The history of the relationship between complementary medicine (CM) and mainstream health care has shifted from the early days of pluralism, through hostility and exclusion, to one of grudging acceptance. The current situation is one of a tacit acknowledgement and in some cases open endorsement by biomedicine for a number of forms of CM practice, largely driven by the popularity of CM to consumers in our increasingly market driven health care system. How this relationship is ultimately worked out will impact both on the practice of CM and biomedicine, and on the health care choices available to consumers. In this article we review the research and commentary literature on the current and emerging relationship between biomedicine and CM. In particular we explore the ways in which mainstream inclusion of CM is discussed in the literature, and the biomedical and CM perspectives of mainstream CM inclusion. Finally we discuss the implications of the emerging relationship for CM, and CM practitioners and consumers.
An unambiguous definition of IHC is critical to establishing a clearer identity for IHC, as well as providing greater clarity for consumers, health providers and policy makers. In recognising the need for a clearer description, we propose a scientifically-grounded, multi-disciplinary stakeholder-informed definition of IHC.
This is first known study to translate HC and HCP attitudes and preferences into an operational framework for IHC. A logical next step of this work will be to ascertain the feasibility of this model in primary care.
This Australian study sought to understand how practitioners of the traditional systems of what is now termed complementary and alternative medicine (CAM) are responding to the adoption of their traditional medicine therapies by the mainstream health care system, and the practice of these therapies by mainstream health care practitioners. A grounded theory approach was used for this study. In-depth interviews were conducted with 19 participants who were non-mainstream practitioners from five traditional systems of medicine - Traditional Chinese Medicine,Ayurveda, Naturopathy, Homeopathy and Western Herbal Medicine. Four main conceptual categories were identified: Losing Control of the CAM Occupational Domain (the participants' main concern); Personal Positioning; Professional Positioning (the core category); and Legitimacy.These categories formed the elements of the substantive theory of 'becoming accepted' as a legitimate health care provider in the mainstream health system, which explained the basic social process that the study's participants were using to resolve their main concern.
Background
The past few decades have witnessed a surge in consumer, clinician and academic interest in the field of integrative healthcare (IHC). Yet, there is still uncertainty regarding the effectiveness of IHC for complex, long‐term health conditions.
Objective
To assess the effectiveness of IHC for the management of any chronic health condition.
Methods
Seven databases and four clinical trial registries were searched from inception through to May 2018 for comparative/controlled clinical trials investigating the effectiveness of IHC for any chronic disease, and assessing any outcome. Risk of bias was assessed using the Cochrane Collaboration Risk of Bias tool.
Results
The search yielded 6,926 results. Eight studies met the inclusion criteria. All studies had at least three design features that carried an uncertain/high risk of bias. Differences in physiological, psychological and functional outcomes, and quality of life between patients receiving IHC and patients receiving conventional/usual care were varied and inconsistent. Changes in patient satisfaction with care were inconclusive. No studies reported the effectiveness of IHC on workforce‐ or administration‐related parameters. Evidence from one trial suggested IHC may be more cost‐effective than conventional care.
Conclusions
The findings indicate some promising effects for the use of IHC to manage chronic disease. However, the uncertain/high risk of bias across multiple domains, diverse and inconsistent findings, and heterogeneity of outcome measures and study populations prevents firm conclusions from being reached. Along with conducting further well‐designed, long‐term studies in this field, there is a need to ensure interventions closely align with the definition/principles of IHC.
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