Complementary Medicine Practitioners Research Articles

Can holism be practiced in a biomedical setting? A qualitative study of the integration of complementary medicine to a surgical department

In recent decades, complementary medicine (CM) has been increasingly integrated to conventional healthcare organizations, in which the biomedical profession clearly maintains dominance. Our objective was to investigate empirically what integration and 'holism' mean to the diverse professional groups involved and whether treatment becomes more holistic when CM is integrated. A qualitative study was conducted in a general surgery department at a public hospital in Israel. Data were collected by means of observations of medical encounters and daily work, and 30 in-depth interviews with medical directors, surgeons, senior nurses, CM practitioners and hospitalized patients. We found that most of the interviewed nurses, surgeons and directors and some patients believed that CM treatments were of value in addressing the psychological needs of patients within this predominantly somatic-oriented department. To CM practitioners and some of the patients, integration means introducing and practicing a holistic outlook in this biomedical context, which involves elements such as Qi, energy, soul and spirit. Such practices were directed to a suitable audience, namely, patients as well as conventional medical staff who were willing to explore a holistic approach. We concluded that patient care tends to become more comprehensive when CM is integrated. Despite the overall dominance of biomedicine, holistic CM practices were introduced to the biomedical setting of the hospital. Yet, the question whether holistic CM practices and perceptions will eventually lead nurses and physicians toward paradigmatic integration, has still to be examined.

A Review of Tensions and Risks in Naturopathic Education and Training in Australia: A Need for Regulation

In line with increasing complementary medicine (CAM) use, the Australian government has committed considerable resources to the training of CAM practitioners. However, it has generally failed to complement this support with regulation or accountability measures. This is particularly true in Australia's largest CAM profession (naturopaths), which remains entirely unregulated but attracts approximately AUD$40 million each year in government funding for its education sector. This article explores the consequences of such unfettered support on professional outcomes. Data on Australian government funding for naturopathic student places were collated and compared with various outcome measures including research and professional outcomes. Lack of accountability measures attached to government support has enabled the proliferation of commercial education providers in the sector. This is often at the expense of the university sector, which is financially disadvantaged in naturopathic education delivery through extra academic and research obligations not shared by private for-profit providers. The major beneficiaries of government funding have facilitated few formal contributions to naturopathic research or professional development, whereas those with the highest research, professional, and academic output attracted the least government funding. Course content has declined in the previous 5 years, and government funding is still directed to courses that do not meet the minimum education levels for the prescribed government definition of naturopath. Unfettered support has also resulted in a significant increase in student numbers growth, which significantly outstrips growth in utilization, potentially affecting the profession's sustainability. Lack of regulation in naturopathic education has resulted in significant risks to patients (through reduced standards) as well as the naturopathic profession itself. Although CAM advocates often focus on pushing for government support for the development CAM, support without the development of appropriate regulatory and accountability measures can ultimately be detrimental to the development of CAM.

Health services use among young Australian women with allergies, hayfever and sinusitis: A longitudinal analysis

The existing knowledge base on the use of complementary and alternative medicine among patients with allergies is built upon findings of cross-sectional surveys and there is a lack of longitudinal data. There is also a lack of studies that examine both the use of conventional medicine and complementary and alternative medicine among allergy patients. This paper reports the findings of the first ever longitudinal study of the use of conventional providers, practitioners of complementary and alternative medicine, and self-prescribed modalities amongst women with allergies, hayfever and sinusitis from a large nationally representative sample. Analysis focused upon data from 7538 women from the younger cohort of the Australian Longitudinal Study on Women's Health collected between 1996 and 2006. Chi-square tests were employed to compare the groups across consultations and self-prescribed treatments and one-way analysis of variance was used to compare the groups across health status. A modified Bonferroni test was used to correct for multiple comparisons. The study identified that women who sought help for their allergic disorder were more likely to consult a range of practitioners and self-prescribed complementary and alternative medicine than women who either did not seek help or did not have allergic disorders. The analysis shows that many women with allergic disorders use complementary and alternative medicine alongside or as a complement to conventional healthcare services. The frequent use of a range of conventional providers and practitioner-based and self-prescribed complementary and alternative medicine amongst women with allergic disorders warrants further investigation.

