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Source publication
Objective:
The study aims to review the legal and regulatory status of complementary and alternative medicine (CAM) in the 27 European Union (EU) member states and 12 associated states, and at the EU/European Economic Association (EEA) level.
Methods:
Contact was established with national Ministries of Health, Law or Education, members of nation...
Context in source publication
Context 1
... European Parliament [1] and the Parliamentary Assembly of the Council of Europe [2] have both passed resolutions recommending a stronger harmonization of, what they call, non-conventional medicine in Europe. The European Union (EU) has, however, repeatedly con- firmed that it is up to each member state to organize and regulate their healthcare system, and this will, of course, also apply to complementary and alternative medicine (CAM). Despite this confirmation, the recent Patients’ Rights in Cross-Border Healthcare Directive 2011/24/EU [3] and other directives indirectly encourage some degree of harmonization. CAM professions can be registered in the European Commission (EC) database of regulated professions, and patients will probably have certain rights according to the Cross-Border Healthcare Directive. The EU has also passed directives regulating medicinal products that also cover CAM medicinal products [4–6]. Previous studies on the European situation with regard to how CAM is regulated [7–9] have shown a diverse pattern. Reports from key CAM stakeholders have indicated that the regulatory situation has changed, and the CAMbrella consortium has therefore seen it as important to establish the current status in order to best prepare a roadmap for CAM research in Europe. The aims of this study were to: 1 Review in 27 EU member states and 12 associated states: ᭺ The legal and regulatory status of CAM. ᭺ The governmental supervision of CAM practices. ᭺ The reimbursement status of CAM practices. 2 Review at the EU/European Economic Association (EEA) level: ᭺ The status of EU/EEA-wide regulation of herbal and homeopathic medicinal products. 3 Review and describe in all 27 EU member states and 12 associated states: ᭺ The extent of country-specific market authorization of herbal and homeopathic medicinal products according to the EU directives. 4 Review at EU level: ᭺ The status of EU-wide regulation of CAM practices. ᭺ The potential obstacles for EU-wide regulation of CAM CAM treatment is in general either unregulated or regulated practices. within the framework of the public health system. The only common factor that we have found across all 39 nations is the amazing ability they have demonstrated for structuring legislation and regulation differently in every single country, no matter how small the size of the population. Of the 39 countries, 17 have a general CAM legislation, 11 of these 17 have a specific CAM law and 6 countries have sections on CAM included in their health laws (like ‘law on healthcare’ or ‘law on health professionals’). In addition to the general CAM legislation, some countries have regulations on specific CAM treatments (fig. 2). The CAM regulations are either very general or very de- tailed, and we found no more similarities between the countries that have a CAM law or general CAM legislation than between the countries with only specific CAM treatment regulations. Some of the general regulations are only a specifica- tion of what CAM is, often to be supported by additional regulations or specifications issued by the Ministry of Health or the professions’ associations. In some countries additional specifications have not been made. As an example, both Norway and Hungary have a CAM law. In Norway the CAM law is general without describing in detail the treatments or practitioners, in Hungary CAM can be regarded as an integral as- pect of the healthcare system. We found few similarities in the regulations of the specific CAM treatments between the countries, and it is challenging to find out who is allowed to practice the different treatments. The 12 common treatment modalities vary considerably with regard to how many countries regulate the profession or practice in some way or another. Acupuncture is regulated in CAM treatment is in general either unregulated or regulated within the framework of the public health system. The only common factor that we have found across all 39 nations is the amazing ability they have demonstrated for structuring legislation and regulation differently in every single country, no matter how small the size of the population. Of the 39 countries, 17 have a general CAM legislation, 11 of these 17 have a specific CAM law and 6 countries have sections on CAM included in their health laws (like ‘law on healthcare’ or ‘law on health professionals’). In addition to the general CAM legislation, some countries have regulations on specific CAM treatments (fig. 2). The CAM regulations are either very general or very de- tailed, and we found no more similarities between the countries that have a CAM law or general CAM legislation than between the countries with only specific CAM treatment regulations. Some of the general regulations are only a specifica- tion of what CAM is, often to be supported by additional regulations or specifications issued by the Ministry of Health or the professions’ associations. In some countries additional specifications have not been made. As an example, both Norway and Hungary have a CAM law. In Norway the CAM law is general without describing in detail the treatments or practitioners, in Hungary CAM can be regarded as an integral as- pect of the healthcare system. We found few similarities in the regulations of the specific CAM treatments