Evidence-based Complementary And Alternative Medicine Research Articles

Use of complementary and alternative medicine in head and neck cancer: Salutary or noxious

Head and neck cancer (HNC) presents intricate challenges in its treatment that may result in adversative local effects impacting patient's critical functions and well-being. Alternatively, patients increasingly explore several other complementary and alternative medicine (CAM) therapies. Though clinical trials of certain CAM modalities have shown effectiveness in managing symptoms and risk behaviours allied with HNC and its treatment, evidence also suggests a need for heed. CAM usage may lead to substantial treatment delays and adverse effects with persistent concerns regarding its efficacy, safety, and potential interactions with conventional treatments, ultimately compromising therapeutic outcomes. Addressing concerns to conventional cancer care and encouraging informed decision-making are critical in ensuring comprehensive and timely interferences for HNC patients. Besides, integrating evidence-based CAM cautiously with conventional approaches holds potential for optimizing cancer management strategies.

Healthcare professionals' perception and practice of complementary and alternative medicine in Qassim region, Saudi Arabia.

Over the last few decades, use of complementary and alternative medicine (CAM) has grown in popularity, changing health professionals' knowledge and attitude toward CAM, and the treatment recommended by them. The aim of the study was to evaluate the perception and practice of CAM among healthcare professionals. A cross-sectional study was conducted among healthcare providers selected by multistage random sampling technique in two governmental hospitals and ten primary healthcare centers in two governorates in the Qassim region, Saudi Arabia. A web-based, self-administered questionnaire was distributed via social media platforms. A total of 350 physicians responded to the survey. Good basic knowledge about CAM was reported by 48.6% of the respondents; a positive attitude was adopted by 53%; and CAM was actively practiced by 9.7%. Being a physician > 40 years and consultant affiliation were significantly associated with higher knowledge level about CAM (p = 0.006 and 0.03, respectively), as well as having a proactive practice (p = 0.007 and 0.04, respectively). Practicing CAM was prevalent among non-Saudi and married physicians (p = 0.02 for both). Knowledge about CAM and its practice were strongly correlated (p = 0.007). The most frequent constraints facing CAM practice were lack of knowledge and training on CAM (81.4%) and lack of studies supporting CAM (74.3%). The practices of health professionals in Qassim region need to be improved despite their expertise and favourable perception of CAM. Educational interventions could play greater roles in providing evidence-based CAM knowledge and enhancing training for physicians.

Managing depression with complementary and alternative medicine therapies: a scientometric analysis and visualization of research activities.

Complementary and Alternative Medicine (CAM) interventions may prove to be an attractive option for the treatment of depression. The aim of this scientometric analysis is to determine the global scientific output of research regarding managing depression with CAM and identify the hotspots and frontiers within this theme. Publications regarding the utilization of CAM for treating depression were collected from the Web of Science Core Collection from 1993 to 2022, and analyzed and visualized by Bibliometrix R-package, VOSviewer, and CiteSpace. A total of 1,710 publications were acquired. The number of annual publications showed an overall rapid upward trend, with the figure peaking at 179 in 2021. The USA was the leading research center. Totally 2,323 distinct institutions involving 7,638 scholars contributed to the research theme. However, most of the cooperation was limited to within the same country, institution or research team. The Journal of Alternative and Complementary Medicine was the most productive periodical. The CAM therapies of most interest to researchers were acupuncture and body-mind techniques, such as yoga, meditation and mindfulness. Systematic review and meta-analysis are commonly used methods. "Inflammation," "rating scale" and "psychological stress" were identified as the most studied trend topics recently. Managing depression with evidence-based CAM treatment is gaining attention globally. Body-mind techniques and acupuncture are growing research hotspots or emerging trending topics. Future studies are predicted to potentially investigate the possible mechanisms of action underlying CAM treatments in reducing depression in terms of modulation of psychological stress and inflammation levels. Cross-countries/institutes/team research collaborations should be encouraged and further enhanced.

