Article

Perceptions and attitudes of rehabilitation medicine physicians on complementary and alternative medicine in Australia

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Abstract

The growing demand for complementary and alternative medicine (CAM) is undeniable. We report a first study about the attitudes and behaviour of Australian rehabilitation physicians to CAM. A prospective cross-sectional survey was undertaken to document the prevalence of, knowledge about and referrals to CAM therapies and their perceived effectiveness, by a sample of Australian rehabilitation physicians. Thirty-six out of 94 actively practising rehabilitation physicians from the Australasian Faculty of Rehabilitation Medicine, the Royal Australasian College of Physicians, replied to the survey, a response rate of 38%, and 85% reported familiarity with CAM, the most familiar therapies being acupuncture (80%), yoga (74%) and Tai-Chi (72%). CAM referral was reported in 84%, 38% personally used CAM, 94% of patients enquired about CAM therapies, 32% of respondents routinely enquired about CAM use. Age, sex and year of Fellowship were not associated with familiarity, personal use or frequency of patient enquiry about CAM. Those who reported to be very familiar with CAM were more likely to routinely enquire about CAM use (P = 0.028) and be more confident in prescribing certain CAM therapies (P < 0.05). Australian rehabilitation physicians report similar CAM referral rates to Canadian physiatrists and Australian general practitioners. The most commonly prescribed therapies were acupuncture, yoga and Tai-Chi. Almost all patients use CAM therapies, but only a minority of rehabilitation physicians enquires about CAM use on a regular basis. The latter may avoid potentially harmful drug interactions, as well as improve the quality of the physician-patient relationship.

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... CAM such as Ayurveda, homeopathy, herbal treatment, meditation and yoga are widely used in chronic illnesses such as diabetes mellitus, hypertension, coronary artery disease, stroke, COPD, asthma, arthritis, gout and other chronic neurological diseases. CAM's utilisation in developed and developing countries has almost doubled in recent years, particularly where long term treatment is required [7]. The utilization rate of CAM in India ranges from 32-63% in chronic medical conditions [8]. ...
... 68% of the physicians who responded to our questionnaire said their patients use CAM therapy for chronic disease. A study done in Australia [7] by JCS Mak reported 85% were familiar with CAM. The commonest therapies were acupuncture (80%), yoga (74%) and Tai-Chi (72%). ...
... A small proportion willingly referred their patients to CAM practitioners, notably Ayurveda and massage. In contrast a study by JCS Mak in Australia reported 84% of physicians referred their patients to CAM therapist, 38% personally used CAM and 94% inquired about CAM therapies [7]. ...
... CAM such as Ayurveda, homeopathy, herbal treatment, meditation and yoga are widely used in chronic illnesses such as diabetes mellitus, hypertension, coronary artery disease, stroke, COPD, asthma, arthritis, gout and other chronic neurological diseases. CAM's utilisation in developed and developing countries has almost doubled in recent years, particularly where long term treatment is required [7]. The utilization rate of CAM in India ranges from 32-63% in chronic medical conditions [8]. ...
... 68% of the physicians who responded to our questionnaire said their patients use CAM therapy for chronic disease. A study done in Australia [7] by JCS Mak reported 85% were familiar with CAM. The commonest therapies were acupuncture (80%), yoga (74%) and Tai-Chi (72%). ...
... A small proportion willingly referred their patients to CAM practitioners, notably Ayurveda and massage. In contrast a study by JCS Mak in Australia reported 84% of physicians referred their patients to CAM therapist, 38% personally used CAM and 94% inquired about CAM therapies [7]. ...
Article
Background: Allopathic physicians are relatively unfamiliar with Complementary and Alternative Medicine (CAM) but they’re in common use. A cross sectional survey was conducted to understand physician’s perception of it. Method: All 385 physicians from St. John’s Medical College & Hospital, Bangalore were approached. Data were collected using anonymised questionnaires on its use, perceptions, recommendation and inclusion in medical curricula. Responses were analysed according to their experience (<5, 5-10 & >10 years) and qualifications (specialists with: MD, MS, MCh, DM, Diploma or GPs with MBBS and Fellowship). Results: Responses were received from 247 (64%) of physicians. 173/38/36 (70/15/15%) had <5/5-10>10 years’ experience, half were specialists, half GPs. Their mean age was 33 years, 114 (46%) were males. 168/169/152/133/91/84 (68/68/53/54/37/34/27%) reported their patients used CAM for chronic diseases/consult their patients about CAM/said their patients informed them about it/considered it may be useful but harmful/that it increases side effects of allopathic medication/ that it worsens the condition. 67 (27%) physicians recommended it. Yoga/meditation, 57/47 (23/19%) were commonest. Most, 97/143/154/98 (39/58/62/40%) disagree with using it when allopathy is ineffective/disagree with including it in medical curricula/disagree on training doctors about it/do not recommend it. Conclusion: CAM is used ubiquitously, especially for chronic diseases. Allopathic doctors need knowledge about them and their appropriate use for better outcomes.
... Other infectious diseases and associated conditions for which CAM and integrative medicine modalities have been used include common cold, recurrent urinary tract infections (UTI), malaria, diarrhea, and HIV/highly active antiretroviral therapy (HAART)associated hypertriglyceridemia [7]. Several studies have assessed how general practitioners and some specialists view CAM and integrative medicine therapies [8][9][10][11][12][13][14][15]. However, there is little data evaluating how infectious diseases (ID) physicians view these modalities. ...
... In addition, greater than 50% of respondents were either very or somewhat likely to recommend acupuncture, mind-body practices, glucosamine +/− chondroitin, and bodywork [10]. In another study of Australian rehabilitation physicians, 80% reported familiarity with acupuncture, 74% with yoga, and 72% with tai chi [13]. ...
... They also demonstrated high rates of recommendation for vitamin/ mineral therapy (80%), yoga (52%), meditation (45%), and massage (62%). Similar to other physicians, ID physicians reported lower familiarity and recommendation rates for energy-based medicine and whole medical systems [10,13,18,19]. ...
Article
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Background. Complementary and alternative medicine (CAM) and integrative medicine (IM) modalities are widely used by patients, including those with infectious diseases (ID). Methods. One thousand randomly selected ID practitioners were surveyed. The survey was divided into domains related to familiarity and recommendation, beliefs and attitudes, and use of CAM/IM modalities. Results. The response rate was 31%. ID physicians were most familiar with vitamin and mineral supplementation (83%), massage (80%), acupuncture (79%), chiropractic (77%), yoga (74%), and herbal medicine (72%). ID physicians most recommended vitamin and mineral supplementation (80%) and massage (62%). Yoga, meditation, and acupuncture were recommended by 52%, 45%, and 46%, respectively. Drug interactions, clinical research, and knowledge of CAM/IM modalities were factors that were considered a major influence. Almost 80% of respondents indicated an interest in IM versus 11% for CAM. Most respondents (75%) felt that IM modalities are useful, and more than 50% believed that they could directly affect the immune system or disease process. Conclusion. ID physicians expressed a markedly greater interest for IM versus CAM. They appear to be familiar and willing to recommend some CAM/IM modalities and see a role for these in the management of certain infectious diseases. Data regarding clinical efficacy and safety appear to be important factors.