between the countries, and it is challenging to find out who is allowed to practice the different treatments. The 12 common treatment modalities vary considerably with regard to how many countries regulate the profession or practice in some way or another. Acupuncture is regulated in 27 countries, anthroposophic medicine in 8 countries, Ay- urveda in 5 countries, chiropractic in 27 countries, herbal medicine/phytotherapy in 11 countries, homeopathy in 25 countries, massage in 20 countries, naprapathy (manual therapy) in 2 countries, naturopathy in 9 countries, neural therapy in 3 countries, osteopathy in 16 countries, and finally Traditional Chinese Medicine in 10 countries. As an example, figure 3 shows the regulation of homeopathy across Europe. Switzerland has regulated homeopathy and has registered homeopath as a profession in the EU regulated professions database under ‘natural health practitioner’ as ‘naturopath/homeopath’. 2 countries (Latvia, Liechtenstein) have regulations that may be seen as a regulation of a homeopathy profession. Latvia has regulated ‘homeopathic doctors’, Liechtenstein has registered ‘natural health practitioner with a homeopathy specialty’. 22 countries have regulated homeopathy treatment. 14 countries have no specific homeopathic treatment regulations, but general CAM or other health legislation may regulate homeopathic practices. Figure 4 ‘Homeopathy – Who may practise’ is an example of how difficult it can be to understand the consequences of national regulation. We have, to our best knowledge, listed whether the different categories of practitioners in each country are allowed to practice homeopathy. If only medical doctors with additional CAM education are allowed to practice, we have put ‘No’ in the column for medical doctors. The same applies for other health personnel. If the regulation (or ab- sence of regulation) was too unclear for us to be certain, we have inserted a question mark. Since the countries with CAM practitioners like ‘Heilpraktiker’, ‘healer’ and likewise may not be correctly represented, we decided not to introduce this table for other treatments because of the unclear situation. Medicinal products are not defined as a part of health policy, and can therefore be regulated at the EU level. The individual states within the EU/EEA area are therefore no longer free to uphold a national regulation of medicinal products in viola- tion of the following 3 EU directives. 1 Directive 2001/83/EC of the European Parliament and of the Council, of November 6, 2001 (on the community code relating to medicinal products for human use) [4]. 2 Directive 2004/24/EC of the European Parliament and of the Council, of March 31, 2004 (amending, as regards traditional herbal medicinal products, directive 2001/83/EC on the community code relating to medicinal products for human use 2001/83/EC) [5]. 3 Directive 2004/27/EC of the European Parliament and of the Council of March 31, 2004 amending directive 2001/83/ EC on the community code relating to medicinal products for human use (Text with EEA relevance) [6]. Until April 30, 2011, herbal medicinal products that were marketed without authorization before this legislation came into force could continue to be marketed under transitional measures defined in directive 2004/24/EC [5]. Now that this time limit has expired, all herbal medicinal products that were previously unauthorized must have market authorization according to directives 2001/83/EC, 2004/24/EC, and 2004/27/EC [4–6] before they can be marketed in the EU/EEA states. Marketing authorizations for herbal and homeopathic medicinal products are mainly given at the national level, but a central procedure can be used in some cases. Herbal and homeopathic medicinal products are subject to ...
Citations
... LC--MS [1,2]. Nature offers a vast repository of chemical compounds with enormous therapeutic potential. ...
Asparagus racemosus Willd, an Ayurvedic medicine, is known for its antioxidant, antiviral, immune-boosting, and neuro-nutraceutical benefits, particularly in female health. However, its metabolites, mechanisms of action, and target proteins are yet to be fully understood. The present study aimed to identify the metabolite constitution and metabolite-associated proteins in neuroprotective mechanisms in neurodegenerative disease. Mass spectrometry-based untargeted metabolomics and network pharmacology approaches were used to identify metabolites in A. racemosus root extract. In vitro studies, including oxidative stress regulation, neuronal apoptosis, and western blot analysis, were conducted to assess the plant’s impact on Alzheimer’s disease (AD). We identified 44,014 spectra in positive and negative modes, corresponding to 31,931 non-redundant metabolites at the MS1 level and 5,608 at the MS2 level, from A. racemosus root extract, which include metabolites belonging to phenols, lipids, flavonoids, isoprenoids, and fatty acyls. Novel and known compounds were identified, such as asparagine, sitosterol, arginine, muzanzagenin, pinene, flavone, and kaempferol. Network pharmacology predicted 44 potential human protein targets linked to Alzheimer’s disease from these metabolites. These proteins belong to neuromodulator classes, including BACE1, CHRM3, APP, MAP2K1, GSK3B, and TNF, and some of the metabolites of A. racemosus including muzanzagenin interact with BACE1 protein. In vitro validation showed that A. racemosus regulates ROS levels, apoptosis pathways, and BACE1 expression in Alzheimer’s disease (AD), highlighting its therapeutic potential. This study integrates network pharmacology and metabolomics, paving the way for clinical research into the neuropharmacological effects of A. racemosus on neurological disorders.