Promoting whole person health: Exploring the role of traditional Chinese medicine in Polish healthcare

Poland has a unique history of traditional Chinese medicine (TCM) dating back to the 17th century when Polish missionary Michael (Michał) Boym was a pioneer in the field. In the 20th century, his successor, Professor Zbigniew Garnuszewski, reintroduced acupuncture to medical practice in Poland. However, other methods of TCM and its holistic approach to patient care have not found their place in modern medicine in Poland. At present, the legal status of TCM in Poland remains unregulated, with TCM included in the broad spectrum of complementary and alternative medicine (CAM) practices. Few reports are available on the use of TCM methods among the Polish population. Integrative medicine combines conventional medicine with evidence-based CAM interventions and considers all aspects of a patient’s health, including physical, emotional, mental, social, and environmental factors. An integrative healthcare model that incorporates TCM modalities and lifestyle recommendations as well as a whole person approach may provide a more sustainable solution for the constantly underfinanced Polish healthcare system, which faces challenges of multimorbidity in an aging society and limited access to care. The coronavirus disease 2019 pandemic, war in Ukraine, and ongoing climate crisis have underscored the need to strengthen the resilience of the Polish healthcare system and search for new solutions. A model of care that blends the best of biomedicine and TCM healing approaches may be a better option for both patients and the healthcare system in Poland.Please cite this article as: Rybicka M, Zhao J, Piotrowicz K, Ptasnik S, Mitka K, Kocot-Kępska M, Hui KK. Promoting whole person health: Exploring the role of traditional Chinese medicine in Polish healthcare. J Integr Med. 2023; 21(6): 509–517.

Attitudes and beliefs regarding complementary and alternative medicine in a diverse gynecologic oncology patient population

ObjectivesTo measure prevalence of complementary and alternative medicine (CAM) use in a diverse gynecologic oncology patient population and evaluate how attitudes and beliefs regarding CAM relate to demographic factors. MethodsA validated Attitudes and Beliefs about Complementary and Alternative Medicine (ABCAM) survey was distributed to patients with gynecologic malignancy. Results were evaluated using Pearson's Chi-squared and Fisher's exact tests for categorical variables and Wilcoxon ranks sum and Kruskal-Wallace tests for non-normally distributed variables. ResultsOne-hundred thirty patients completed the ABCAM survey. Self-reported race and ethnicity included Asian or Pacific Islander (n = 54; 42%), Hispanic/Latino (n = 23; 18%), White (n = 21; 16%), Black or African American (n = 20; 15%), American Indian/Alaska Native (n = 8; 6.2%) and Other (n = 4; 3.1%). Twenty-four respondents (18%) reported use of CAM. There was a significant difference in expected benefits to CAM between respondents of different races/ethnicities (p < 0.001). Black and Asian respondents reported greater expected benefit to CAM. Hispanic/Latino, American Indian/Alaskan Native, and White respondents reported fewer expected benefits. A significant association was found between perceived barriers to CAM and race/ethnicity (p 0.043), with Asian, Hispanic/Latino and White respondents perceiving more barriers while Black and American Indian/Alaskan Natives reported perceiving fewer barriers to CAM. Respondents with incomes greater than $100,000 reported fewer barriers to CAM. ConclusionsUse of CAM among gynecologic oncology patients is lower than previously thought. Income, race, and ethnicity inform patient engagement with CAM and can be used to better tailor the provision of evidence-based CAM interventions to benefit a greater number of gynecologic cancer patients.

KNOWLEDGE, ATTITUDES, AND BEHAVIORS RELATED TO COMPLEMENTARY AND ALTERNATIVE MEDICINE PRACTICES IN PHYSIOTHERAPY AND REHABILITATION STUDENTS

Purpose: There are studies in the literature evaluating students’ attitudes toward and knowledge of complementary and alternative medicine (CAM) practices, with most of this research focusing on medical, pharmacy, nursing and psychology students; however, few studies have been conducted with physiotherapy and rehabilitation (PTR) students. The aim of this study was to investigate knowledge, attitudes, and behaviors related to CAM among students of PTR.&#x0D; &#x0D; Method: This cross-sectional study was conducted between October 2018 to March 2019. A self-administered questionnaire form developed to identify the knowledge, attitudes, and behaviors regarding CAM practices among students of PTR. The questionnaire form included eighteen items that was sent via email to the participants. &#x0D; &#x0D; Results: A total of 504 participants were included in this study. Their mean age was 21.66±2.50 years, 69.84% was female and 30.16% was male. Most participants (76.99%) thought that various CAM practices could be beneficial adjuncts to modern medicine. The most used sources of CAM practices was reported as online resources (64.68%). Moreover, the most well-known CAM practice among the students was massage (82.90%).&#x0D; &#x0D; Conclusions and Suggestions: Majority of PTR students had a positive opinion about CAM practices. Incorporating evidence-based CAM practices with high levels of efficacy into the curricula can reliably increase physiotherapists’ knowledge about CAM practices.

