Integrative Medicine Research Research Articles

Addressing the Challenges of Traditional, Complementary, and Integrative Medicine Research: An International Perspective and Proposed Strategies Moving Forward

Traditional, complementary, and integrative medicine (TCIM) encompasses a broad range of healthcare practices beyond conventional Western medicine. Despite its use globally and increased research, many TCIM research challenges persist impeding its progress and integration into clinical practice. Key challenges involve financial constraints, insufficient research training and educational support, and the methodological barriers which arise from a lack of standardization. Financial limitations hinder investment into crucial research limiting both the quantity and quality of TCIM research. Inadequate training in research and educational support limit the development of TCIM research, hindering growth and recognition of TCIM in academic and clinical settings. The inherent dynamic nature of TCIM therapies poses additional challenges for applying standardized biomedical research models. These challenges not only impede the advancement of TCIM research but also perpetuate negative attitudes and biases within the healthcare and research communities. To overcome these challenges, a comprehensive strategy is necessary to increase funding, improve literacy, and the promotion of open science practices in TCIM. Addressing these confounding factors will enable well-informed TCIM research literacy and the development of TCIM skills and facilitate the integration of evidence based TCIM therapies into a more inclusive healthcare domain, ultimately reducing negative attitudes and biases towards TCIM.

Open science practices in traditional, complementary, and integrative medicine research: A path to enhanced transparency and collaboration

This educational article explores the convergence of open science practices and traditional, complementary, and integrative medicine (TCIM), shedding light on the potential benefits and challenges of open science for the development, dissemination, and implementation of evidence-based TCIM. We emphasize the transformative shift in medical science towards open and collaborative practices, highlighting the limited application of open science in TCIM research despite its growing acceptance among patients. We define open science practices and discuss those that are applicable to TCIM, including: study registration; reporting guidelines; data, code and material sharing; preprinting; publishing open access; and reproducibility/replication studies. We explore the benefits of open science in TCIM, spanning improved research quality, increased public trust, accelerated innovation, and enhanced evidence-based decision-making. We also acknowledge challenges such as data privacy concerns, limited resources, and resistance to cultural change. We propose strategies to overcome these challenges, including ethical guidelines, education programs, funding advocacy, interdisciplinary dialogue, and patient engagement. Looking to the future, we envision the maturation of open science in TCIM, the development of TCIM-specific guidelines for open science practices, advancements in data sharing platforms, the integration of open data and artificial intelligence in TCIM research, and changes in the context of policy and regulation. We foresee a future where open science in TCIM leads to a better evidence base, informed decision-making, interdisciplinary collaboration, and transformative impacts on healthcare and research methodologies, highlighting the promising synergy between open science and TCIM for holistic, evidence-based healthcare solutions.

Setting a dutch integrative medicine research agenda: Results of a consensus-based strategy

IntroductionThe WHO Traditional Medicine Strategy 2014–2023 emphasises the significance of traditional medicine systems for preventing and treating diseases, worldwide. As a result, many countries have developed national research programmes and research institutes dealing with traditional, complementary and integrative medicine (TCIM) (WHO Global Report on Traditional and Complementary Medicine, Geneva, 2019) or integrative medicine (IM). Despite considerable public interest in IM in the Netherlands, no Dutch programme or research institute has been established, yet. In 2018, a consortium for integrative care and health was founded, and developed a national research agenda with research priorities for the Netherlands. MethodsThe consensus-based strategy for developing the research agenda involved: (1) conducting a literature review, (2) organising an online consensus meeting with a select group of integrative medicine (IM) experts, (3) conducting a survey among IM stakeholders, and (4) organising a second consensus meeting with the same group of IM experts to discuss the survey results and further refine the research agenda. Snowball sampling was used to recruit IM stakeholders, starting from a list of those interested in or connected to IM. ResultsNinety-two stakeholders completed the survey. The most promising research areas were oncology, pain management and palliative care. Respondents awarded the highest priority to research on the effectiveness, cost-effectiveness and safety of IM interventions. Directions for research included mind–body interventions, biological interventions and whole medical systems. Moreover, respondents strongly recommended developing reliable patient information tools. Facilitators for IM implementation were increasing attention on prevention, the rising incidence of chronic diseases and the shift from disease-focused to health-focused approaches. The identified barriers included a lack of knowledge about IM, the absence of health insurance reimbursement for complementary medicine, and governance structures of healthcare organisations. ConclusionsThe first Dutch IM research agenda was developed based on consensus among Dutch healthcare professionals, along with input from a smaller group of patients and researchers. This agenda provides clear research directions and distinguishes both positive developments and barriers for IM in the Netherlands.