... 28 Notwithstanding these attitudes, there has been a gradual shift in awareness and engagement with TCIM among medical practitioners both in Australia and abroad. [29][30][31][32] In general, medical specialists tend to be more receptive to body-work/manual therapies, acupuncture, meditation and movement therapies, perceiving them to be safer and more efficacious than ingestible therapies. 29,30,32,33 The exception appears to be gastroenterologists who also commonly prescribe priobiotics. ...
... [29][30][31][32] In general, medical specialists tend to be more receptive to body-work/manual therapies, acupuncture, meditation and movement therapies, perceiving them to be safer and more efficacious than ingestible therapies. 29,30,32,33 The exception appears to be gastroenterologists who also commonly prescribe priobiotics. 34 The specifics of which TCIM practitioners and therapies the centre should provide was not discussed. ...
... Consistent with previous research, insufficient consultation time, knowledge about TCIM evidence, and identifying suitable TCIM practitioners for referrals, were barriers to IHC. 29,34,35 The potential educational role of an academic IHC centre for the benefit of patients and practitioners alike was, therefore, welcomed. So too was the reassurance that credentialing of practitioners would help address the wide variations in TCIM practitioner education and accreditation. ...
Article
Objectives This qualitative study aimed to explore medical specialists’ perspectives on a proposed academic integrative healthcare (IHC) centre to be established in their local district. Methods A convenience sample of medical specialists were recruited via direct email invitations that was augmented with snowball sampling until data saturation was reached. The in-depth, semi-structured interviews were conducted via telephone, audio recorded and transcribed verbatim, followed by a thematic analysis. Results Eight participants took part in the study. Three main themes emerged: 1) the benefits of an academic setting, 2) sound clinical governance, and 3) specialists in the field of TCIM. Underpinning the three themes was the belief that patients were at risk of harm due to haphazard, unsupervised use of unproven traditional, complementary and integrative medicine (TCIM). It was anticipated that an academic centre would address these issues with appropriate risk management protocols, effective interprofessional communication and by upholding the principles of evidence-based practice to ensure safe and coordinated patient-centered care. Opportunities from collaborations within secondary care included centre being recognized as specialists in the field of TCIM, conducting research and bidirectional learning. Conclusions The findings demonstrated that medical specialists acknowledged the need for a TCIM model of care that interfaces with the local secondary care landscape through the implementation of sound safeguards, credentialed practitioners, and evidence-based practice to adequately protect patients and clinicians. The findings will be amalgamated with the input from other stakeholder groups via a community-based participatory research framework to refine the model of care.
... The implication is that a substantial number of students were seeing both conventional health care providers and Feldenkrais Teachers. This is consistent with other studies that reported health care consumers often combine conventional health care with CAM practices [1,29,[39][40][41]. However, it is not always clear whether conventional health care providers are aware of their patients' use of CAM practices. ...
... A survey of patients with arthritis reported that most used at least 1 type of CAM and a smaller majority had discussed this with their physicians [42]. A study of rehabilitation medicine physicians indicated most had been asked about CAM by their patients and most had spoken against some form of CAM use [40]. Broader surveys reported that less than half of patients who combined CAM and physician visits discussed the CAM visits with their physicians [29]. ...
Article
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Background Feldenkrais Method® teachers help students improve function and quality of life through verbally and manually guided lessons. The reasons people seek Feldenkrais® lessons are poorly understood. Similarly, little is known about practice characteristics and patterns. To address these knowledge gaps, we conducted an extensive survey of United States Guild Certified Feldenkrais Teachers®. Methods We invited all Feldenkrais Teachers to participate in this survey delivered in web-based or print formats. We obtained overall and question-specific response rates, descriptive statistics, chi-square tests of response bias, and performed qualitative thematic review of comments. Results Overall response rate was 30.5% (392/1287). Ninety percent of responders had college degrees in diverse fields; 12.5% had credentials outside health care, 36.9% held conventional health care licenses, and 23.1% had complementary and alternative medicine credentials. Mean age was 55.7 years; most teachers were women (83%). California (n = 100) and New York (n = 34) had the most teachers. Forty-five percent of teachers earned ≤ 20% of their gross income from their practices, while 26% earned > 80%. Most saw < 10 students/week for individual lessons and < 10 students/week for group lessons. Students were mostly women (71.1%) and 45–64 years old. The primary reason students sought Feldenkrais lessons was pain. A quarter of students self-referred, a fifth were referred by conventional health care providers, and two-thirds paid for services directly. Themes from comments included: beliefs that Feldenkrais training had important personal and professional benefits for teachers; recognition of the challenges of operating small businesses and succinctly describing the Feldenkrais Method; the variety of practice approaches; and a deep commitment to the Feldenkrais Method. Conclusions Most Feldenkrais Teachers were well educated, often held additional credentials, were located in the West, were women, were older than 50 years, and had part-time practices. Most students were women, were adults, came from various referral sources, and paid directly for services. Teachers and students utilized the Feldenkrais Method in diverse settings and applications. These findings may foster practice development by Feldenkrais Teachers, improve communication between health care consumers and providers and assist decision-making, and stimulate more research concerning the Feldenkrais Method.
... In a limited way they also knew the methods of reflexology (10.1%), massage (9.1%), and prayer (5.6%) very well, but they had never heard of chiropractic methods (58.8%), Tai-Chi (21.9 %), and magnetic-based therapies (40.8%) (Yom & Lee, 2008). Mak et al., (2009) International Journal of Caring Sciences September-December 2014 Volume 7 Issue 3 917 www.internationaljournalofcaringsciences.org study conducted in Australia with physicians working with rehabilitation, acupuncture (80%), yoga (74%), and Tai-Chi (72%) found that they were most familiar with these methods of CAT. ...
... Several studies have noted that women are more interested in CAT methods and our study confirmed this finding. Some studies have reported that physicians have used CAT methods for their own health care and treatment (Ko & Berbrayer, 2000;Ozcakir et al., 2007;Mak et al., 2009;DeKeyser & Cohen, 2001;Sikand, 1998;Winslow & Shapiro 2002;Burke et al., 2005;Flannery, et al., 2006;Ben-Arye et al., 2008). In our study, CAT usage among physicians was lower than in other studies. ...
Article
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Objectives: To determine the knowledge and views of the physicians and nurses related to the complementary and alternative therapies (CAT) in a training medical center. Design: This descriptive analytical study was carry out through interviews using a questionnaire that prepared by the compilation from the literature for data collection. Using a simple random sampling method the total sample consisted of 289 individuals (126 nurses and 163 physicians). Setting: In and outpatient units of Gulhane Military Medical Faculty (GMMF) Training Hospital, Ankara, Turkey. Main outcome measures: We measured nurses and physicians' knowledge of, their experience with, their views towards and utilization of CAT. Results: This study included 126 female nurses and 163 physicians (92% male). The majority of nurses (97.6%) and physicians (95.7%) reported that they had not received any training about CAT. It was identified that 50% of the nurses and 27% of the physicians had previously used CAT for themselves (p<0.05). Results of our study identified that the nurses and the physicians mostly responded with "have no idea" to the questions about the effect, reliability and usage of CAT methods, and there were no statistically significant differences. Conclusions: Results of our study showed that the nurses and the physicians working at a medical centre in Turkey had only limited knowledge about CAT but had positive attitudes about their wish to make use of CAT methods.