Research Trends of Moxibustion Therapy for Pain Treatment Over the Past Decade: A Bibliometric Analysis.

BackgroundAccumulate evidence indicated that moxibustion has a positive effect on pain treatment. However, the bibliometric analysis of moxibustion on pain remains uncertain. Herein, this study aimed to explore the current hotspots and the research trends over the past decade to bring a great panorama in this field.MethodsPublications were retrieved from the database Web of Science Core Collection (WoSCC) related to moxibustion therapy for pain treatment from January 1, 2012, to December 31, 2021. CiteSpace and Excel were applied to analyze the volume of publications, journals, cited journals, dual-map analysis, countries, institutes, authors, references, and keywords with citation bursts.ResultsA total of 360 publications were retrieved from 2012 to 2021. The annual number of publications increased steadily with some fluctuations over the past 10 years. “The Evid Based Complement Alternat Med” and “the Gut” were the top-cited journals in frequency and centrality. China and Shanghai University of Traditional Chinese Medicine were the most prolific country and institutions, respectively. Among authors, Huangan Wu was the most active author with the highest cited frequency. Jun Xiong, Fanrong Liang and Guixing Xu held the articles with higher centrality. In the ranking of frequency and centrality in cited references, the top one was the article published by Shamseer L and Deng HY, respectively. “Acupuncture” was the keyword with the highest frequency. Pain disease (including rheumatoid arthritis, knee osteoarthritis, herpes zoster), research method (including randomized controlled trial), and risk (including quality of life, economic burden, physical and psychological problems) were the hotspots and frontier trends in this field.ConclusionThis bibliometric study reveals the current status and research trend in the treatment of pain with moxibustion. The formulation with bibliometric analysis further elicits hot spots and frontier issues in this field.

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.

Complementary and Alternative Medicine Online Learning Intervention for Oncology Healthcare Providers: A Mixed-Methods Study.

Introduction:With the increased usage of complementary approaches in oncology comes the need for its integration into healthcare professional (HCP) education. The purpose of this single-arm, mixed-methods study was to examine the feasibility and benefits of a brief complementary and alternative medicine (CAM) learning intervention for improving HCP knowledge, attitudes, and practices regarding CAM use in cancer care, and explore the experiences of participating HCPs.Methods:HCPs from the Tom Baker Cancer Centre in Alberta, Canada, were invited to participate in 3 online interactive learning modules that reviewed: (1) basic CAM information, (2) HCP-patient CAM communication, and (3) evidence-based CAM decision support. The study survey consisted of attitude (n = 14), knowledge (n = 31), and practice (n = 31) items, administered at baseline and two-months post-intervention. Semi-structured interviews were conducted with a subset of participants.Results:Approximately 300 HCPs were invited to participate, of which 105 expressed interest in the study (35%), and 83 of them consented to participate (79%). The intervention completion rate was 73% (61/83 HCPs). There was a significant pre-post change in HCPs’ attitudes and, to a lesser extent, knowledge and practices related to CAM (8/14 attitude items changed pre-post compared to 13/31 knowledge items and 5/31 practice items), in which more HCPs reported patients should be assisted in making complementary therapy (CT) decisions, exhibited greater knowledge about CAM, and more often engaged in a CAM-related clinical practice. Qualitative findings supported the beneficial effects of the modules, with HCPs describing themselves as being more likely to ask patients about their CAM use and referring them to credible CAM resources. Nonetheless, the majority did not feel adequately prepared to make recommendations about specific CTs, even after the intervention.Conclusion:The current study suggests that online CAM learning offers a feasible and potentially promising intervention for improving oncology HCP knowledge, attitudes, and practices regarding CAM, warranting further investigation. This study highlights a need for institutional resources to help HCPs fully integrate CT decision support into cancer patient care. A coordinated evidence-based CAM program at cancer centers may help ensure that all patients’ CAM-related needs are properly attended to.