Home-Use and Portable Biofeedback Lowers Anxiety and Pain in Chronic Pain Subjects

In this study, we investigated the use of novel, home-use and portable biofeedback devices in a remote program for managing chronic pain. In three separate 4-week pilot studies, participants engaged in twice-daily, 10-minute biofeedback sessions, with self-assessed reductions in anxiety and pain levels using the 6-item State-Trait Anxiety Inventory (STAI-6) and Visual Analogue Scale (VAS), respectively, in Studies 2 and 3. Among these 113 (Study 2) and 237 (Study 3) biofeedback sessions, 81 (∼72%) and 130 (∼55%) showed reductions in pain, while 93 (∼82%) and 184 (∼78%) experienced reductions in anxiety. A positive relationship was found between anxiety and pain reduction, indicating that larger reductions in anxiety correspond to larger reductions in pain. In Study 1, only anxiety reductions were measured: across 143 biofeedback sessions, 127 experienced reductions in anxiety (∼89%). Participants in all studies demonstrated reductions in baseline to final results in pain, anxiety, and showed increases in satisfaction and recovery. Our results provide strong evidence that portable biofeedback devices can enhance pain management programs by helping to alleviate anxiety and pain in individuals living with chronic conditions. This study can provide a basis for the integration of biofeedback devices into the expanding research of lifestyle and integrative medicine.

Real-world data analysis on effectiveness of integrative therapies: A practical guide to study design and data analysis using healthcare databases

Real world data (RWD) is increasingly used to investigate health outcomes and treatment efficacy in the field of integrative medicine. Due to the fact that the majority of RWDs are not intended for research, their secondary use in research necessitates complex study designs to account for bias and confounding. To conduct a robust analysis of RWD in integrative medicine, a comprehensive study design process that reflects the characteristics of integrative therapies is necessary. In this paper, we present a guide for designing comparative effectiveness RWE research in integrative medicine. We discuss key factors to consider when selecting RWDs for research on integrative medicine. We provide practical steps for developing a research question, formulating the PICOT objectives (population, intervention, comparator, outcome, and time horizon), and selecting and defining covariates with a summary table. Specific study designs are depicted with corresponding diagrams. Finally, data analysis procedures are introduced. We hope this article clarifies the importance of RWE research design and related processes in order to improve the rigor of RWD studies in the field of integrative medicine research.

The Integrated Bioinformatic Assay of Genetic Expression Features and Analyses of Traditional Chinese Medicine Specific Constitution Reveal Metabolic Characteristics and Targets in Steatosis of Nonalcoholic Fatty Liver Disease.

In this study, our primary aim is to analyze the genetic expression feature and analyze specific Traditional Chinese medicine (TCM) constitution distribution in non-alcoholic fatty liver disease (NAFLD) and reveal the metabolic characteristic of NAFLD. For revealing genetic features, we obtained the gene expression data from the Gene Expression Omnibus (GEO) database of the National Center for Biotechnology Information(NCBI). The genetic data on NAFLD were analyzed by identifying differentially expressed genes (DEGs), associated pathways, co-expressed genetic networks, and gene set enrichment function. Concurrently, we assessed specific constitution distributions among local NAFLD patients through established TCM constitution models and determined the independent variable, including specific constitution to the NAFLD via the regression analyses. The analyses on GEO datasets showed that simple steatosis in NAFLD is strongly associated with HOMA-insulin resistance (HOMA-IR). Analyses of GEO datasets revealed significantly altered genetic expression profiles between NAFLD and normal populations. For TCM constitution analyses, we demonstrated a decline in yin-yang harmony (YYH) and yang-asthenia (YAAC) constitution, whereas there was an increase in qi-stagnation (QSC) and phlegm-dampness (PDC) in NAFLD. The binary logistic regression analysis indicated that besides other metabolic parameters, YYH, qi asthenia (QAC), YYAC, and yin-asthenia (YAC) were the independent variables of NAFLD, while YAC was the independent variables of T2D. The multilinear regression analyses suggested that NAFLD, DM, BMI, waist, TC, TG, hypertension, ALT, AST, and YAC were the significant determinators of the FPG. This study presents a relatively comprehensive metabolic profile in steatosis of NAFLD, revealed by significant genetic expression feature alterations and different TCM constitution distribution in NAFLD. Through this method, the study intends to associate the genetic feature with the phenotype of TCM constitution. The results could be applied to assist integrative medicine research in exploring the appropriate personalized approaches for NAFLD.