... In a limited way they also knew the methods of reflexology (10.1%), massage (9.1%), and prayer (5.6%) very well, but they had never heard of chiropractic methods (58.8%), Tai-Chi (21.9 %), and magnetic-based therapies (40.8%) (Yom & Lee, 2008). Mak et al., (2009) International Journal of Caring Sciences September-December 2014 Volume 7 Issue 3 917 www.internationaljournalofcaringsciences.org study conducted in Australia with physicians working with rehabilitation, acupuncture (80%), yoga (74%), and Tai-Chi (72%) found that they were most familiar with these methods of CAT. ...
... Several studies have noted that women are more interested in CAT methods and our study confirmed this finding. Some studies have reported that physicians have used CAT methods for their own health care and treatment (Ko & Berbrayer, 2000;Ozcakir et al., 2007;Mak et al., 2009;DeKeyser & Cohen, 2001;Sikand, 1998;Winslow & Shapiro 2002;Burke et al., 2005;Flannery, et al., 2006;Ben-Arye et al., 2008). In our study, CAT usage among physicians was lower than in other studies. ...
Article
Full-text available
Objectives: To determine the knowledge and views of the physicians and nurses related to the complementary and alternative therapies (CAT) in a training medical center. Design: This descriptive analytical study was carry out through interviews using a questionnaire that prepared by the compilation from the literature for data collection. Using a simple random sampling method the total sample consisted of 289 individuals (126 nurses and 163 physicians). Setting: In and outpatient units of Gulhane Military Medical Faculty (GMMF) Training Hospital, Ankara, Turkey. Main outcome measures: We measured nurses and physicians' knowledge of, their experience with, their views towards and utilization of CAT. Results: This study included 126 female nurses and 163 physicians (92% male). The majority of nurses (97.6%) and physicians (95.7%) reported that they had not received any training about CAT. It was identified that 50% of the nurses and 27% of the physicians had previously used CAT for themselves (p<0.05). Results of our study identified that the nurses and the physicians mostly responded with " have no idea " to the questions about the effect, reliability and usage of CAT methods, and there were no statistically significant differences. Conclusions: Results of our study showed that the nurses and the physicians working at a medical centre in Turkey had only limited knowledge about CAT but had positive attitudes about their wish to make use of CAT methods.
... This finding is surprising in view of the long, nationally-based, cultural and historical CAM traditions in Asia, and since the prevalence of CAM use among tumour patients in this study was over 80 % [22]. In Australia, doctors working in the field of oncology rehabilitation refer 84 % of patients for CAM [23]. The requirement is therefore understandable that oncologists should be aware of potential interactions between standard prescribed treatment regimes and the CAM products patients use independently [14]. ...
... In the field of rehabilitative medicine, which is often the point of initial follow-on treatment for oncology patients, the prescription of certain CAM methods is also common. The Australian study by Mak et al. lists acupuncture (80%), yoga (70%) and Tai Chi (72 %) as the most common [15,23]. Fasching et al. report that in Germany 50% of breast cancer patients and 44% of patients with gynaecological tumours in general use CAM. ...
Article
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In recent years complementary and alternative medicine (CAM) has increasingly been the focus of international research. Numerous subsidised trials (7903) and systematic reviews (651) have been published, and the evidence is starting to be integrated into treatment guidelines. However, due to insufficient evidence and/or insufficient good quality evidence, this has mostly not translated to practice recommendations in reviews by the Cochrane collaboration gynaecology group. There is nevertheless a not insignificant number of CAM providers and users. The percentage of oncology patients who use CAM varies between 5 and 90 %. Doctors have been identified as the main providers of CAM. Half of gynaecologists offer CAM because of personal conviction or on suggestion from colleagues. This must be viewed in a critical light, since CAM is mostly practiced without appropriate training, often without sufficient evidence for a given method - and where evidence exists, practice guidelines are lacking - and lack of safety or efficacy testing. The combination of patient demand and lucrativeness for doctors/alternative medicine practitioners, both based on supposed effectiveness CAM, often leads to its indiscriminate use with uncertain outcomes and significant cost for patients. On the other hand there is published, positive level I evidence for a number of CAM treatment forms. The aim of this article is therefore to review the available evidence for CAM in gynaecological oncology practice. The continued need for research is highlighted, as is the need to integrate practices supported by good evidence into conventional gynaecological oncology.
... Increasingly medical practitioners are prescribing or recommending CM. 4,26 An estimated 30-40% of Australian general practitioners (GP) integrate CM into their clinical practice and over 75% refer their patients for such therapies. 4,27 Based on the opinions of surveyed GP, CM effectiveness can be grouped into (i) non-medicinal or non-manipulative therapies, such as acupuncture, massage, meditation, yoga and hypnosis, which most GP considered to be highly effective and safe; (ii) medicinal or manipulative therapies, such as herbal medicine, nutritional therapies, homoeopathy, Chinese medicine, naturopathy, chiropractic and osteopathy, which more GP considered potentially harmful than potentially effective; and (iii) esoteric therapies, such as spiritual healing, aromatherapy and reflexology, which were seen to be relatively safe yet also relatively ineffective. ...
... The perceived risks of CM according to the surveyed GP were seen to arise from incorrect, inadequate or delayed diagnoses and interactions between complementary medications and pharmaceuticals, rather than the specific risks of the therapies themselves. 27 A survey of Australian rehabilitation physicians found similar results to the GP survey regarding perceived effectiveness and safety of various types of CM. 26 Other recent surveys of medical practitioners outside of Australia include surveys of different types of doctors in Germany, 28 paediatricians in the Netherlands, 29 GP in North West England 30 and gastroenterologists in the United States. 31 These surveys found that a significant proportion of medical practitioners consider there is a role for CM in their clinical practice, and many prescribe CM or refer patients for a limited range of CM interventions. ...
... 246 Todos los métodos y técnicas empleadas, así como, las terapias de apoyo ocupan un lugar cada día más importante en el arsenal terapéutico de destacadas instituciones de países desarrollados 3,4 . ...
... La localización precisa de los puntos de correspondencia y su debida estimulación condicionan la exitosa curación. Deben presionarse los puntos de dos a tres minutos como mínimo tres veces al día 3 . También mediante el uso de semillas (chícharo, lenteja,arroz). ...
Article
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El manual para el tratamiento de la Estrategia Curricular de Medicina Tradicional y Natural en la Especialidad de Coloproctología, en el tema de las enfermedades anorrectales benignas, muestra las afecciones más comunes en la Consulta de Coloproctología que se encuentran en el programa de estudio de la asignatura de Cirugía General de cuarto año de la carrera de medicina, enfermedades que requieren de un diagnóstico precoz, oportuno y adecuado tratamiento. La medicina tradicional y natural ayuda al alivio de los síntomas de estas dolencias que aquejan a estos pacientes atendidos en la atención primaria de salud y que puedan remitirse al Servicio de Coloproctología con un mejor estado de salud. La aplicación de la fitoterapia, digitopuntura, homeopatía, terapia floral, auriculoterapia y microsistema de mano fueron aspectos tratados en este manual con el fin de lograr una formación integral del futuro médico que necesita el mundo actual. Palabras clave: fitoterapia, digitopuntura, homeopatía, terapia floral, auriculoterapia, microsistema.
... CAM has been defined above as a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine. 1 Twelve (12) common types of CAM were assessed based on previous surveys on CAM use, 7 and patients were given the opportunity to list others that were used but not on the survey. While the standard CAM definition has been widely used, it is potentially too liberal in what it includes. ...