Using Role Substitution To Address The Health Workforce Shortage And To Facilitate Integration?

The health workforce is perceived to be in short supply in most developed and developing countries. There are concerns that this could result in reduced coverage of health services and the delivery of suboptimal care. Strategies to address the health workforce shortage have focussed predominantly on recruitment and training, with relatively little regard to the equally important issue of retention. One approach that may improve job satisfaction, opportunities for specialisation and the workload of health workers, and thus, improve retention and more importantly, patient outcomes, is role substitution. Many complementary and alternative medicine (CAM) practitioners appear to be well placed in terms of educational preparation to substitute (either horizontally or vertically) a number of roles traditionally performed by conventional health disciplines. As well as the potential benefits to the health workforce and the quality of patient care, role substitution could provide an important first step toward integrating CAM practitioners into mainstream health care settings.

Patterns and Determinants of Complementary and Alternative Medicine Practitioner Use among Adults with Diabetes in Queensland, Australia.

There is evidence that complementary and alternative medicine (CAM) use is common among people with diabetes. The role of CAM in the treatment or management of diabetes is an emerging health issue given the potential side effects and benefits associated with the use of this kind of medicine. This paper examined patterns and determinants of CAM practitioner use in Queensland, Australia, using a large population-based sample of people with type 1 and type 2 diabetes. The study found that within a 12-month period, 7.7% of people with diabetes used the services of CAM practitioners alongside or as a complement to conventional health care service. Younger age, female gender, a higher education, having private health insurance, and engagement in preventive health behaviours are significant predictors of individuals who are more likely to visit a CAM practitioner. There was no significant difference in CAM practitioner use between people with type 1, type 2 insulin requiring, or type 2 noninsulin requiring diabetes. The findings highlight the need for further research on the role of CAM in the prevention and management of diabetes.

Older Australian Women Use Complementary Fertility Care: A Practice Audit

The Journal of Alternative and Complementary MedicineVol. 18, No. 1 Letters to the EditorOlder Australian Women Use Complementary Fertility Care: A Practice AuditJo-Anne Rayner, Karen Willis, and Charmaine DennisJo-Anne RaynerFaculty of Arts & Education, Deakin University, Burwood, Victoria, Australia.Search for more papers by this author, Karen WillisSchool of Sociology & Social Work, University of Tasmania, Launceston, Tasmania, Australia.Search for more papers by this author, and Charmaine DennisFertile Ground Health Group, East Melbourne, Victoria, Australia.Search for more papers by this authorPublished Online:23 Jan 2012https://doi.org/10.1089/acm.2011.0687AboutSectionsView articleView Full TextPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail View article"Older Australian Women Use Complementary Fertility Care: A Practice Audit." , 18(1), pp. 6–7FiguresReferencesRelatedDetailsCited byThe Role of Research in Guiding Treatment for Women’s Health: A Qualitative Study of Traditional Chinese Medicine Acupuncturists19 January 2021 | International Journal of Environmental Research and Public Health, Vol. 18, No. 2The Characteristics of Women Who Use Complementary Medicine While Attempting to Conceive: Results from a Nationally Representative Sample of 13,224 Australian WomenWomen's Health Issues, Vol. 27, No. 1Perspectives of complementary and alternative medicine (CAM) practitioners in the support and treatment of infertility14 October 2014 | BMC Complementary and Alternative Medicine, Vol. 14, No. 1 Volume 18Issue 1Jan 2012 InformationCopyright 2012, Mary Ann Liebert, Inc.To cite this article:Jo-Anne Rayner, Karen Willis, and Charmaine Dennis.Older Australian Women Use Complementary Fertility Care: A Practice Audit.The Journal of Alternative and Complementary Medicine.Jan 2012.6-7.http://doi.org/10.1089/acm.2011.0687Published in Volume: 18 Issue 1: January 23, 2012Online Ahead of Print:January 5, 2012PDF download