Graphical Abstract
... Ensuring the safety and efficacy of CAM practices is paramount, requiring rigorous scientific evaluation and comparative assessments of their effectiveness relative to conventional medicine. 153 Moreover, a holistic understanding of CAM outcomes necessitates a deeper exploration of the interplay between patient beliefs, expectations, and the broader healthcare context. The development and rigorous evaluation of diverse models for integrating CAM into existing healthcare systems are indispensable for achieving successful and sustainable implementation. ...
Integrative medicine (IM) aims to create a comprehensive healthcare system by combining conventional medicine with complementary and alternative approaches. This model prioritizes patients, emphasizing the importance of the doctor–patient relationship. By integrating the most beneficial elements of both conventional and complementary medicine, patients can benefit from enhanced therapeutic outcomes while minimizing risks associated with their combination. Given this complexity, patients need access to qualified IM practitioners who can provide guidance on the potential benefits and drawbacks of these combined approaches. One notable complementary approach is prophetic medicine (PM), particularly prevalent in Muslim communities. This practice offers preventive and curative treatments based on the teachings and practices of Prophet Muhammad. Its global recognition is on the rise, attracting increasing interest from scientists regarding its potential benefits. For instance, cupping therapy, a technique employed in PM, has been shown to offer advantages over conventional medications for various ailments, including pain management and blood conditions, such as thalassemia, offering potentially superior outcomes. A precise delineation of the scope of PM practices is crucial for a comprehensive understanding of the methodologies employed, their potential integration into contemporary healthcare systems, and the multifaceted factors influencing patient outcomes. By combining conventional medical practices with the principles of PM, IM can provide a more holistic approach to patient care. Hence, this paper explores this new model, its diverse applications, and its potential impact on IM.
... The regulation of CAM practice is really a challenge because of the nature of its diversity. In different European countries various CAM treatments are regulated differently 12 . While in most countries the law suggests that the delivery of health care should be controlled by biomedically-trained professionals; however, alternative healers operate very openly, and many don't even have any proper training 13 . ...
Background: Despite tremendous advances in medical sciences still a large section of the population in rural areas is heavily dependent on indigenous and Traditional Medicine (TM) for treatment. Moreover, there has been a resurgence of interest in the use of Complementary and Alternative Medicine (CAM), globally. Objective: To review the overall regulator structure for the control of TM and the course curriculum for TM education in Nigeria. Method: Information on CAM and TM was collected via online search. Results: Responding to this unprecedented situation government of many countries have taken proactive steps to streamline and regulate the practitioners of CAM and TM in their countries as mandated by WHO. In many African countries because of the availability of research and training programs many traditional herbal medicines are now being sold over the counter. However, the situation is different in Nigeria, even though TM is very popular across the country, structured institutionalized teaching and research activity on TM are inadequate. Conclusion: Health is a key component in determining the Human Development Index (HDI) of a country. CAM and TM practitioner may play an important role in improving the HDI score of the country. Government-sponsored education & training program for TM practitioners is crucial.
... Some regulate only specific CAM treatments, while most CAM products are subjected to the same market authorization procedures as conventional medicine, apart from documentation of efficacy. [27][28][29] In the Asian context, such as China and India, and even in more technologically advanced nations, such as Korea and Singapore, CAM products such as traditional medicines are officially recognized and integrated into the public health care system. In these regions, regulation of CAM becomes secondary, and promotion of traditional medicines and practices is prioritized, bypassing scientific evidence driven by nationalism, to maintain cultural, political, faith, and religion-based sentiments alive within the public. ...
