High prevalence but limited evidence in complementary and alternative medicine: guidelines for future research

Abstract

The use of complementary and alternative Medicine (CAM) has increased over the past two decades in Europe. Nonetheless, research investigating the evidence to support its use remains limited. The CAMbrella project funded by the European Commission aimed to develop a strategic research agenda starting by systematically evaluating the state of CAM in the EU. CAMbrella involved 9 work packages covering issues such as the definition of CAM; its legal status, provision and use in the EU; and a synthesis of international research perspectives. Based on the work package reports, we developed a strategic and methodologically robust research roadmap based on expert workshops, a systematic Delphi-based process and a final consensus conference. The CAMbrella project suggests six core areas for research to examine the potential contribution of CAM to the health care challenges faced by the EU. These areas include evaluating the prevalence of CAM use in Europe; the EU cititzens’ needs and attitudes regarding CAM; the safety of CAM; the comparative effectiveness of CAM; the effects of meaning and context on CAM outcomes; and different models for integrating CAM into existing health care systems. CAM research should use methods generally accepted in the evaluation of health services, including comparative effectiveness studies and mixed-methods designs. A research strategy is urgently needed, ideally led by a European CAM coordinating research office dedicated to fostering systematic communication between EU governments, the public, charitable and industry funders, researchers and other stakeholders. A European Centre for CAM should also be established to monitor and further a coordinated research strategy with sufficient funds to commission and promote high quality, independent research focusing on the public’s health needs and pan-European collaboration. There is a disparity between highly prevalent use of CAM in Europe and solid knowledge about it. A strategic approach on CAM research should be established to investigate the identified gaps of knowledge and to address upcoming health care challenges.

Natural Products & Complementary Medicines: where are we up to?

“…For this debate and to address this issue, a research strategy is needed to evaluate the efficacy of commonly used therapies, patient's attitudes regarding CAM, the effects of CAM outcomes and the safety of CAM. Also, this is required to identify the most relevant CAM therapies for specific clinical settings, to personalise this treatment and to understand user experiences (Fischer, Lewith et al 2014). The outcome of this research will pave the way to make a stronger contribution to the need of patients and healthcare professionals enabling the engagement of CAM in healthcare framework.…”

A Randomized Open Comparative Clinical Trial on the Effectiveness, Safety and Tolerability of a Homeopathic Medicinal Product for the Treatment of Painful Teething in Children

“…Further research is warranted to confirm this hypothesis. As recommended in the roadmap for future CAM research [37], further research on ChamBell-5-02 may include comparative effectiveness research in a real world setting comparing ChamBell-5-02 to conventional treatment strategies. Despite these limitations, the present study served its purpose as a large randomized controlled study demonstrating the clinical use of ChamBell-5-02 in children, its excellent safety profile and treatment satisfaction of parents/children with ChamBell-5-02.…”

Conocimiento, aceptación y uso de medicina tradicional peruana y de medicina alternativa/complementaria en usuarios de consulta externa en Lima Metropolitana

“…No tiene bases científicas 52 (14,8) 23 (6,6) No está reconocida legalmente 37 (10,5) 59 (16,8) Tiene efectos adversos 3 (0,9) 6 (1,7)…”

“…Por otro lado, la medicina tradicional china está distribuida globalmente llegando a tener porcentajes de usos entre 75-100% en población asiático-americana en USA (7) y llegando a representar el 40% del sistema sanitario en China (8) . En Europa, un reciente metaanálisis (9) estima la prevalencia de uso de MAC entre 0,3 a 83%, siendo los países con mayores porcentajes de uso: Turquía (48-86%), Italia (16-84%) y Alemania (4.6-62%); sin embargo, reconoce un vacío en el campo del conocimiento y de los futuros desafíos en esta rama de la medicina (10) . Por otro lado, el estudio WHO-SAGE (WHO Study on Global AGEing and Adult Health) (11) concluye que, a pesar de encontrar frecuencias de uso de medicina tradicional menores al 5% en países de bajos o medianos ingresos (a excepción de India que presentó una prevalencia de uso de 19%), estas prácticas se consideran un importante recurso para ayudar a satisfacer las necesidades de salud, además de ser más aceptadas y accesibles para la población.…”