The perceived impact of integrative medicine in a surgical department

IntroductionIntegrative medicine in a surgical department is an innovative phenomenon. Patients in acute conditions are treated with guided imagery, hypnosis, acupuncture and reflexology for perioperative symptoms in the surgical department of an Israeli hospital. The purpose of this research was to inductively explore how diverse stakeholders perceive the impacts of integrative medicine. MethodologyThe research was conducted in the surgical department of a public teaching hospital by means of observations; in-depth qualitative interviews with managers, physicians, senior nurses, integrated complementary medicine (CM) practitioners and patients; and analysis of electronic medical records. ResultsThe most prevalent CM treatments addressed pain, anxiety and nausea. Most of the patients reported improved wellbeing following the treatments. Surgeons reported heightened awareness of patients’ emotions. CM practitioners assisted surgeons and nurses by dealing with patients’ emotions and other perioperative symptoms, such as high blood pressure and urinary retention. Some surgeons and nurses reported using lower doses of analgesics. CM practitioners welcomed the opportunity of gaining practical experience and participating in team work. Disadvantages were also mentioned: some patients reported feeling no benefit; a sense of intrusion to their daily routine was reported by nurses; CM practitioners mentioned certain drawbacks associated with working in the hospital, such as low salary, feelings of marginality, and the dominance of biomedical knowledge. ConclusionsThis inductive exploration paves the way for further research that should examine patients’ experiences, cost-effectiveness and means to facilitate multidisciplinary collaboration.

Complementary and Alternative Medicine Practitioners' Standard of Care: Responsibilities to Patients and Parents

In this article we explain (1) the standard of care that health care providers must meet and (2) how these principles apply to complementary and alternative medicine practitioners. The scenario describes a 14-year-old boy who is experiencing back pain and whose chiropractor performed spinal manipulation but did not recognize or take steps to rule out serious underlying disease-in this case, testicular cancer--either initially or when the patient's condition continued to deteriorate despite treatment. We use chiropractic care for a patient with a sore back as an example, because back pain is such a common problem and chiropracty is a common treatment chosen by both adult and pediatric patients. The scenario illustrates the responsibilities that complementary and alternative medicine practitioners owe patients/parents, the potential for liability when deficient care harms patients, and the importance of ample formal pediatric training for practitioners who treat pediatric patients.

Referrals and Shared or Collaborative Care: Managing Relationships With Complementary and Alternative Medicine Practitioners

In this article we discuss steps that clinicians should take after deciding to include a complementary and alternative medicine (CAM) treatment that is beyond the clinician's expertise in a patient's treatment plan. We use the example of an adolescent patient with chronic recurrent headaches that have not been relieved by medication or other therapies and whose physician refers her to an acupuncturist for treatment. We focus on (1) circumstances under which referral is appropriate, (2) the nature of the relationship between the referring clinician and the practitioner to whom the referral is made (considering conventional health care and CAM, regulated and unregulated practitioners), and (3) considerations when undertaking shared or collaborative care with other health care practitioners (conventional health care or CAM). We also suggest best practices in managing such relationships.

Five Keys to Real Transformation in Health Care

Transformation in health care requires a deeply holistic approach. Natural leaders of such a transformation are the complementary and alternative medicine practitioners who already share a vision of wellness, prevention, and optimal human function. Central to this shared vision is lifestyle change for patients and practitioners. Yet, to change a lifestyle is to change a self. Assisting individuals to transform their very sense of self in order to live healthier, more fulfilling lives centered on flourishing requires several important keys. Visionary and unified leaders are the first key. Structural support through coordination of health clinics locally and nationally is the second key. This can be optimized by utilizing initiatives of the new Affordable Health Care Act, because it provides a potential impetus for deep structural changes. An expanded evidence base for multifactorial approaches to wellness lifestyles is the third key. A reorganizational orientation with an emphasis on the right timing of transformation is the fourth key. The fifth key is an Integral map, which brings together the personal, behavioral, cultural, and social domains. By utilizing such a map, one ensures that no aspect of the transformative revolution at hand slips away due to any misplaced focus, such as emphasizing only on the things we can see with our eyes. By embracing the essence of transformation in terms of a wholeness to all reality, an evolutionary unifying field with interior depth and exterior expression, health care is redefined more authentically.