Complementary and alternative medicines (CAM) include conventional medical treatments. Patients worldwide use CAM at alarming rates; thus, reports of CAM-related DILI have been on the rise. The clinical presentations include asymptomatic liver test abnormalities, acute hepatitis with or without jaundice, acute cholestatic liver disease (bland or with hepatitis), acute liver failure, severe hepatitis with features of portal hypertension, and acute decompensation of known or unknown cirrhosis that can lead to acute-on-chronic liver failure. Acute hepatitis with or without necrosis, hepatocellular and canalicular cholestasis, herb-induced or CAM-triggered autoimmune hepatitis, granulomatous hepatitis, severe steatohepatitis, and vanishing bile duct syndrome are common liver biopsy findings in CAM-DILI. The presence of preexisting liver disease predicts severe liver injury, risk of progression to liver failure, and decreased transplant-free survival in patients with CAM-DILI. This review discusses global epidemiology and trends in CAM-DILI, clinical presentation, assessment and outcomes, commonly emerging threats in the context of hepatotoxic herbs, pragmatic assessment of “liver beneficial” herbs and health care myths, patient communication, regulatory framework, and future directions on research in CAM.
... Healthcare Systems and Policies: [37][38] Analyzing the impact of medical pluralism on healthcare systems, policies, and insurance coverage. This research can inform the development of policies that accommodate diverse healthcare preferences and practices. ...
Medical pluralism, a phenomenon wherein individuals engage with multiple healthcare systems and healing practices, has become an increasingly important area of research within the field of medical anthropology and public health. This research provides an overview of the current state of knowledge in the realm of medical pluralism, highlighting the need for a multidisciplinary approach to better understand its implications on healthcare delivery and outcomes. Medical pluralism is a complex and dynamic interplay of diverse medical systems, such as traditional medicine, complementary and alternative medicine (CAM), and biomedicine, that individuals utilize to address their health needs. The key themes within medical pluralism research, including the cultural, social, and economic factors influencing the choice of healthcare systems, the challenges and opportunities for healthcare integration and collaboration, and the impact of medical pluralism on health disparities and patient outcomes. Furthermore, the abstract emphasizes the importance of bridging the gap between conventional biomedical healthcare and traditional or alternative healing practices. By understanding the diverse ways individuals seek health and healing, researchers and healthcare providers can develop more inclusive and effective healthcare strategies that are sensitive to cultural differences and individual preferences. Additionally, exploring the safety and efficacy of various complementary and alternative therapies within the context of medical pluralism is crucial to ensuring the well-being of patients. The growing significance of medical pluralism in the modern healthcare landscape encourages further research and collaboration between medical anthropologists, healthcare providers, and policymakers. A comprehensive understanding of medical pluralism will aid in the development of healthcare systems that respect and accommodate the diverse healthcare choices of individuals, ultimately leading to more equitable and patient-centered care.
... Legislation around CAM use differs across different countries; where some countries regulate the manufacturing, distribution, and sale of CAMs like pharmaceutical products [109], but most governments do not regulate CAMs as medical or health products [110]. This lack of regulation allows manufacturers of CAMs to promote their products without a scientific check on the promotional content [111]. ...
Background
Social Media Influencers (SMIs) are a fashionable way of marketing products by creating electronic word-of-mouth (e-WOM) on social media. The marketing of complementary and alternative medicines (CAMs) by SMIs is becoming increasingly popular and gaining credibility within consumers on social media platforms. Nonetheless, advising about healthcare products on social media should be examined as it is different from endorsing other kinds of commercial products. The aim of this study is to develop a model that provides the underlying mechanisms of the stimuli of SMIs on social media towards consumers’ purchase intention of CAMs.
Methods
This study used best fit framework synthesis methods to develop the model. A priori theory selection was conducted by identifying a BeHEMoTh strategy (Behavior of Interest, Health context, Exclusions and Models or Theories) to systematically approach identifying relevant models and theories relative to the research aim. Further evidence derived from primary research studies that describe the behavior identified is coded against selected a priori theory to develop the model.
Results
This study presents a novel model for understanding the purchase behavior of CAMs using SMIs as a marketing strategy. The model included two well-known theories (theory of planned behaviour theory and source credibility theory) as well as extensive existing research from a multidisciplinary perspective. The model is exclusively designed to help identify elements affecting perceived source credibility and factors that have an influence over consumers’ preferences to purchase CAMs by taking into consideration SMIs’ endorsements.
