application, including limited undergraduate research opportunities and diverse views of evidence. ConclusionFindings from this research suggest a multitude of barriers negatively impact the conduct and application of research in CAM. Insights gained from this research will be instrumental in developing actionable strategies aimed at mitigating the impact of these barriers to improve research engagement in CAM.

The role of complementary and alternative medicine practitioners in the information-seeking pathway of vaccine-hesitant parents in the Blue Mountains area, Australia.

While immunisation rates were 94.63% for the whole Nepean Blue Mountains region of New South Wales in 2017, coverage for 1year olds in the upper Blue Mountains was under 80%. There is a known relationship between vaccine-hesitant parents and complementary and alternative medicine (CAM) use; however, little is known about how CAM practitioners fit within the information-seeking pathway of parents. This exploratory study sought to address this knowledge gap. Qualitative semi-structured interviews with vaccine-hesitant and vaccine rejecting parents and CAM practitioners purposively sampled from the Blue Mountains area revealed three sets of themes: 1) Parents' search for further information about immunisation; 2) Parents' use of CAM practitioners as an immunisation information source; and 3) CAM practitioners' engagement with parents about immunisation. CAM practitioners form a definite, if complex, part of vaccine-hesitant and vaccine-rejecting parents decision-making pathway in the Blue Mountains area. The notion of patient choice is crucial to vaccine discussions. Development of support materials, such as decision resources which give impartial and detailed information while acknowledging and supporting patient choice, are needed to support both CAM practitioners and parents in making informed vaccination decisions.

Regulatory environment for complementary and alternative medicine in Georgia-a health policy analysis.

International bodies such as the WHO call on member states to regulate and, where possible, integrate Complementary and Alternative Medicine (CAM) into health systems, to the benefit and safety of patients. Research on CAM regulations in the Republic of Georgia has been limited. The aim of this study was to identify key actors and analyse the regulatory environment for CAM in Georgia in its local and international contexts. We conducted a health policy analysis using a triangle framework of content, context and processes. We used data from national government, professional associations and academia; and drew from primary qualitative data of stakeholders' perspectives and needs regarding CAM in Georgia. The several CAM associations we identified have limited capacities for self-regulation. CAM practices are currently not effectively regulated in Georgia, while the government has no expressed intention to develop regulatory frameworks. Georgia's CAM health policy is currently not compliant with WHO and European directives and recommendations. Government, lawmakers, public administration, academia, physicians, non-physician CAM practitioners and other actors should constitute a national working group dedicated to CAM regulations in Georgia to identify, classify CAM practices; and develop core principles for policy making for safe and effective CAM practiced in Georgia's health system.

Physician perspectives on complementary and alternative medicine in hidradenitis suppurativa.

Hidradenitis suppurativa (HS) is a chronic and often debilitating inflammatory condition characterized by frequent nodules, abscesses, sinus tracts, and scars impacting the intertriginous areas. Many patients with HS often report limited treatment success and symptom coverage with conventional therapies. Recent studies have reported the widespread use of complementary and alternative medicine (CAM) among patients with HS. In this study, our aim was to examine current physician practice patterns, opinions, and comfort with recommending CAM. Our results indicate that provider comfort and opinions on CAM varied based on the provider's experiences, demographics, and the CAM modality itself. Overall, nearly two-thirds (n = 30, 61.2%) of respondents agreed that CAM and conventional medicine were more effective together than either alone. Meanwhile, 44.9% (n = 22) of respondents routinely recommend CAM while 64.6% (n = 31) of respondents reported that they are routinely asked about CAM. The majority (n = 41, 83.7%) of respondents indicated a lack of scientific evidence in the medical literature as a barrier to recommending CAM along with efficacy concerns (n = 34, 69.4%) and ability to recommend reputable CAM products (n = 32, 65.3%) and practitioners (n = 32, 65.3%). Future investigations are warranted to establish a better understanding of the efficacy and benefit of CAM methods in conjunction with conventional methods.

Complementary and alternative medicine - practice, attitudes, and knowledge among healthcare professionals in New Zealand: an integrative review

BackgroundThe prevalence of CAM use is increasing. This integrative review investigated New Zealand healthcare professionals’ practice of, attitudes toward, and knowledge about complementary and alternative medicine (CAM).MethodsLiterature search was conducted in four databases from inception to April 2020. Studies were included if they reported results from primary data collection on practice of, attitudes toward, or knowledge about CAM amongst New Zealand healthcare professionals.ResultsEleven studies (two of ‘high-quality’, seven of ‘moderate-quality’, and two of ‘low-quality’) were identified with 2060 healthcare professionals including general practitioners (GPs), nurses, midwives, pharmacists, physiotherapists, and medical specialists. New Zealand healthcare professionals were generally positive regarding CAM use, but have concerns on the scientific evidence, regulation, safety, financial costs of CAM, and encourage an evidence-based CAM practice and stronger CAM regulation. Findings indicated that around 25% of GPs practise CAM, and 82.3% refer patients to CAM practitioners. When treating pregnant women, 48.4% of physiotherapists practise acupuncture, and 37.3% of midwives recommend CAM. GPs believe that acupuncture is the most helpful CAM modality, and most commonly practiced and referred patients to acupuncture. Up to 58% of GPs and Plunket nurses wanted to receive further education on CAM, and up to 66.7% GPs favour the idea CAM should be included in medical curriculums.ConclusionsNine of the 11 included studies were of moderate to high quality, thus enhancing the reliability of the review findings. In order to better manage CAM in New Zealand New Zealand clinical settings, there is a need to invest in CAM research and education, and enhance CAM regulation. This review is a first step in developing an evidence base to offer insights for further development of effective CAM policies regarding safety, efficacy, regulation and integration in New Zealand.

Complementary and alternative medicine: A pilot survey of current clinical practice and attitudes of physiotherapists in the Otago region of New Zealand

This pilot survey aimed to explore the feasibility of conducting a nationwide survey investigating the current practice and attitudes towards complementary and alternative medicine (CAM) in New Zealand registered physiotherapists. This was a cross-sectional, online study using a questionnaire developed from previous survey instruments. An electronic link to the questionnaire was distributed via email to members of the Otago Branch of Physiotherapy New Zealand (n = 344). Questions included current clinical practice and use of CAM as well as attitudes and opinions on its effectiveness. Feasibility outcomes of this survey included the response rate and completion rate. Data were analysed in Microsoft Excel®. The response rate was 10.5% (n = 36) and the completion rate was 86.1% (n = 31/36). A range of conditions treated with CAM were cited by respondents; the most frequently treated condition was “back and neck pain” (n = 10/36). Physiotherapists in this sample believed acupuncture and massage are the most effective CAM modalities used for “back and neck pain” treatment and were most likely to use acupuncture and massage as CAM modalities when treating these conditions. Acupuncture was found to be the most common CAM practiced by respondents, and an acupuncturist was the CAM practitioner to which patients are most commonly referred by respondents. This study demonstrated that conducting a nationwide survey is feasible, subject to an improved survey design and increased response rate.