Predictors for Adolescent Visits to Practitioners of Complementary and Alternative Medicine in a Total Population (the Young-HUNT Studies)

AimTo investigate the factors predicting adolescent visits to practitioners of complementary and alternative medicine (CAM).MethodsA longitudinal cohort study conducted in an adolescent total population in Central Norway (The Nord-Trøndelag Health Studies (HUNT)). In Young-HUNT 1, all inhabitants aged 13 to 19 years (N = 8944, 89% response rate) were invited to participate, and the youngest group (13 to 15 year olds) was surveyed again 4 years later (Young-HUNT 2, N = 2429, 82% response rate). The participants completed a comprehensive questionnaire on health and life style which included a question regarding visits to a CAM practitioner in the last 12 months.ResultsOne in eleven (8.7%, 95%CI 7.6-9.8%) had visited a CAM practitioner, an increase of 26% in 4 years (1.8% points). The final multivariable analysis predicted increased odds of an adolescent becoming a CAM visitor four years later (p<0.05) if she or he had previously visited a CAM practitioner (adjOR 3.4), had musculoskeletal pain (adjOR 1.5), had migraine (adjOR 2.3), used asthma medicines (adjOR 1.8) or suffered from another disease lasting more than three months (adjOR 2.1). Being male predicted reduced odds of visiting a CAM practitioner in the future (adjOR 0.6).ConclusionWe can conclude from this study that future visits to a CAM practitioner are predicted by both predisposing factors (being female, having visited a CAM practitioner previously) and medical need factors (having had musculoskeletal pain, migraine, used asthma medicines or experienced another disease lasting more than three months). None of the specific variables associated with CAM visits were predictive for CAM visits four years later.

Undergraduate homeopathy education in Europe and the influence of accreditation

The safety of patients consulting with practitioners of complementary and alternative medicine (CAM) partially depends on practitioners' competence, and thus the standard of undergraduate education. Describe undergraduate homeopathy courses in Europe, student/graduate numbers and whether there were differences between recognised/accredited and non-recognised/non-accredited courses. Cross sectional survey of current homeopathy undergraduate education in Europe in 2008. Data from 145 (94.8%) out of 153 identified courses were collected. Eighty-five (55.6%) responded to a questionnaire survey. For others some data was extracted from their websites. Only data from the questionnaire survey is used for the main analysis. The average course in the questionnaire survey had 47 enrolled students and 142 graduates, and lasted 3.6years part-time. An estimated 6500 students were enrolled and 21,000 had graduated from 153 identified European undergraduate homeopathy courses. Out of 85 courses most had entry requirements and provided medical education (N=48) or required students to obtain this competence elsewhere (N=33). The average number of teaching hours were 992 (95% confidence interval (CI) 814, 1170) overall, with 555h (95%CI 496, 615) for homeopathy. Four out of five courses were recognised/accredited. Recognised/accredited part-time courses lasted significantly longer than non-recognised/non-accredited courses (difference 0.6years, 95%CI 0.0-1.2, P=0.040), and offered significantly larger numbers of teaching hours in homeopathy (difference 167h, 95%CI 7-327, P=0.041). About 6500 currently enrolled students are doing undergraduate homeopathy education in Europe and 21,000 have graduated from such courses over a period of about 30years. Undergraduate homeopathy education in Europe is heterogeneous. Recognised/accredited courses are more extensive with more teaching hours.