To Use or Not Use Complementary and Alternative Medicine (CAM) in Psychiatric Care: Interviews with Clinical Decision-Makers in Sweden

Complementary and alternative medicine (CAM) is used as a complementary intervention in psychiatric healthcare. The reasons for using or not using CAM in psychiatric care in Sweden, and how such decisions are taken, are largely unknown. The aim was to investigate arguments for and against the use of CAM in Swedish psychiatric care, and how decisions are made. Interviews with 10 persons in decision-making positions in psychiatric health care were analysed thematically. The result shows diverging understandings of the evidence base for CAM. Arguments against CAM referred to scepticism, the importance of evidence-based practice and the obligation to follow national guidelines. Arguments in favour of CAM were that CAM was person-centred, safe, cost-effective, nursing interventions with positive effects, appreciated and demanded by patients, providing space for non-verbal communication and reflection, supporting the therapeutic alliance. Decision paths were described as top-down through a hierarchical structure, or bottom-up, driven by committed staff members. We discuss how detailed national guidelines should be to achieve equal and evidence-based care, while still allowing clinics to make local exceptions, adjusting the care according to clinical expertise and patients’ preferences. Conclusion: Evidence-based, safe and cost-effective CAM methods may be relevant complementary interventions in psychiatric care, or as self-care, not to cure the psychiatric disease, but to reduce symptoms and promote sleep. With better knowledge of CAM, health professionals could guide patients through the jungle of CAM methods. Due to research problems on complex multicomponent interventions, high-quality pragmatic trials, including biomarkers, and qualitative studies are recommended.

Investigation of force-like effects of potentized preparations

Abstract&#x0D; The scope of this project is the investigation of the possible occurrence of force-like effects of potentized preparations. Based on earlier work [1, 2] we have chosen two preclinical models: a droplet evaporation method applied on wheat seeds and a bioassay with cress stressed with colchicine. In both methods we investigate if potentized and not potentized substances exhibit force-like effects. &#x0D; We study two types of potentization procedures. First we study classical homeopathic potentization (Natrium muriaticum 30cH) and compare it with unpotentized NaCl 0.9%. Second, we study anthroposophic potentization (Iscador, mistletoe (Viscum album L.) extracts treated with a special mechanized pharmaceutical process) and compare it with unpotentized mistletoe extract (not mechanically treated).&#x0D; Droplet evaporation method is performed as described in detail elsewhere [1]. In short: wheat seeds were placed in the inner space of bilayer recipients, whereas, in the outer space (i) the unpotentized substance, (ii) the potentized substance, or (iii) a water control is placed. After one week wheat seeds are removed from the recipients and placed in water for 1h. Droplets of the obtained leakage were evaporated on glass-slides in controlled conditions. The droplet residues are photographed in magnification 100x and analyzed for fractal dimension.&#x0D; Cress growth test is performed as described in detail elsewhere [2]. For the study of force-like effects, ampoules of the above mentioned substances and ampoules of water for injection are placed for 2 days in recipients filled with purified water. Subsequently 20 µg/ml colchicine were added. The so prepared water is used to grow selected cress seeds in bags for 4 days. The plants grow in darkness under controlled conditions and show a morphological malformation due to the colchicine. The length of the root and shoot at each plant is measured and the root/shoot ratio is calculated, to determine if there is any difference between the treatments.&#x0D; &#x0D; 1. Kokornaczyk, M.O., S. Baumgartner, and L. Betti, Preliminary study on force-like effects between As45x, water, and wheat seeds performed by means of the droplet evaporation method. International Journal of High Dilution Research, 2015. 14(2): p. 17-19.&#x0D; &#x0D; 2. Baumgartner S, Flückiger H, Kunz M, Scherr C, Urech K. Evaluation of Preclinical Assays to Investigate an Anthroposophic Pharmaceutical Process Applied to Mistletoe (Viscum album L.) Extracts. Evid Based Complement Alternat Med. 2014: Article ID 620974.