Article
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Complementary and alternative medicine (CAM) therapies have become increasingly popular and are used regularly by patients with osteoporosis in Australasia and worldwide. This study was done to determine the prevalence and patterns of use of CAM in an Australian osteoporosis clinic. This was a prospective, cross-sectional questionnaire-based study of 202 patients attending an academic osteoporosis clinic in Sydney, Australia. Subject had a mean age of 68.5 +/- 10.9 years, 79.7% were female, and 55.9% were born overseas. CAM use was reported by 104 patients (51.5%) using the standard and 62 patients (30.7%) using the stringent definition of CAM. The most frequent CAM were multivitamins (24.0%), acupuncture (19.2%), t'ai chi (14.4%), and yoga (12.5%). Seventy-three percent (73%) did not consult a physician before starting CAM and 23.1% stated that their treating specialists were unaware of CAM use. The most common reasons for using CAM were having a holistic approach (53.0%) and inadequate pain control (29.0%). CAM users were associated with Asian country of birth (23.1% versus 12.2%, p = 0.03), more frequent clinic visits over a 12-month period (1.8 versus 1.5 times, p = 0.03), and a trend for a worse lumbar spine T-score (-2.35 versus -2.20 SD, p = 0.05) and higher rates of university education (26.0% versus 14.3%, p = 0.05). It is estimated that $696 million is spent annually on CAM by patients with osteoporosis. Patients attending osteoporosis clinics frequently use CAM. Physicians may need to routinely inquire about a history of CAM use to ensure better screening for possible adverse clinical interactions.
... From the provider's side, female physicians (Corbin Winslow and Shapiro 2002), those who are younger in the profession (Sleath et al. 200 I), and those who have had more training about CAM (Staples et al. 2007) tend to recommend CAM more. Providers who use CAM themselves also recommend CAM more (Corbin Winslow and Shapiro 2002;Mak et al. 2009). Physicians report that they are more likely to recommend CAM if it is available at their current clinic (Wahner-Roedler et al. 2006) and ifthere is more evidence-based research about CAM (Janamian et al. 2011). ...
Chapter
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In this publication, Evelyn Ho (first author) and I outline the history and development of communication between providers and patients about Complementary and Alternative Medicine (CAM) and critique current research in light of recent contributions of discourse analysis to studying this important area of research.
... An Australian based article reported on the first study about the attitudes and behavior of Australian rehabilitation physicians to complementary and alternative medicine (CAM). The article reported knowledge about and referrals to CAM therapies and their perceived effectiveness, with yoga among the most commonly prescribed therapies [6]. ...
Article
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Mind-body interventions, such as yoga, that teach stress management with physical activity may be well suited for investigation in both osteoarthritis and rheumatoid arthritis.In order to be considered as viable care options integrative studies need to offer a comprehensive design and include clinicians familiar with the disease process of the study populations.A review of the literature reveals a dearth of information related to the collaboration between yoga and physical rehabilitation medicine.This article discusses the collaboration with physical rehabilitation medicine to collect relevant pre- and post-intervention measures for an on-going pilot acceptability/feasibility yoga study for minority patients with osteoarthritis or rheumatoid arthritis. An interdisciplinary clinical research team selected psychosocial and physical measures for a community sample of bilingual minority patients, not typically identified as practicing yoga. Sixteen female adults aged 40-63 years (mean =51) completed baseline physical assessments using single leg stance, functional reach test, time up and go test, timed up from the floor test and the Disabilities of the Arm, Shoulder and Hand measures.Baseline values show an average level of functional ability prior to beginning the intervention.Preliminary results indicate some improvement; however, selected measures may not have the sensitivity and specificity needed to identify significant change.In this study, combining interdisciplinary perspectives enhanced the quality of the research study design.The experience of this interdisciplinary clinical research team opens the discussion for future collaborations.
... Focusing on the use of Chinese traditional medicine by PRM specialists, and even more at the European level, only a German study 14 from 1980 could be found in the literature. In order to find some studies of reference, it is necessary to focus on USA, Canada, Australia or China where the studies carried out by Shiflett, 15 Braverman, 16 Mak et al 17 The main limitation of the present study was the simple size. Since the time that the questionnaire was available, despite of having distributed the questionnaire via the PRM associations at the regional, national and international level, the degree of participation was low. ...
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Objetive: To know the prevalence of acupuncturists within physical and rehabilitation medicine specialists in Europe and their characteristics, as well as to analyze the pathologies treated and therapeutic techniques used. Methods: This is a cross-sectional descriptive study based on a structured and closed questionnaire. The study was carried out from October 2011 to May 2014. Results: A total of 115 specialists from 19 countries completed the questionnaire. The mean characteristics of the physical and rehabilitation medicine (PRM) specialists who are also acupuncturists in Europe were: women (62.6 %); mean age of 47.91 years old; 4.20 years of physical and rehabilitation medicine school and 2.00 years of acupuncture training; 15.03 years of mean time of clinical practice as physical and rehabilitation medicine specialists and 10.42 years of experience as acupuncturists; 35.65 % had a doctorate (PhD) degree, obtained at a mean age of 33.55 years old; working in a public hospital (80%); treating mainly neurological conditions (48.1% ) and using mainly techniques such as kinesiotherapy (11.81%), orthosis (10.40%) and electrotherapy (9.92%). Acupuncture was applied by 32.2% of the participants mainly in musculoskeletal conditions (27.38%). A mean number of more than 20 patients a day were treated by 47.04% of the specialists, being 41.8% of the patients (adults and children). Significant differences were found between the variables, acupuncture and gender (Pearson's correlation Index = 0.007). However, no differences were observed in relation to acupuncture and age, doctorate degree, years of clinical practice and workplace (all with P values > 0.05). Conclusion: In the European area, physical and rehabilitation medicine specialists who are also acupuncturists are mainly female, middle-aged, with 15 years of professional experience, PhD holders, working in public hospitals, treating mainly neurological conditions with kinesiotherapy and acupuncture, and treating over 20 patients a day (adults and children) during a 7 h shift. Further epidemiological studies on PRM to provide more information regarding the real situation of this medical specialty and the possibility to open to Chinese traditional medicine techniques such as acupuncture are necessary.
... CAM's utilisation in developed and developing countries has almost doubled in recent years, particularly where long term treatment is required [6]. The utilization rate of CAM in India ranges from 32-63% in chronic medical conditions [7]. ...
Article
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Background: Complementary and alternative medicine (CAM) has been practised in India since many years. People unsatisfied with conventional medicine often turn to unconventional alternatives. Aim is to appraise the extent of use of CAM amongst doctors and to examine their perception, attitude and practice towards CAM. Methods: This study was conducted among 105 doctors. A predesigned validated, questionnaire was used to evaluate the attitude and practice. Of 150 physicians who were given questionnaire to participate in the survey, 105 (70%) responded. Results: 22 (20.95%) were specialists and 83 (79.04%) General physicians. 79 (75.23%) Physician's considered that CAM has a beneficial role and 69 (65.71%) advised use of CAM in patients but only 25.71% would refer patients to CAM practitioners for treatment of an ailment. Of the total 105 physicians 31.42%. General practitioners suggested Ayurveda therapy as compared to 10.47% specialists. 36% of the patients preferred Ayurveda as opined by the physician. Homeopathy was recommended by 35% followed by herbal medicine 32% and 30% naturopathy. However, physicians' responses on most of the CAM therapies i.e. Ayurveda, homeopathy, naturopathy, herbal medicine etc. was found to be statistically not significant. Conclusions: In the future, physicians can more readily used CAM. Because evidence for the effectiveness of CAM remains sparse, more research is needed for the prudent use of CAM. An education and training system for potential CAM providers remains to be developed.