Changes among male and female visitors to practitioners of complementary and alternative medicine in a large adult Norwegian population from 1997 to 2008 (The HUNT studies)

BackgroundThe aim was to investigate changes in the prevalence and characteristics of male and female visitors to practitioners of complementary and alternative medicine (CAM) in a large adult population from 1997 to 2008.MethodsTwo cross sectional adult total population health surveys from Central Norwegian (the Nord-Trøndelag Health Studies (HUNT)). In 1997 42,277 and in 2008 50,713 respondents were included. Variables included demographics (age, education, working status), lifestyle (daily smoker, did hard physical activities), health status (self-rated health status, recent complaints, chronic complaints, psychiatric complaints, a range of diseases) and health care use (visit general practitioner, chiropractor). A test of difference between the results of multivariable logistic regression models for each year, including all variables, was used to analyse changes from 1997 to 2008.ResultsIn 1997 9.4% (95%CI 9.1-9.6) of the population had visited a CAM practitioner in the last 12 months and this increased to 12.6% (12.3-12.9) in 2008 (p < 0.001 for difference). Prevalence of CAM use in females was almost twice as high as that in males both years. For males, the significant changes from 1997 to 2008 (p < 0.05) were an increase in odds of visiting for those under 50 years, who had a recent complaint, were widower or did hard physical activities. There was a decrease for males who had a university degree, psychiatric complaint or hay fever. For females there was an increase in the odds for those under 50 years, who had a recent complaint or chronic complaint. It was a decrease for females with reported fair global health, psychiatric complaint, hay fever or if they had visited a chiropractor.ConclusionThe increase in visits was mainly among younger people of both genders with more limited complaints. A larger proportion of the more healthy part of the population is increasing their visits to CAM practitioners.

Complementary and Alternative Medicine Practitioners and Accountable Care Organizations: The Train Is Leaving the Station

Legislation that supports the establishment of Accountable Care Organizations (ACOs) was recently enacted into law as part of the Patient Protection and Affordable Care Act, and in 2012 the Centers for Medicare and Medicaid Services will begin contracting with ACOs. Although ACOs will play a significant role in reform of the U.S. health care delivery system, thus far, discussions have focused exclusively on the coordination of conventional health services. This article discusses the potential engagement of the complementary and alternative (CAM) workforce in ACOs and the foreseeable impacts of ACO legislation on the future of U.S. CAM services.

Fatalities after CAM: an overview

Many practitioners of complementary and alternative medicine (CAM) and most patients seem to believe that CAM is almost totally devoid of risks. Critical observers, however, should know better. There are numerous risks and some of them can be serious. In this overview, I very briefly summarise reports of fatalities that have occurred after acupuncture, EDTA-chelation therapy, and chiropractic. This article is based on three recently published systematic reviews.1–3 It is aimed at highlighting the rare but potentially serious nature of adverse events after CAM. A systematic review included 86 instances of deaths after acupuncture.1 Many of the primary reports were incomplete, and causality was often less than certain. The most frequent causes of death were pneumothorax; puncture of the heart, large blood vessel, central nervous system, or liver; and various types of (mostly bacterial) infections. The majority of the reports originated from China, Japan and other Asian countries. Others came from Germany, Norway, and the US. In CAM EDTA-chelation therapy is sometimes advocated for cardiovascular diseases such as claudicatio intermittens . A systematic review summarised all deaths after EDTA-chelation therapy reported …

The prevalence and experience of Australian naturopaths and Western herbalists working within community pharmacies

BackgroundNaturopaths and Western herbal medicine (WHM) practitioners were surveyed to identify their extent, experience and roles within the community pharmacy setting and to explore their attitudes to integration of complementary medicine (CM) practitioners within the pharmacy setting.MethodPractising naturopaths and WHM practitioners were invited to participate in an anonymous, self-administered, on-line survey. Participants were recruited using the mailing lists and websites of CM manufacturers and professional associations.Results479 practitioners participated. 24% of respondents (n = 111) reported they had worked in community pharmacy, three-quarters for less than 5 years. Whilst in this role 74% conducted specialist CMs sales, 62% short customer consultations, 52% long consultations in a private room and 51% staff education. This was generally described as a positive learning experience and many appreciated the opportunity to utilise their specialist knowledge in the service of both customers and pharmacy staff. 14% (n = 15) did not enjoy the experience of working in pharmacy at all and suggested pharmacist attitude largely influenced whether the experience was positive or not. Few practitioners were satisfied with the remuneration received. 44% of the total sample provided comment on the issue of integration into pharmacy, with the main concern being the perceived incommensurate paradigms of practice between pharmacy and naturopathy. Of the total sample, 38% reported that they would consider working as a practitioner in retail pharmacy in future.ConclusionsThe level of integration of CM into pharmacy is extending beyond the mere stocking of supplements. Naturopaths and Western Herbalists are becoming utilised in pharmacies