Research Trends from 2010 to 2020 for Pain Treatment with Acupuncture: A Bibliometric Analysis.

BackgroundGiven that acupuncture treatment for pain has gradually been accepted by researchers from various countries. However, few bibliometric analyses have been performed on the published articles. The objective of this research was to review its application for pain in recent 10 years and analyze, demonstrate and evaluate the trends, major research hotspots and frontier areas.MethodsThe Web of Science retrieved literature from 2010 to 2020 on acupuncture for pain. The CiteSpace and Excel were used to analyze annual volumes of publications, journals, cited journals, countries, institutions, authors, cited authors, references and keywords and to draw collaborative networks and reference co-citation network maps.ResultsThe search finally included 4227 related studies. Results show that the number of annual publications has been increasing gradually. Evid Based Complement Alternat Med (366) was the most productive journal, while Pain (2270/0.04) ranked first in terms of frequency and centrality of cited journals, respectively. Among countries/institutions, the China (1252) and the Kyung Hee University (228) ranked first. Lee MS (51 articles) was the most effective author while MacPherson H (577) was the most cited author. The most frequently cited reference was a systematic review of individual patient data on acupuncture for chronic pain (322). “Burden” was identified as a frontier research item for 2017–2020.ConclusionThis study provides a new and in-depth understanding of current acupuncture used for the treatment of pain. We anticipate that this study will stimulate international cooperation among research teams to advance the field.

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.

A DEEP-TISSUE MASSAGE WITH UNINTENDED CONSEQUENCES

SESSION TITLE: Fellows Critical Care Posters SESSION TYPE: Fellow Case Report Posters PRESENTED ON: October 18-21, 2020 INTRODUCTION: Rhabdomyolysis is a common clinical syndrome that can result from a variety of insults that are generally evident, and well-described. We report a patient with rhabdomyolysis associated with an unusual inciting event. CASE PRESENTATION: A 44-year-old gentleman presented to the hospital with upper extremity myalgias. About 48 hours prior to presentation, he received an upper body massage at a commercial spa over a 30-60 minute duration. Hours after, he sustained a fall from standing via a relatively low mechanism of injury. After waking from sleep the following day his symptoms worsened and he developed dark-brown urine discoloration, prompting his presentation to the hospital. He denied any new medications, excessive physical exertion, or prior similar episodes in himself or relatives. His medication list included gabapentin, oxycodone, and doxepin, without concurrent anabolic steroid use, or illicit drug use. On examination, he was mildly tachycardic but otherwise hemodynamically normal. He had a general muscular build, and bilateral deltoid, upper arm, and forearm edema and tenderness. There was no evidence of neurovascular compromise. Workup showed an elevated creatine phosphokinase (CPK) (66,100 U/L), myoglobinuria (3+ blood, 0-5 RBCs), with unremarkable potassium, phosphate, urine drug screen, and plain films of the affected extremities. The patient was admitted to the medical ICU for hydration and neurovascular monitoring. His serial CPK levels gradually improved over days (1,483 U/L) and he was discharged home. DISCUSSION: Rhabdomyolysis occurs when injured myocytes release their intracellular contents into the extracellular space, which results in subsequent myoglobinuria. Supporting diagnostic features include elevated serum muscle enzymes (CPK =500-1000 U/L), myoglobinuria, proteinuria, hyperkalemia, hyperphosphatemia, and acute kidney injury. Insults include physical, ischemic, chemical and biologic causes. Physical insults such as prolonged exertion and immobilization are established causes for rhabdomyolysis. However, only one previously published report has implicated massage therapy, in which an elderly man developed rhabdomyolysis after a 120-minute massage by two therapists. While massage remains a common Complementary and Alternative Medicine modality, serious adverse events rarely may occur. CONCLUSIONS: Our patient's course highlights a rare encounter which associates deep-tissue massage and rhabdomyolysis by close temporal association, anatomic distribution, and lack of other significant contributing causes. Reference #1: Zimmerman JL, Shen MC. Rhabdomyolysis. Chest. 2013 Sep;144(3):1058-1065. doi: 10.1378/chest.12-2016. Review. PubMed PMID: 24008958. Reference #2: Lai MY, Yang SP, Chao Y, Lee PC, Lee SD. Fever with acute renal failure due to body massage-induced rhabdomyolysis. Nephrol Dial Transplant. 2006 Jan;21(1):233-4. Epub 2005 Oct 4. PubMed PMID: 16204282. Reference #3: Yin P, Gao N, Wu J, Litscher G, Xu S. Adverse events of massage therapy in pain-related conditions: a systematic review. Evid Based Complement Alternat Med. 2014;2014:480956. doi: 10.1155/2014/480956. Epub 2014 Aug 12. Review. PubMed PMID: 25197310; PubMed Central PMCID: PMC4145795. DISCLOSURES: No relevant relationships by Jason Stankiewicz, source=Web Response No relevant relationships by Nevins Todd, source=Web Response