... This difference may be due to the reduction in the use of acupuncture in the academic hospitals [13] as well as personal use. Nearly two-thirds of the rehabilitation physicians advised against the use of CAM as a therapeutic option [14]. The lowest prevalence of acceptance and usage of CAM was observed in Surgery. ...
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Background Complementary and Alternative Medicine (CAM) has gained popularity among the general population but its acceptance and use among medical specialists have been inconclusive.Methods We conducted a systematic literature search in PubMed and Scopus databases for the acceptance and use of CAM among medical specialists. Each article was assessed by two screeners. Only survey studies relevant to the acceptance and use of CAM among medical specialists were reviewed. The pooled prevalence estimates were calculated using random-effects meta-analyses.ResultsOf 5,628 articles published between 2002 and 2017, 25 fulfilled the selection criteria. Ten medical specialties were included: Internal Medicine (11 studies), Pediatrics (6 studies), Obstetrics and Gynecology (6 studies), Anesthesiology (4 studies), Surgery (3 studies), Family Medicine (3 studies), Physical Medicine and Rehabilitation (3 studies), Psychiatry and Neurology (2 studies), Otolaryngology (1 study), and Neurological Surgery (1 study). The overall acceptance of CAM was 52% (95%CI: 42-62%). Family Medicine reported the highest acceptance (67%; 95%CI: 60-73%), followed by Psychiatry and Neurology (64%; 95%CI: 35-85%), Neurological Surgery (63%; 95%CI: 43-79%), Obstetrics and Gynecology (62%; 95%CI: 36-82%), Pediatrics (60%; 95%CI: 41-77%), Anesthesiology (52%; 95%CI: 45-58%), Physical Medicine and Rehabilitation (51%; 95%CI: 42-61%), Internal Medicine (41%; 95%CI: 39-43%), and Surgery (26%; 95%CI: 22-30%). The overall use of CAM was 45% (95% CI: 37-54%). The highest use of CAM was by the Obstetrics and Gynecology (68%; 95%CI: 63-73%), followed by Family Medicine (63%; 95%CI: 58-68%), Psychiatry and Neurology (55%; 95%CI: 35-73%), Pediatrics (44%; 95%CI: 42-46%), Otolaryngology (43%; 95%CI: 30-57%), Anesthesiology (42%; 95%CI: 37-47%), Internal Medicine (38%; 95%CI: 36-41%), Physical Medicine and Rehabilitation (32%; 95%CI: 24-41%), and Surgery (25%; 95%CI: 22-29%). Based on the studies, meta-regression showed no statistically significant difference across geographic regions, economic levels of the country, or sampling methods.Conclusion Acceptance and use of CAM were moderate and varied across medical specialists.Systematic review registrationThis systematic review has been registered in PROSPERO (CRD42019125628) and the protocol can be accessed at http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42019125628.
... This difference may be due to the reduction in the use of acupuncture in the academic hospitals [7] as well as personal use. Nearly two thirds of the rehabilitation physicians advised against the use of CAM as a therapeutic option [41]. The lowest prevalence of acceptance and usage of CAM was observed in Surgery. ...
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Background Complementary and Alternative Medicine (CAM) has gained popularity among the general population, but its acceptance and use among medical specialists have been inconclusive. This systematic review aimed to identify relevant studies and synthesize survey data on the acceptance and use of CAM among medical specialists. Methods We conducted a systematic literature search in PubMed and Scopus databases for the acceptance and use of CAM among medical specialists. Each article was assessed by two screeners. Only survey studies relevant to the acceptance and use of CAM among medical specialists were reviewed. The pooled prevalence estimates were calculated using random-effects meta-analyses. This review followed both PRISMA and SWiM guidelines. Results Of 5628 articles published between 2002 and 2017, 25 fulfilled the selection criteria. Ten medical specialties were included: Internal Medicine (11 studies), Pediatrics (6 studies), Obstetrics and Gynecology (6 studies), Anesthesiology (4 studies), Surgery (3 studies), Family Medicine (3 studies), Physical Medicine and Rehabilitation (3 studies), Psychiatry and Neurology (2 studies), Otolaryngology (1 study), and Neurological Surgery (1 study). The overall acceptance of CAM was 52% (95%CI, 42–62%). Family Medicine reported the highest acceptance, followed by Psychiatry and Neurology, Neurological Surgery, Obstetrics and Gynecology, Pediatrics, Anesthesiology, Physical Medicine and Rehabilitation, Internal Medicine, and Surgery. The overall use of CAM was 45% (95% CI, 37–54%). The highest use of CAM was by the Obstetrics and Gynecology, followed by Family Medicine, Psychiatry and Neurology, Pediatrics, Otolaryngology, Anesthesiology, Internal Medicine, Physical Medicine and Rehabilitation, and Surgery. Based on the studies, meta-regression showed no statistically significant difference across geographic regions, economic levels of the country, or sampling methods. Conclusion Acceptance and use of CAM varied across medical specialists. CAM was accepted and used the most by Family Medicine but the least by Surgery. Findings from this systematic review could be useful for strategic harmonization of CAM and conventional medicine practice. Systematic review registration PROSPERO CRD42019125628 Graphical abstract
... 11Çalışmamızda benzer şekilde hekimler GETAT uygulamaları hakkında kısmen bilgi sahibi olduklarını ya da hiç bilgi sahibi olmadıklarını düşünmektedir.Mak ve ark.'nın Avusturalya'da hekimlerle yürüttüğü bir çalışmada katılımcılar en sık akupunktura aşina olduklarını belirtmektedir.12 Kanada'da Verhoef ve ark.'nın yaptığı bir çalışmada hekimlerin en sık kayropraktik hakkında bilgisi olduğu görülmektedir.13 ...
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Amaç: Son yıllarda Geleneksel ve Tamamlayıcı Tıp (GETAT) uygulamalarına ilgi tüm dünyada ve ülkemizde artış göstermektedir. Bu çalışmada Samsun ilindeki aile hekimlerinin GETAT ile ilgili bilgi düzeylerini ve tutumlarını araştırmak amaçlanmıştır. Materyal ve Metot: Tanımlayıcı, kesitsel türde tasarlanan bu çalışmaya Ocak 2021- Mart 2021 tarihleri arasındaki 3 aylık süre içerisinde, Samsun İl Sağlık Müdürlüğü’ne bağlı aile sağlığı merkezinde çalışan hekimler katılmıştır. Hekimlere literatürden faydalanılarak hazırlanan GETAT ile ilgili bilgi düzeyi ve tutumlarını içeren bir veri toplama formu uygulanmıştır. İstatistiksel analizler SPSS 17.0 paket programı yardımıyla gerçekleştirilmiştir. Bulgular: Toplamda 213 hekim katılmıştır, yaş ortalaması 45,54±7,68’dir. Hekimlerin en sık duyum ya da bilgisi olduğu uygulama hipnozdur (%89,67). Kendilerine en sık kupa terapisi yaptırdıkları görülmüştür (%8,92). Hekimler hastalarına en sık ozon terapisi tavsiye etmektedir (%27,23). Hastalarına uyguladıkları ve sertifikasyona sahip oldukları en sık uygulama ise kupa terapisidir (sırasıyla %2,35, %1,41). GETAT uygulamalarının faydalı olduğunu ve klasik tıp ile tamamlayıcı tıbbın bir bütünün parçaları olduğunu düşünenler çoğunluktadır. Hekimler GETAT ile ilgili bilgileri %77 oranında sosyal çevre ve medyadan öğrendiklerini belirtmiştir. Sonuç: Birinci basamak hekimlerinin GETAT hakkındaki bilgi düzeyinin yeterli olmadığı görülmektedir. Kanıta dayalı bilimsel çalışmaların artırılmasıyla GETAT bilinirliği ve doğru kullanımı da yaygınlaşacaktır.