The Use of Complementary and Alternative Medicine During Pregnancy: A Longitudinal Study of Australian Women

The use of complementary and alternative medicine is increasingly prevalent in contemporary Western societies. The objective of this study was to explore trends and patterns in complementary and alternative medicine practitioner consultations and the use of complementary and alternative medicine consumption before, during, and after pregnancy and between pregnancies. Analysis focused on data from 13,961 women from the younger cohort of the Australian Longitudinal Study on Women's Health collected between 1996 and 2006. Chi-square tests were employed for the cross-sectional analysis of categorical variables and t tests for continuous variables. Generalized estimating equations were used to conduct multivariate longitudinal analysis. Complementary and alternative medicine use among pregnant and nonpregnant women continued to increase over the 10-year period. Although pregnancy status was not predictive of the use of alternative treatments, pregnant women employed these therapies or modalities for the relief of pregnancy-related complaints and symptoms. Analysis also revealed that women used complementary and alternative treatments selectively during pregnancy. This study highlights the need for further research that is sensitive to the consumption of specific complementary and alternative therapies or modalities and to the wider contexts within which women perceive risk associated with their use of complementary and alternative treatments.

Are complementary medicine practitioners implementing evidence based practice?

Over the past few decades the health professions have witnessed increasing pressure to shift from a culture of delivering care based on tradition and intuition, to a situation where decisions are guided and justified by the best available evidence. While there are concerns that many complementary and alternative medicine (CAM) practitioners may be cautious about embracing such an approach, no studies to date have effectively tested this assumption. To identify the skills, attitude, training and use of evidence-based practice (EBP) amongst CAM practitioners. Descriptive survey, using the evidence-based practice attitude and utilisation survey (EBASE). Randomly selected nationwide sample of system-based, non-medically qualified CAM practitioners practicing in a clinical capacity within Australia. Practitioner skill, attitude, training and use of EBP. Of the 351 questionnaires successfully dispatched, 126 were returned (36%). Most practitioners believed EBP was useful (92%) and necessary (73%) in CAM practice. While the majority of clinicians (>74%) reported participation in EBP activities, albeit infrequently, only a small to moderate proportion of decisions were based on evidence from clinical trials, with most practitioners relying on traditional knowledge, textbooks and clinical practice guidelines. Lack of available evidence, time, industry support and skills were perceived as barriers to EBP uptake. While the small response rate limits the generalisability of these findings, the sample was considered representative of Australian CAM practitioners. What this study shows is that even though CAM practitioners may be supportive of EBP, education and training is needed to further improve clinician understanding and application of evidence-based practice.

Integrative oncology in Australia

The use of alternative medicine (AM) in Australia dates back to its earliest times, with the indigenous medicine of the aboriginal peoples and the folk medicine of the early English settlers. AM has until recently existed quite separately from Western biomedicine (WB) and there has been little integration of the two systems. Now, referred to as complementary medicine (CM), there has been a movement over the last 20 years to include CM in WB mainstream practices. Varying degrees of success have been reported but for the discipline of oncology. Medical oncology (MO) in Australia is demanding CM provide high levels of evidence for any inclusion in cancer protocols. There are just now the beginnings of this integration, particularly as CM is now being taught in the public university system to a PhD level as well as the public demand for their medical doctors to communicate with their CM practitioners. MO specialists are now open to a dialogue with their CM counterparts.

Seeds of Meaning, Transformations of Health Care, and the Future

Seeds of Meaning, Transformations of Health Care, and the Future