First, keep it safe: Integration of a complementary medicine service within a hospital

Abstract

Summary Objectives This paper sought to explore risk/safety considerations associated with the integration of a complementary medicine (CM) service within a public academic medical centre in Israel. Methods We reviewed various sources pertaining to the CM service (interviews with CM staff, patients' electronic charts, service guidelines, correspondence with hospital administration) and conducted a thematic analysis to evaluate safety‐related incidents during the 7 years of operation. In addition, we systematically assessed the charts for reports of treatment‐associated adverse effects, which were documented in an obligatory field on treatment reports. Results After reviewing transcripts of interviews with 12 CM practitioners and with the director and vice‐director of the CM service as well as transcripts of 8560 consultations that included 7383 treatments, we categorised 3 major domains of CM safety management: (i) prevention of safety‐related incidents by appropriate selection of CM practitioners and modalities, (ii) actual adverse incidents and (iii) prevention of their recurrence using both hospital and CM service safety protocols. CM staff reported 5 categories of adverse incidents, most of which were minor. Twenty‐nine adverse incidents were documented in the 7383 treatment sessions (0.4%). Conclusions Safety management needs to be addressed both before introducing CM services in hospitals and throughout their integration. Important considerations for the safe integration of CM practices in the hospital include communication between CM and conventional practitioners, adherence to hospital safety rules, implementing a systematic approach for detecting and reporting safety‐related incidents and continuous adaptation of the CM service safety protocols.

Acupuncture Treatment of Delirium in Older Adults Hospitalized in Internal Medicine Departments: An Open-Label Pragmatic Randomized-Controlled Trial

“…Participants included in this study were adults older than 65 years, hospitalized in a medical inpatient unit, and diagnosed with delirium or subsyndromal delirium within the past 48 hours. They were excluded if they had a contraindication to acupuncture (e.g., platelets ≤ 20 x 10 9 /L), 36 a history of severe dementia (documented history and/or IQCODE score ≥ 4), an acute neurological injury (stroke), a history of schizophrenia or a formal thought disorder, an active acute alcohol or drug withdrawal, a history of end stage liver failure (to distinguish between delirium and hepatic encephalopathy), or language barriers preventing delirium assessment.…”

Complementary Medicine Provision in an Academic Hospital: Evaluation and Structuring Project

“…Indeed, training qualifications were not subjected to structured control, unlike other integrative medicine projects, which assigned high importance to the training evaluation of practitioners. 23,32,33 Therefore, institutional standardization of training requirements should be required to ensure quality and safety of care. Thus, requirements of training for each CM would be specified by a working group of physicians, nurses, and human resources staff.…”

Harmful Interference of Detoxifying Diets and Nutraceuticals with Adherence to Abemaciclib in Advanced Estrogen Receptor-Positive, Human Epidermal Growth Factor Receptor-2-Negative Breast Cancer: A Case Report

“…Many patients follow detoxifying or anticancer diets and take nutraceuticals often without discussion with their treating oncologists [ 7 ]. This attitude toward the use of nutraceuticals should be carefully evaluated in a team of integrative medicine since natural products does not always correspond to safety in oncology [ 8 ]. This article reports a negative interaction between detoxifying diet and nutraceuticals with adherence to antihormonal therapy in a woman with advanced estrogen receptor-positive, her-2-negative breast cancer.…”