... Fang et al. [2] recently described a protocol to gather data on the simultaneous use of acupuncture and phytotherapy. The perceptions and attitudes of conventional rehabilitation doctors towards the use of complementary and alternative medicine (CAM) have also been investigated [11,12]. As there is an ever-increasing patient demand for CAM therapies, it is necessary for doctors to be informed about their use. ...
... For instance, the presentation of a non-Hispanic White welleducated female patient who suffers from joint pain, and lives on the west coast of the United States, should prompt a PM&R provider to enquire about the patient's use of nonmainstream modalities for arthritis. Based on the surveys conducted in Canada and Australia, 33,45 although rehabilitation physicians or physiatrists appear to be more supportive of CAM than their general practitioner colleagues, few rehabilitation physicians enquire about CAM use on a regular basis. Routinely asking patients about the use of CAM for the management of their conditions, particularly those with a higher likelihood of doing so, may assist PM&R providers in making appropriate decisions about patient care. ...
Article
Background The use of complementary and alternative medicine (CAM) therapies have been reported for the management of arthritis. However, little is known about CAM use among adults with self‐reported doctor‐diagnosed (SRDD) arthritis since 2012. Objectives: To determine: 1) the prevalence and type of CAM use, 2) the difference in characteristics between CAM users and non‐CAM users, and 3) the factors related to CAM use, among US adults with SRDD arthritis. Design Secondary analysis of the 2012 National Interview Health Survey (NHIS) data. Setting The NHIS is a cross‐sectional survey that gathers health‐related data on the civilian, non‐institutionalized U.S. population. Participants The NHIS 2012 uses a complex, multi‐stage sampling design and oversamples minorities to achieve population representation, and included 34,525 adults, with 7,179 adults having SRDD arthritis. Methods Data were analyzed using Stata 15.1 survey syntax. The potential factors related to CAM use included socio‐demographics and health related characteristics. Main Outcome Measurements CAM modalities were categorized into six groups: natural products, manipulative therapies, mind‐body therapies, special diets, movement therapies, and other practitioner‐based CAM modalities. Results Of the adults with SRDD arthritis, 2,428 (weighted estimate of 36.2% of US adult population) had used CAM within the last year. Adults with SRDD arthritis reported greater use of CAM than those without, particularly the use of natural products, manipulative therapies and other practitioner‐based CAM modalities. Factors associated with higher CAM use included being female, residing in regions other than the U.S. South, having a college degree or higher, reporting very good/excellent self‐rated health status and having current symptoms of joint stiffness/pain. Conclusion As more than one‐third of US adults with SRDD arthritis seek CAM therapies, open and non‐judgmental conversations between conventional medicine providers, CAM providers and patients should be encouraged to ensure patient health care needs are being met. This article is protected by copyright. All rights reserved.
... A high uptake of CAM among New Zealand healthcare professionals was identified by this review. The estimates of CAM practice and referral rates are comparable to those oversea figures: 20.6% of United Kingdom (UK) physicians used CAM [37] and 84% of Australian rehabilitation physicians referred patients to CAM practitioners [38]. The overall positive attitude of CAM among New Zealand healthcare professionals is similar to those seen in as surveys of physicians in the UK [39,40], with many healthcare professionals considering CAM as natural and effective, and regard the use of CAM as a complement to conventional therapy. ...
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Background: The prevalence of CAM use is increasing. This integrative review investigated New Zealand healthcare professionals' practice of, attitudes toward, and knowledge about complementary and alternative medicine (CAM). Methods: Literature search was conducted in four databases from inception to April 2020. Studies were included if they reported results from primary data collection on practice of, attitudes toward, or knowledge about CAM amongst New Zealand healthcare professionals. Results: Eleven studies (two of 'high-quality', seven of 'moderate-quality', and two of 'low-quality') were identified with 2060 healthcare professionals including general practitioners (GPs), nurses, midwives, pharmacists, physiotherapists, and medical specialists. New Zealand healthcare professionals were generally positive regarding CAM use, but have concerns on the scientific evidence, regulation, safety, financial costs of CAM, and encourage an evidence-based CAM practice and stronger CAM regulation. Findings indicated that around 25% of GPs practise CAM, and 82.3% refer patients to CAM practitioners. When treating pregnant women, 48.4% of physiotherapists practise acupuncture, and 37.3% of midwives recommend CAM. GPs believe that acupuncture is the most helpful CAM modality, and most commonly practiced and referred patients to acupuncture. Up to 58% of GPs and Plunket nurses wanted to receive further education on CAM, and up to 66.7% GPs favour the idea CAM should be included in medical curriculums. Conclusions: Nine of the 11 included studies were of moderate to high quality, thus enhancing the reliability of the review findings. In order to better manage CAM in New Zealand New Zealand clinical settings, there is a need to invest in CAM research and education, and enhance CAM regulation. This review is a first step in developing an evidence base to offer insights for further development of effective CAM policies regarding safety, efficacy, regulation and integration in New Zealand.
Article
Background: Complementary and alternative medicine (CAM) use amongst Americans is increasingly widespread. Recent data shows that 33% of Americans have used CAM therapy in the past 12 months. The prevalence of CAM use highlights the need for pharmacists and health care providers and their respective students to be knowledgeable regarding these therapies. Objective In order to assess attitudes and perceptions of health professional faculty regarding CAM modalities, an on-line survey was developed and distributed by e-mail in 2010 to targeted participants. This study aimed to: (1) describe attitudes and perceptions of faculty regarding CAM use, and (2) assess changes in these markers since the initial 2002 survey. Design A Qualtrics® anonymous survey link was sent to health sciences faculty listservs in 2002 and 2010. Survey questions assessed frequency of subject CAM self-use, referral frequency and CAM modalities that they felt were essential for health care education today. Results Faculty had significant increase in self-use of CAM and increased likelihood to refer for most CAM modalities (mind–body interventions (17% vs. 41%), p < 0.00, biologically based (17% vs. 42%), p < 0.001, manipulative and body-based methods (28% vs. 41%), p = 0.002, and energy therapies (4% vs. 9%), p = 0.03). They also considered teaching about mind–body, biologically based, and manipulative and body-based modalities an essential component of curricula. Future implications Survey data will inform research, education, and practice gaps, and be utilized to educate health professionals about CAM resources in patient care, research, and to develop didactic and experiential teaching.