Genotyping ITS and matK regions of Hedera nepalensis K. Koch in Vietnam

Genotyping ITS and matK regions of Hedera nepalensis K. Koch in Vietnam

Research Trends of Acupuncture Therapy on Knee Osteoarthritis from 2010 to 2019: A Bibliometric Analysis.

BackgroundAcupuncture has been widely applied to relieve knee osteoarthritis (KOA) in many countries. However, the bibliometric analysis of the global use of acupuncture on KOA is largely unknown. Therefore, this study aimed to explore the current status and trends of the global use of acupuncture on KOA in recent 10 years by using CiteSpace (5.6.R3).MethodsPublications regarding acupuncture therapy for treating KOA between 2010 and 2019 were extracted from the Web of Science database. CiteSpace was used to analyze the number of publications, countries, institutions, journals, authors, cited references and keywords by using standard bibliometric indicators.ResultsA total of 343 publications were retrieved from 2010 to 2019. The total number of publications continually increased over the past four years, and the most active journals, countries, institutions and authors in the field of acupuncture therapy on patients with KOA were identified. The Evid Based Complement Alternat Med (28) was the most prolific journal, and the Ann Intern Med (202) was the most cited journal. The most productive country and institution in this field was China (115) and University of York (18), respectively. Hugh Macpherson (18) was the most prolific author and Witt C ranked the first in the cited authors. In the ranking of frequency in cited reference, the first article was published by Scharf HP (54). The keyword of ‘randomized controlled trial’ ranked first for research developments with the highest citation burst (3.9486). Besides, there were three main frontiers in keywords for KOA research, including ‘research method, ‘age’ and ‘measure of intervention’.ConclusionThe findings from this bibliometric study provide current status and trends in clinical research of acupuncture therapy on patients with KOA over the past ten years, which may help researchers identify hot topics and explore new directions for future research in this field.

Development of Key Performance Indicators for Capturing Impact of Pharmaceutical Care in Palestinian Integrative Healthcare Facilities: A Delphi Consensus Study

Background The current study was performed to develop a consensus-based core inventory of key performance indicators (KPIs) to be used in capturing the impact of pharmaceutical care in healthcare facilities that employ integrative medicine paradigm in Palestine. Methods A panel of healthcare professionals and risk/quality assurance managers was composed employing a judgmental sampling technique. The study tool was a questionnaire. Views and opinions of the panelists on the roles of pharmacists in caring for patients admitted to or visiting healthcare facilities that employ integrative medicine were collected using 11 statements. An initial inventory of activities and services that potentially can be used as KPIs was compiled from the literature and interviews with key contact experts in the domain. Three iterative Delphi rounds were conducted among the panelists (n = 50) to achieve formal consensus on the KPIs that should be used. The consensus-based KPIs were ordered by the scores of the panelists. Results A total of 8 consensus-based KPIs were developed. The KPIs related to the number of problems related to medications and complementary and alternative medicine (CAM) that were resolved by pharmacists and CAM practitioners (p < 0.0001), number of patients for whom reconciliations were documented (p < 0.0001), number of patients receiving direct, comprehensive, and/or collaborative care (p < 0.0001), and number of patients for whom pharmacists and CAM practitioners were involved in implementing a therapeutic plan (p < 0.05) were rated significantly higher than the KPI (#8) related to the participation in multi-healthcare provider discussions/deliberations. Conclusions Consensus-based KPIs that can be used in capturing the impact of evidence-based CAM and pharmaceutical care of patients in healthcare facilities that employ integrative medicine paradigm were developed. Future studies are still needed to investigate if implementing these KPIs might promote evidence-based CAM and pharmaceutical care in healthcare facilities that employ the integrative medicine paradigm.