Conclusions
This study provides unique insights introducing new research areas to health literature and offers, new roles for healthcare professionals in this digital era by gaining new skills and competencies required to provide more credible and accurate information about CAMs. The study also highlights the new marketing era of online health-related product endorsements and recommends that policymakers and researchers carefully evaluate the impact of SMI’s on the use of CAMs, as well as to regulate the content of these promotional materials.
... A similar range of research concerns was found, such as the content of accreditation standards [309,310], implementing evidence-based national examinations [24,[311][312][313], regulatory strengthening [314,315], and regulating scopes of practice [297,304,[316][317][318][319]. Studies note some of the policy challenges and adjustments required when applying statutory registration to the T&CM occupations, such as evaluating risk, protecting traditional knowledge, applying flexible language requirements, or delivering care to underserved populations [291,297,[316][317][318][320][321][322][323][324][325][326]. ...
Background
Health practitioner regulation (HPR) systems are increasingly recognized as playing an important role in supporting health workforce availability, accessibility, quality, and sustainability, while promoting patient safety. This review aimed to identify evidence on the design, delivery and effectiveness of HPR to inform policy decisions.
Methods
We conducted an integrative analysis of literature published between 2010 and 2021. Fourteen databases were systematically searched, with data extracted and synthesized based on a modified Donabedian framework.
Findings
This large-scale review synthesized evidence from a range of academic (n = 410) and grey literature (n = 426) relevant to HPR. We identified key themes and findings for a series of HPR topics organized according to our structures–processes–outcomes conceptual framework. Governance reforms in HPR are shifting towards multi-profession regulators, enhanced accountability, and risk-based approaches; however, comparisons between HPR models were complicated by a lack of a standardized HPR typology. HPR can support government workforce strategies, despite persisting challenges in cross-border recognition of qualifications and portability of registration. Scope of practice reform adapted to modern health systems can improve access and quality. Alternatives to statutory registration for lower-risk health occupations can improve services and protect the public, while standardized evaluation frameworks can aid regulatory strengthening. Knowledge gaps remain around the outcomes and effectiveness of HPR processes, including continuing professional development models, national licensing examinations, accreditation of health practitioner education programs, mandatory reporting obligations, remediation programs, and statutory registration of traditional and complementary medicine practitioners.
Conclusion
We identified key themes, issues, and evidence gaps valuable for governments, regulators, and health system leaders. We also identified evidence base limitations that warrant caution when interpreting and generalizing the results across jurisdictions and professions. Themes and findings reflect interests and concerns in high-income Anglophone countries where most literature originated. Most studies were descriptive, resulting in a low certainty of evidence. To inform regulatory design and reform, research funders and governments should prioritize evidence on regulatory outcomes, including innovative approaches we identified in our review. Additionally, a systematic approach is needed to track and evaluate the impact of regulatory interventions and innovations on achieving health workforce and health systems goals.
... Currently, there are no standard training requirements for CAM providers working in cancer care and other healthcare settings in the EU. 51 Mackereth et al surveyed CAM providers working in cancer care. The authors highlighted the need for training standardization for providers, where specific training regarding safe practice was considered essential. ...
Introduction:
Although more than 300 000 children and adolescents worldwide are diagnosed with cancer yearly, little research has been conducted investigating how healthcare providers consider risk and patient safety connected with supportive care (including complementary and alternative medicine [CAM]) in this age group. This study aimed to explore how different healthcare providers perceive and evaluate risk when patients combine supportive care and conventional medicine in clinical practice and how they communicate and inform parents about the use of these modalities.
Materials and methods:
In-depth semi-structured interviews were conducted with 22 healthcare providers with expertise in treating pediatric oncology patients from 5 countries. Systematic content analysis was conducted using Nvivo 1.61.
Results:
The analysis resulted in 3 themes and 8 subthemes. Generally, participants were cautious about implementing unproven new modalities or therapies when recommending supporting care modalities to parents of children and adolescents with cancer. The most important criterion when recommending a modality was evidence for safety based on a risk/benefit evaluation. Negative interactions with conventional medicine were avoided by using the half-life of a drug approach (the time it takes for the amount of a drug's active substance in the body to reduce by half). For patients with severe symptoms, less invasive modalities were used (ear seeds instead of ear needling). To enhance safety, participants practiced open and egalitarian communication with parents.
