How knowledgeable are investigators studying therapies of traditional medicines?

Narahari, S. R.; Aggithaya, Madhur Guruprasad; Thamban, C.; Muralidharan, Kunnathody; Kanjarpane, Aniruddha B

doi:10.4103/0974-8520.153734

Cited by 4 publications

(3 citation statements)

References 13 publications

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“…A major focus of existing studies has been on the reduction of objectively measured outcomes (e.g., pain interference, severity of disability). Investigators involved in Ayurvedic research face the challenge of conducting clinical research in abstract Ayurvedic concepts and principles such as dosha, prakriti, and agni [31] that are fundamentally distinct from and poorly understood in biomedical ontologies. However, some ethnomedical approaches have been rigorously investigated in clinical settings.…”

Section: Introductionmentioning

confidence: 99%

Patient Assessment and Chronic Pain Self-Management in Ethnomedicine: Seasonal and Ecosystemic Embodiment in Ayurvedic Patient-Centered Care

Agarwal

2020

IJERPH

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Background: Ayurveda’s preventive focus complements its strength with the interventionist approach of the biomedical in chronic pain self-management. Patient-centered care (PCC) using ethnomedicine promises greater patient self-management; however, few studies have examined environmental relationships and PCC in self-management of chronic pain through Ayurveda. Objective: To examine how Ayurveda’s philosophical focus on whole system frameworks describes the integration of the individual and the ecological in tailoring an integrative patient-centered diagnostic and prognostic approach to chronic pain management. Methods: This qualitative case study conducted in-depth semi-structured interviews of Ayurvedic physicians from India (N = 10) and a qualitative inductive content analytic approach. Findings: The diagnostic and interpretational framework of the doshas supports the integration of the individual and the ecological through (a) the circadian and seasonal cycles relating mind-body awareness with diet, lifestyle (e.g., yoga), and breath (e.g., pranayama), and (b) biogeographical and ecosystemic regions relating the biogeographical and the ecological (e.g., desh) with the regulatory principle of pain and its physiological and anatomical perception (vata) in an approach that goes beyond treating pain etiology to a whole person PCC approach. Conclusions: The study highlights how circadian and seasonal cycles and evolutionary spatial-temporal factors of biogeographical and ecological regions are employed in patient assessment and self-management to support patient involvement. Recommendations for PCC in integrative chronic pain management include supporting patient ownership of their care through the dosha framework that relates the individual and the ecological in the patient’s own life-context and supports co-creation of a collaborative plan of care using an ethnomedical framework.

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Section: Introductionmentioning

confidence: 99%

Patient Assessment and Chronic Pain Self-Management in Ethnomedicine: Seasonal and Ecosystemic Embodiment in Ayurvedic Patient-Centered Care

Agarwal

2020

IJERPH

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“…Although major clinical studies are undertaken in the Indian Government's CAM institutions, albeit with methodological errors 62 , a large number of studies are not published. At this early stage of development of CAM and IM literature, institutions conducting IM studies should aim to publish all their data, even if the results are negative 63 and ideally follow the relevant BMJ guidelines 64 .…”

Section: Publication Policymentioning

confidence: 99%

Developing an Integrative Medicine Patient Care Protocol from the Existing Practice of Ayurveda Dermatology

et al. 2016

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Doctors who use biomedicine with complementary and alternative medicine (CAM) in a carefully integrated way offer benefits from both systems to chronic patients without compromising on safety. The Institute of Applied Dermatology, Kasaragod has successfully developed a model of integrative medicine (IM) and effectively managed lymphoedema patients. This article describes the process of developing IM treatment adopting 'standard protocol items and recommendations for interventional trials'. All patients were examined by a team of doctors, biomedical and CAM, and nurses, thus enabling each patient's condition to be understood from these different perspectives, and diagnosis and management through an IM approach. A minimum of 30 min counselling is essential for every patient before informed consent is gained. The 'systems-based' conclusive process follows the standard guidelines in each therapeutic discipline. IM management is achieved following 'bedside discussion'. The minimum requirements for a clinical setting to conduct IM studies, documentation, patient selection and follow-up are described, utilizing biomedical outcome measures to demonstrate the effectiveness of IM. Components of the IM case record algorithm are described here. The process of clinical examination for Ayurveda is described along with comparative biomedical explanation. Biomedical confirmatory study, maintaining records of primary outcome measures, transcription of IM discussions and follow-up entries of patients under IM are also explained. Improving IM protocols for patient care has involved input from global experts together with feedback from patients who have received IM treatment. The IM treatment protocol should evolve as a patient-oriented approach. The protocol discussed here focuses on biomedical systems and structures to measure its effectiveness. This article provides a method for conducting evidence-based clinical studies to develop new IM therapies for chronic skin diseases.

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“…While doing research in the Ayurvedic institutions, there is a lack of therapeutic or diagnostic intent as well as any deep understanding of ethical issues such as informed consent. Narahari et al 61 assessed the knowledge level of Ayurveda researchers. Miller and Joffe 62 developed scientific criteria for using uncontrolled clinical trials in the context of life-threatening diseases.…”

Section: Sciencementioning

confidence: 99%

The Integration of Complementary and Alternative Medicine:The Way Forward for the Health of Skin and Gut

Kalsi

Ryan

2016

Current Science

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In this review of Sanskrit translations in traditionalAyurveda texts studies on skin and gut health we consider the integration of complementary and alternative medicine (CAM) with biomedicine (BM). We focus on irritable bowel syndrome (IBS) as a problem affecting 22% of the population with multiple known causes and unresponsive to biomedical and CAM intervention, but for which integrated medicine (IM) might be more useful. As up to 80% of medical patients concurrently use CAM alongside BM, it is imperative that doctors are able to understand and discuss its use with patients. In order to facilitate these therapeutic combinations, we must identify safe and effective CAM treatment protocols for their administration. CAM offers many treatment options, especially for IBS; however, its presentation can prove a barrier to understanding these options. Here, we consider the example of Ayurveda: a traditional Indian system of medicine in which derangements of the digestive system are well described but with unclear English translations. Forceful language and opinions are sometimes used to support traditional medicine. These unscientific obstacles detract from the multitude of treatment options CAM provides. If CAM were presented in a more scientific manner, modern medical practitioners would take IM more seriously. Research of CAM often lacks scientific rigour, leaving questions regarding its evidence base. Moreover, CAM literature does not utilize advances in the understanding of disease and epidemiology. BM has been less successful at disease prevention and managing chronic conditions while CAM focuses on optimizing health, even in the absence of obvious pathology. Patients are now more focused on health optimization leading to increased uptake of CAM. The onus is on us as health professionals to make sure that they are able to do this as safely and effectively as possible.

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How knowledgeable are investigators studying therapies of traditional medicines?

Cited by 4 publications

References 13 publications

Patient Assessment and Chronic Pain Self-Management in Ethnomedicine: Seasonal and Ecosystemic Embodiment in Ayurvedic Patient-Centered Care

Patient Assessment and Chronic Pain Self-Management in Ethnomedicine: Seasonal and Ecosystemic Embodiment in Ayurvedic Patient-Centered Care

Developing an Integrative Medicine Patient Care Protocol from the Existing Practice of Ayurveda Dermatology

The Integration of Complementary and Alternative Medicine:The Way Forward for the Health of Skin and Gut

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