The Impact of an Evidence-Based Education on Complementary and Alternative Medicine Usage in People with Cancer: Pilot Study.

Complementary and alternative medicine (CAM) usage amongst cancer patients is high globally and in Australia. CAM use in cancer care has the ability to increase chemotherapy toxicity or cause sub-therapy due to altered metabolism as well as increase a patient's bleeding risk. Furthering these risks, people with cancer are largely obtaining their CAM use information from non-evidence-based sources. This study aimed to determine whether the implementation of a CAM education influenced decision-making with regard to CAM usage amongst cancer patients. Twenty people with cancer were recruited for participation in this study. The aims of this study were achieved by surveying patients via questionnaire, both prior to and following receiving an evidence-based CAM education, in either or both written or audiovisual format. This exploratory study found, consistent with the literature, that the majority of participants were obtaining their CAM use information from non-evidenced-based sources. Additionally, it found that the participants wanted more CAM use information and that they demonstrated some altered decision-making after receiving evidenced-based information. On the post-educational questionnaire, the number of participants that stated that they would use CAMs decreased by almost 14%, and some participants made CAM use decisions in accordance with the information provided in the resources. Furthermore, a small increase in CAM knowledge was demonstrated, and it was reported that the resource had prompted them to look further into CAM information. Lastly, the participants in this study found the resource to be mostly useful and helpful and preferred the animated video to the written information.

The use of Complementary and Alternative Medicine (CAM) among Italian children: A cross-sectional survey

OBJECTIVETo examine prevalence and modalities of CAM use in children living in Novara, a northern Italian city, and to estimate the prescription rate from paediatricians. METHODWe administered a phone questionnaire to the parents of a sample of 147 children, asking questions about CAM use, children’s health profile, parental socio-economic status, use modalities, effectiveness perceptions, and motivations. A parallel survey was conducted by e-mail by investigating family paediatricians attitudes about CAM. RESULTSAmong 147 children whose families responded to our survey 48.3% was treated with CAM at least once in life and 38,1% during the previous year. Children treated with CAM were on average younger than those who were not. The types of CAM used were herbal medicine and homeopathy. Parents who choose CAM for their children were more skeptical about vaccinations. CAM were most frequently used to treat pathologies of ear, nose and throat. 85.9% of parents was willing to use CAM in future, 78.9% would pass to conventional medicine if CAM failed. Among paediatricians 81.5% prescribed CAM at least once, but only 13.6% received specific CAM training. CONCLUSIONThe prevalence of children using CAM in Novara is high, in line with investigations conducted in Northern European countries. The distribution of pathologies treated with CAM, parental socio-economic status and general scepticism towards vaccination are consistent with the literature. Physicians should keep themselves up-to-date also about evidence-based CAM therapies and, most importantly, should have an open dialogue about CAM with their patients.

Online information on oncologists’ and non-medical practitioners’ websites in Germany: A critical comparison

ObjectiveTo survey websites of oncologists and non-medical practitioners (NMPs) in Germany regarding range of treated symptoms, diagnostic tools and therapies offered to cancer patients as well as the quality of websites. MethodsAnalysis of 98 websites of oncologists and NMPs was conducted between April and July 2018 with a standardized tool. ResultsRange of diagnostic and therapeutic methods was high and differed between both groups. Many NMPs (65.3%) intended to support conventional therapy rather than to treat cancer. Most oncologists (85.7%) did not mention the role of complementary and alternative medicine (CAM). Texts on oncologists’ websites, showed high complexity according to readability analysis using LIX score as opposed to those on NMPs websites that showed medium complexity. Only small difference of quality of websites between both groups could be detected. ConclusionMethods not acknowledged by evidence-based medicine as well as methods at risk for interaction with conventional cancer therapy but also treatment offers with potential benefits for cancer patients were found on NMPs websites. Practice implicationsAs evidence-based CAM methods can be a useful support of cancer treatment, risk of herb drug interactions can be minimized by oncologists offering reasonable CAM.