Integrative oncology: evidence-based medicine - The multidisciplinary experience of the Integrative Medicine Research Group (IMRG).

The purpose of this conference was to explain the relationship between the integrative and complementary medicine and cancer disease through evidence-based medicine. The topics covered are numerous and are characterized by the multidisciplinary approach of the researchers involved in this complex scenario. The Integrative Medicine Research Group (IMRG) studies the complementary and integrative approach in cancer patients with the aim to highlight the risk of drug and nutraceutical interactions and, at the same time, improve the quality of life in this particular set of patients. Our auspicious is to have an integrative medicine approach to all chronic diseases, oncological included.

Effect of Wet Cupping Treatment on Pain Intensity of Patients with Low Back Pain Attending Integrative Medicine Research Clinic, Suez Canal University Hospital, Ismailia

Effect of Wet Cupping Treatment on Pain Intensity of Patients with Low Back Pain Attending Integrative Medicine Research Clinic, Suez Canal University Hospital, Ismailia

Effect of Wet Cupping Treatment on Pain Intensity of Patients with Low Back Pain Attending Integrative Medicine Research Clinic – Suez Canal University Hospital - Ismailia

Effect of Wet Cupping Treatment on Pain Intensity of Patients with Low Back Pain Attending Integrative Medicine Research Clinic – Suez Canal University Hospital - Ismailia

Health TrueInfo: A multilingual Android app and social media approach in tackling COVID-19 vaccine misinformation and hesitancy in Bolivia, India, and Canada

COVID-19 vaccine misinformation has been fueling vaccine hesitancy, which has been one of the main factors in slowing down the vaccination rate (Loomba et al., 2021). An increase in vaccine hesitancy, especially among the vulnerable communities, will exacerbate the already overwhelming economic and health burden of COVID-19. The purpose of Health TrueInfo is to use knowledge translation strategies to implement evidence-based health communications via social media in order to tackle COVID-19 vaccine misinformation and hesitancy among vulnerable populations in Bolivia, India, and Canada. The Health TrueInfo initiative is in collaboration with health experts and community members, asking them to create audiovisuals that convey powerful and culturally relevant messages to their communities. Such content combats local misinformation and encourages vaccine uptake. The audiovisual content is then uploaded to our multilingual Android app and social media platforms on Twitter, Facebook, Instagram, and LinkedIn.The concept of using social media to tackle misinformation was informed from systematic reviews, highlighting its potential by health organizations to combat prevalent misinformation as social media is widely used to share and seek health information (Chou et al., 2018; Suarez-Lledo & Alvarez-Galvez, 2021). Community engagement and searching grey literature were important methodologies to understand different local contexts of misinformation. For instance, to better comprehend how misinformation plays a role in increasing vaccine hesitancy among the Indigenous Quechua peoples in Bolivia, we collaborated with a Quechua social media influencer, who helped us create a skit inspired by the current local misinformation. Likewise, we have asked other stakeholders in healthcare like local teenagers, frontline doctors, and health experts to help create content addressing their respective communities. The knowledge translation strategies utilized here were to contextualize information, appeal to potential vaccine-hesitant groups, and use community engagement strategies like involving influencers to help us reach specific demographic groups and overcome linguistic and cultural barriers (Bella et al., 2021). One way to quantitatively estimate the impact of the project is through social media analytics. When contributors or influencers helped create audiovisuals and share with their followers, some of our content have reached over 1000 impressions and 200 views within targeted demographics. This initial success may imply how Health TrueInfo models the idea of health experts, social media influencers, and members of their own communities working together to reduce vaccine misinformation and hesitancy via creating multimodal social media contents, which in turn might help increase health and digital literacy, and battle social isolation. As health misinformation is a relatively new research field and vaccine hesitancy literature for countries like Bolivia and for the Indigenous communities in general are limited, Health TrueInfo can inspire participatory action research in countries and communities that are under-represented in the peer-reviewed literature to better understand different context-specific factors contributing to vaccine misinformation and hesitancy.