Conclusion:
Healthcare providers reported using a variety of approaches to achieve a safe practice when parents wanted to combine supportive care and conventional cancer treatment. They emphasized that these modalities should be foremost safe and not become an extra burden for the patients. Providers highlighted patient-centered care to meet the individual's specific health needs and desired health outcomes. A lack of national and regional standardized training programs for supportive care in pediatric oncology was considered a hazard to patient safety.
... The WHO has engaged in regular global exercises, the last one published in 2019. 4 Regional efforts, such as reviews performed by the WHO South-East Asia Region, 72 the CAMbrella project in Europe, 53 or a Southern Africa sub-regional study by Abrams et al. 73 have offered useful descriptive overviews. In Latin America, PAHO compiled a legislation and regulation review in the late 1990s, 74 and Lovera in 2014, 75 for selected countries. ...
Introduction: The 1978 Alma Ata Declaration initiated international recognition of non-biomedical healing systems and their relevance for primary health. World Health Assembly (WHA) resolutions have called for the study and inclusion of traditional and complementary medicine (T&CM) into national health systems through policy development. The increased public, political, and scholarly attention given to T&CM has focused on clinical efficacy, cost-effectiveness, mechanisms of action, consumer demand, and supply-side regulation. Although >50% of WHO member states have T&CM policies, scant research has focused on these policies and their public health implications. This paper defines a novel term "therapeutic pluralism," and it aims at characterizing related policies in Latin America. Methods: A qualitative content analysis of Latin American therapeutic pluralism policies was performed. Policies' characteristics and the reported social, political, and economic forces that have made possible their development were assessed. Pre-defined policy features were categorized on an MS-Excel; in-depth text analyses were conducted in NVivo. Analyses followed the steps described by Bengtsson: decontextualization, recontextualization, categorization, and compilation. Results: Seventy-four (74) policy documents from 16 of the 20 sovereign Latin American countries were included. Mechanisms for policy enactment included: Constitution, National Law, National Policy, National Healthcare Model, National Program Guideline, Specific Regulatory Norms, and Supporting Legislation, Policies, and Norms. We propose a four-category typology of policy approaches in Latin America: Health Services-centered, Model of Care-based, Participatory, and Indigenous People-focused. Common themes countries used when justifying developing these policies included: benefits to the health system, legal and political mandates, supply and demand, and culture and identity. Social forces these policies referenced as influencing their development included: pluralism, self-determination and autonomy, anticapitalism and decolonization, safeguarding cultural identity, bridging cultural barriers, and sustainability. Conclusion: Policy approaches to therapeutic pluralism in Latin America go beyond integrating non-biomedical interventions into health services; they offer perspectives for transforming health systems. Characterizing these approaches has implications for policy development, implementation, evaluation, international collaboration, the development of technical cooperation tools and frameworks, and research.
... CAM is defined as a group of diverse medical healthcare system practices and products that are not considered part of conventional medicine [12]. Different countries have different definitions and regulations for CAM [13]. What is considered CAM in one country might not be considered CAM in another country. ...
Background
The aim of this study is to gain insight into the clinical experiences and perceptions that pediatric oncology experts, conventional healthcare providers, and complementary and alternative medicine (CAM) providers in Norway, Canada, Germany, the Netherlands, and the United States have with the use of supportive care, including CAM among children and adolescents with cancer.
Methods
A qualitative study was conducted using semi-structured in-depth interviews (n = 22) with healthcare providers with clinical experience working with CAM and/or other supportive care among children and adolescents with cancer from five different countries. Participants were recruited through professional associations and personal networks. Systematic content analysis was used to delineate the main themes. The analysis resulted in three themes and six subthemes.
Results
Most participants had over 10 years of professional practice. They mostly treated children and adolescents with leukemia who suffered from adverse effects of cancer treatment, such as nausea and poor appetite. Their priorities were to identify the parents' treatment goals and help the children with their daily complaints. Some modalities frequently used were acupuncture, massage, music, and play therapy. Parents received information about supplements and diets in line with their treatment philosophies. They received education from the providers to mitigate symptoms and improve the well-being of the child.
Conclusions
Clinical experiences of pediatric oncology experts, conventional health care providers, and CAM providers give an understanding of how supportive care modalities, including CAM, are perceived in the field and how they can be implemented as adaptational tools to manage adverse effects and to improve the quality of life of children diagnosed with cancer and the families.