Thesis
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International and national use of complementary and alternative medicine (CAM) is high in the general population and among patients. The level of knowledge about CAM among health care professions is low, but an interest in receiving education about this field has been observed. Concerning surgical care, previous studies indicate a wide range of CAM use among patients, but the level of knowledge among health care professions is poorly investigated, both internationally and in Sweden. Concerning CAM therapies in the management of signs and symptoms in surgical care, transcutaneous electric nerve stimulation (TENS) was used with a variety of effectiveness and osteopathic medicine was found to be poorly investigated in this context. The overall objective of this thesis was to investigate CAM in the surgical context with a focus on health care professions’ perceptions and understanding and the usefulness of therapy in symptom management in clinical settings. Both inductive (paper I; semi structured interviews, n=16) and deductive (paper II; questionnaire, n=737) methods were used to investigate perceptions and understanding of CAM among Swedish health care professions in surgical care. TENS as a pain relieving complement during the transition from epidural analgesia (EDA) to general analgesia after major abdominal surgery was investigated in a randomized controlled trial design (paper III; n=20). Osteopathic intervention in management of chronic signs and symptoms after thoracotomy was investigated with a single-subject research design (paper IV; n=8). The results reveal that surgical health care professions understand and perceive CAM as a wide range of therapies, remedies and systems. Their self valued level of knowledge was low, both concerning CAM and CAM research, but a desire was found to gain knowledge about CAM. A majority of the participants would consider learning a CAM therapy. Dialog about and referral to CAM occurred, but to a limited extent. Concerning therapy usability, TENS was not found to significantly relieve pain, promote recovery or reduce consumption of analgesics. In addition, comments from nurses and patients indicated that TENS treatment obstructed postoperative care. A significant improvement was observed in the osteopathic intervention in stiffness and benefits for pain, but not in breathing. The comprehensive conclusion of the thesis is that Swedish health care professions recognise the concept of CAM and some of its therapies, but their knowledge is in general low. Concerning therapy usability and the effectiveness of CAM in surgical care, the context is essential; TENS after major abdominal surgery in EDA elimination is questionable as concerns pain and its clinical application, while osteopathy may be beneficial in the management of chronic signs and symptoms after thoracotomy.
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One of the objectives of the Professional Practice Committee (PPC) of the Physical and Rehabilitation Medicine (PRM) Section of the Union of European Medical Specialists (UEMS) is the development of the field of competence of PRM physicians in Europe. To achieve this objective, UEMS PRM Section PPC has adopted a systematic action plan of preparing a series of papers describing the role of PRM physicians in a number of disabling health conditions, based on the evidence of effectiveness of the physical and rehabilitation medicine interventions. Inflammatory arthritis is a major cause of disability with an important economic burden in society. The goals in the management of inflammatory arthritis are to control pain and disease activity, prevent joint damage, protect and enhance function and improve quality of life. This paper aims to define the role of PRM physicians in people with inflammatory arthritis. PRM interventions imply non-pharmacological treatments which include patient education for joint protection, energy conservation and self-management techniques, exercise therapy, physical modalities, orthoses/assistive devices and balneotherapy. Therapeutic patient education and exercises are the cornerstones of therapy with strong evidence of their effectiveness to improve function. Physical modalities are primarily used to decrease pain and stiffness whereas orthoses/assistive devices are usually prescribed to enhance activities and participation. PRM physicians have distinct roles in the management of people with inflammatory arthritis such that they effectively organise and supervise the PRM program in the context of interdisciplinary team work. Their role starts with a comprehensive assessment of patient's functioning based on the International Classification of Functioning Disability and Health (ICF) as the framework. In the light of this assessment, appropriate PRM interventions individualised for the patient are administered. Future research and actions regarding the role of PRM in inflammatory arthritis should target access to care, updates on the use and effectiveness of physical modalities, orthoses/assistive devices, and standardization of therapeutic patient education programs.
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One of the objectives of the Professional Practice Committee (PPC) of the Physical and Rehabilitation Medicine (PRM) Section of the Union of European Medical Specialists (UEMS) is the development of the field of competence of PRM physicians in Europe. To achieve this objective, UEMS PRM Section PPC has adopted a systematic action plan of preparing a series of papers describing the role of PRM physicians in a number of disabling health conditions, based on the evidence of effectiveness of the PRM interventions. Osteoarthritis (OA) is the most common joint disorder and the major cause of musculoskeletal pain and limited mobility in the elderly in the world. Therefore, proper management of persons with OA is of substantial importance. The goal of OA management is to reduce the impact of OA on the individual by reducing pain and improving function, activities and participation. The aim of this paper is to descibe the explicit role of PRM physicians in providing management for persons with OA. The optimal management of OA requires the combination of both non-pharmacological and pharmacological approaches, an issue most of the main guidelines on the evidence-based management of OA share in common. There is good level of evidence about the effectiveness of PRM interventions in the management of OA: high level of evidence about the effect of education, weight reduction and exercise and growing evidence about the effectiveness of physical agent modalities. PRM specialists are involved not only in diagnosis and medical and physical treatments of OA, but, as a rehabilitation strategy, they also deal with the problems of the person focusing on the improvement of all components of human functioning as defined in the ICF including personal and environmental factors with a holistic approach. ICF core sets for OA serve as excellent models for directing proper assessments as well as targeting interventions. PRM specialists well meet the needs of people with OA from the early stages of the disease to the stage of disability that could cause activity limitations and participation restrictions. In conclusion, PRM specialists can make substantial contributions to providing management of OA in order to improve the functioning of individuals with OA from both personal and societal perspective.
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Son yıllarda dünyada ve ülkemizde “Geleneksel ve Tamamlayıcı Tıp” (GETAT) uygulamalarında ve ürünlerinin kullanımında artış izlenmektedir. Hekimler GETAT uygulama ve ürünlerinin gerekliliği, yararı konusunda ikiye bölünmüş durumdadır. Bir görüş bu uygulamaların medikal tedavide yeri olduğunu savunmaktayken, diğer görüş kullanımının ve kullanımına bağlı sonuçların hekimin sorumluluğunda olmadığını savunmaktadır. Bu çalışmada Zonguldak Bülent Ecevit Üniversitesi Tıp Fakültesi’nde görevli öğretim üyesi ve araştırma görevlisi hekimlerin GETAT uygulamaları konusundaki bilgi ve görüşlerini değerlendirmek amaçlanmıştır. Araştırma kesitsel tiptedir. Şubat 2017- Mayıs 2018 tarihlerinde görevli 327 hekimin tümüne ulaşılması hedeflenmiştir, 262’sine (%80,1) ulaşılmıştır. Verilerin toplanmasında anket kullanılmıştır. Hekimlerin %66,4’ünün kendi görüşlerine göre GETAT yöntemleri konusunda bilgi düzeyleri düşüktür, %43,1’i eğitim almak istemektedir, %2,3’ü GETAT kurs/sertifika programına katılmıştır. Hekimlerin %45,0’ı hastalarının GETAT kullanma durumunu bilmektedir, bilenlerin %41,5’i hastalarının GETAT yöntemi kullandığını, en fazla akupunktur (%63,2) ve kupa (%40,8) kullandıklarını belirtmiştir. Hekimlerin %48,5’i GETAT’ın faydalı olduğunu düşünmektedir. Hekimlerin hastalarına bir GETAT yöntemi önerme oranı %16,0, uygulama oranı %4,9’dur. Hekimlerin %15,2’sinin kendisi, %24,4’ünün ailesindeki bireyler bir GETAT yöntemi kullanmıştır. Öneren hekimlerin en fazla önerdikleri (%57,1), kullanan hekimlerin en fazla kullandıkları (%45,0) yöntem akupunkturdur. Hekimlerin GETAT yöntemlerini önerme durumu; kendi görüşlerine göre GETAT bilgi düzeylerine, kurs/sertifika programına katılma durumlarına, faydasına dair görüşlerine, hekimin ve ailesinin GETAT kullanma durumuna göre farklı bulunmuştur. Hekimlerin GETAT eğitimi almak isteme durumu; yaşa, akademik ünvana, bölüme, faydasına dair görüşlerine göre farklılık göstermiştir. Hekimlerin yarısından fazlası, GETAT ile ilgili yeterli bilgisi bulunmadığını belirtmiştir ve hastalarının yöntemleri kullanma durumuyla ilgili bilgi sahibi değildir. Meslekte geçirdikleri süre daha kısa olan genç hekimler ve dahili bilimlerde çalışan hekimler daha fazla GETAT eğitimi almak istemektedirler. Hekimler, tedavileri ile etkileşimleri bakımından hastalarının GETAT yöntemi kullanma durumunu sorgulamalı, toplumda sık kullanılan yöntemler konusunda yapılan bilimsel araştırmaları takip etmelidirler. Bununla birlikte hekimler, GETAT yöntemlerini ancak bilimsel yöntem izlenerek yapılan araştırmalar sonucunda ulaşılacak bilgiler ışığında tedavi seçeneği olarak düşünebilirler.