The role of integrative and complementary medicine in the management of breast cancer patients on behalf of the Integrative Medicine Research Group (IMRG).

The aim of this conference was to explain the role of integrative and complementary medicine in breast cancer patients. The topics covered are numerous and their peculiarities are the multidisciplinary characteristics of the researchers involved. The Integrative Medicine Research Group (IMRG) believes in the complementary and integrative approach in cancer patients to improve the quality of life in this particular setting.

The role of gut microbiota in complementary and integrative medicine: on behalf of the integrative medicine research group (IMRG)

The role of gut microbiota in complementary and integrative medicine: on behalf of the integrative medicine research group (IMRG)

Ageing and osteoarticular system for healthy ageing on behalf of Integrative Medicine Research Group (IMRG).

Integrative Medicine Research Group (IMRG) presents a new conference scene about the "Ageing and osteoarticular system for healthy ageing" within a multidisciplinary approach of Integrative Medicine.

Bibliometric Analysis of Integrative Medicine Studies from 2000 to 2019.

Integrative medicine has become a vital component of patient care. It provides patient-centered care that is focused on prevention and overall well-being. As there has been a growing number of patients favoring a blend of conventional, complementary and alternative approaches, integrative medicine has exceeded beyond the evaluation of complementary therapies. However, it is noteworthy that there has been a dilemma of providing substantial evidence supporting the efficacy of some complementary and alternative therapies. This study's goals were to analyze publication trends, most productive journals, most productive funding agencies, most productive authors, most relevant keywords, and countries in the field of integrative medicine research. Additionally, science mapping included country collaboration analysis and thematic evolution analysis. The findings from this study showed a constant rise in annual growth of publications from 2000 to 2019; the United States was dominant in various analysis categories. In conclusion, a comprehensive review of the evolution of research of integrative medicine will help healthcare providers understand an overview of the present status while encouraging more evidence-based research for the betterment of integrative patient care.

Patients\u2019 and clinicians\u2019 expectations on integrative medicine Services for Diabetes: a focus group study

BackgroundDifference of perspective between patients and physicians over integrative medicine (IM) research and service provision remains unclear despite significant use worldwide. We observed an exceptionally low utilisation of IM and potential underreporting in diabetes. We aimed to explore the barriers and recommendations regarding service delivery and research of IM service among diabetes patients and physicians.MethodsA 10-group, 50-participant semi-structured focus group interview series was conducted. Twenty-one patients with diverse severity of disease, comorbidities and education levels; and 29 physicians (14 conventional medicine (ConM) and 15 Chinese medicine (CM)) with diverse clinical experience, academic background and affiliation were purposively sampled from private and public clinics. Their perspectives were qualitatively analysed by constant comparative method.ResultsSeven subthemes regarding barriers towards IM service were identified including finance, service access, advice from medical professionals, uncertainty of service quality, uncertainty of CM effect, difficulty in understanding CM epistemology and access to medical records. Patients underreported the use of CM due to the concern over neutrality of medical advice among physicians. Inconvenience of service access, frequent follow-up, use of decoction and long-term financial burden were identified as key obstacles among patients. Regarding research design, ConM physicians emphasised standardisation and reproducibility while CM physicians emphasised personalisation. Some CM-related outcome measurements were suggested as non-communicable. Both physicians acknowledged the discordance in epistemology should be addressed by pragmatic approach.ConclusionKey obstacles of CAM clinical utilisation are different between patients. Further assessment on IM should be pragmatic to balance between standardisation, reproducibility and real-world practice. Evidence-based IM programs and research should merge with existing infrastructure.

P1045MISALIGNED EXPECTATIONS ON INTEGRATIVE MEDICAL SERVICE FOR DIABETES AND DIABETIC KIDNEY DISEASE: A COMPARATIVE FOCUS GROUP SERIES OF PATIENTS AND PHYSICIANS

Abstract Background and Aims Difference of perspective between patients and physicians over integrative medicine (IM) research and service provision remains unclear despite significant use worldwide. We sought to explore the barriers and recommendations regarding IM service among diabetes and diabetic kidney disease (DKD) patients and physicians. Method A 10-group, 50-participant semi-structured focus group interview series was conducted. Twenty-one patients with diverse severity of disease, comorbidities and education levels; and 29 physicians (14 western medicine (WM) and 15 Chinese medicine (CM)) with diverse clinical experience, academic background and affiliation were purposively sampled from private and public clinics. The perspectives were qualitatively analysed by constant comparative method with grounded theory approach. Results Seven subthemes regarding barriers towards IM service were identified including finance, service access, advice from medical professionals, uncertainty of service quality, uncertainty of CM effect, difficulty in understanding CM epistemology and access to medical records. Patients underreported the use of CM due to the concern over neutrality of medical advice among physicians. Practical issues including inconvenience of access to service, frequent follow-up, use of decoction and long-term financial burden were identified as key obstacles among patients. Regarding research design, WM physicians emphasized standardization and reproducibility while CM physicians emphasized personalization. Some CM-related outcome measurements were suggested as abstract and non-communicable. Both WM and CM physicians acknowledged the discordance in epistemology should be addressed by pragmatic approach. Conclusion Further assessment on IM should be pragmatic to balance between standardisation, reproducibility and real-world practice. Evidence-based IM programs and research should merge with existing infrastructure.

The role of qualitative methods in integrative medicine research

The role of qualitative methods in integrative medicine research

Enhancing complementary and integrative medicine research through the use of data linkage

Enhancing complementary and integrative medicine research through the use of data linkage

Development of Online Integrative Medicine Research Curriculum

To determine if Muscle Response Testing (MRT) can be used to distinguish lies from truths using blind test patients.A prospective study of diagnostic test accuracy was carried out using MRT to distinguish lies from truth.Twenty practitioners who routinely practised MRT were paired with 20 blind test patients (TPs). TPs were asked to speak simple true and false statements about visual stimuli presented subliminally (at 20 ms). In the subliminal phase, pairs performed 20 MRTs and 20 Intuitive Guesses (IG), consisting of 2 blocks of 10 statements each. In the Supraliminal Phase, the same picture-statement pairs were repeated. The order of stimuli presentation was randomly assigned so that each pair was presented with a unique series of stimuli.In the Subliminal Phase, MRT accuracy (as percent correct) was found to be 48.5% (95% CI 42.8–54.2), which was no different from IG accuracy (47.8%; 95% CI 43.2–52.3; p = 0.68) or chance (50.0%; p = 0.59), and no different from MRT accuracy during the supraliminal phase (59.0%; 95% CI 50.4–67.6; p = 0.05). However, supraliminal MRT accuracy was significantly different from chance (p = 0.04), indicating that the pairs could perform MRT proficiently.The main reason for finding no effect is suspected to be due to an inadequate subliminal methodology, a process which is quite complex. Other explanations of results include: (1) MRT is not a valid test when the TP is blind, (2) Blinding TPs during MRT will produce ambiguous or unpredictable results, or (3) Nonconscious beliefs cannot be elicited using subliminal stimuli. Future research may wish to focus on exploring these possibilities. More specifically, subsequent studies may wish to use different methods to blind TPs, and establish whether MRT can be used to detect nonconscious processes, a generally held consensus among MRT practitioners.

2018 INCAM Research Symposium: Complementary and Integrative Medicine Research in an Era of Skepticism.

2018 INCAM Research Symposium: Complementary and Integrative Medicine Research in an Era of Skepticism.