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En Cuba la medicina natural y tradicional es considerada una disciplina médica reconocida por el Ministerio de Salud Pública (MINSAP), por lo que los profesionales y técnicos de los servicios de salud deben estar preparados en el manejo de las diferentes técnicas de esta terapéutica. Con el objetivo de caracterizar el comportamiento del conocimiento y práctica de procedimientos terapéuticos de medicina natural y tradicional, se realizó un estudio descriptivo transversal a profesionales y técnicos de la salud del Policlínico "Isidro de Armas" en el año 2009. La muestra estuvo constituida por 64 profesionales y 47 técnicos de la salud a los que se les aplicó un cuestionario sobre el conocimiento de las diferentes terapéuticas de medicina natural y tradicional y su aplicación. Se obtuvo que la totalidad de los encuestados refirieron tener conocimiento acerca de la medicina natural y tradicional, el proceder más conocido fue la acupuntura y técnicas afines (88,3 %) y el más aplicado fue la Fitoterapia (49,5 %). Se concluyó que la proporción de profesionales y técnicos que aplica los procedimientos de medicina natural y tradicional, fue más pequeña que la proporción que refirió tener conocimiento de estas terapéuticas.
Article
Resumen Objetivo Identificar los conocimientos y actitudes sobre la acupuntura en los médicos vinculados a hospitales públicos de la región central del Ecuador. Método Se realizó un estudio cuantitativo, transversal, descriptivo y multicéntrico en una población total de 289 médicos. El estudio se realizó en varios hospitales, aunque la población mayor pertenece al Hospital General Policlínico de Riobamba. Participantes Médicos rurales, generales y especialistas. Se excluyeron estudiantes de pre y posgrado. Resultados Los fundamentos teoricocientíficos de la acupuntura son desconocidos para el 73% de los médicos, aunque el 51,3% de ellos conocen lo que significa la acupuntura y el 59% presenta una buena actitud para someterse a tratamiento con acupuntura. La referencia de pacientes a servicios de acupuntura alcanza solo un 33,5%. La aceptación para la enseñanza de estos fundamentos es compartida por el 54,7% de los médicos. Conclusiones Existe un nivel de conocimiento básico de los médicos sobre el significado de la acupuntura, aunque no sobre sus fundamentos teoricocientíficos. Además, se manifiesta una actitud positiva para aceptar terapias de acupuntura y la inclusión de estos estudios en los planes de estudio de medicina. Existe un bajo nivel de recomendación y referencia de pacientes para servicios de acupuntura.
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Background: Complementary and alternative medicine (CAM) use has been increasing and these unconventional therapies do have important adverse effects. We evaluated predictors of CAM use among U.S. adults. Methods: We analyzed the 2007 Health Information National Trends Survey (n=7503) and used logistic regression models to evaluate the association of demographic, lifestyle characteristics and healthcare perceptions of respondents who used CAM within the previous 12 months (n=1980) versus those who did not (n=5523). We used survey weights in all analyses and performed variance estimations using Taylor series linearization to account for the complex survey design. Results: Females (odds ratio [OR]=1.46; 95% confidence interval [CI]: 1.15-1.86), college graduates (OR=1.61; 95% CI: 1.24-2.08) and those who considered the quality of their healthcare to be poor (OR=2.16; 95% CI: 1.28-3.65) were more likely to use CAM, whereas blacks (OR=0.58; 95% CI: 0.39-0.85) were less likely to use CAM. Among CAM users, 47.6% did not inform their doctors. However, no factor predicted those who did not inform their doctors of their CAM use. Conclusions: Many adults in the United States use CAM without informing their doctors. Care providers should inquire about CAM usage from their patients, document them and counsel their patients regarding their use of these less regulated therapies.
Article
In Cuba the natural and traditional medicine is considered a medical discipline recognized by Public Health Ministry, thus the professionals and technicians of health services must to be trained in the management of different techniques of this therapeutics. A cross-sectional and descriptive study was conducted in health professionals and technicians of the "Isidro de Armas" polyclinic in 2009 to characterize the behavior of knowledge and practice of therapeutical procedures of natural and traditional medicine. Sample included 64 health professionals and 47 health technicians underwent a questionnaire on the knowledge of the different therapeutics of natural and traditional medicine and its implementation. The total on polled considered to have enough knowledge on this field, where the more known procedure was acupuncture and related techniques (88,3 %) and the more applied one was the Physiotherapy (49,5 %). We conclude that the rate of professionals and technicians who to apply the procedures related to natural and traditional medicine, was smaller than the rate referred to have knowledge on these therapeutics.
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Giriş: Bu çalışmada aile hekimlerinin tamamlayıcı ve alternatif tedavilere karşı tutumlarının ortaya koyulması amaçlanmıştır. Yöntem: Çalışmaya Afyonkarahisar Halk Sağlığı Müdürlüğü Aile Hekimliği Birimine bağlı olarak çalışan 78 aile hekimi katılmıştır. Katılan aile hekimlerine tamamlayıcı ve alternatif tedavi uygulamaları hakkındaki tutumlarını değerlendirmek amacıyla oluşturulan bir anket formu uygulanmıştır. Bulgular: Çalışmaya katılan aile hekimlerinde tamamlayıcı ve alternatif tedavi yöntemlerinin etkinliğine inanma %83,3 (n=65), tamamlayıcı ve alternatif tedavi yöntemlerinden herhangi birini kullanma %75,,6 (n=59) olarak izlenmiştir. Aile hekimleri %80,,8 oranında tamamlayıcı ve alternatif tedavi yöntemlerini hastalarına tavsiye etmektedir. En çok tavsiye ettikleri yöntem bitkisel ilaçlar ve vitaminlerdir (%79,,5). Kırk yaş ve altı aile hekimlerinde enerji terapileri ve akupunktur uygulamalarını kullanmanın istatistiksel anlamlı olarak yüksek olduğu görülmektedir (p<0,05). Çalışma süresi 10 yıl ve altında olan aile hekimlerinin tamamlayıcı ve alternatif tedavi kullanma oranları %35,,6, 10 yılın üzerinde olanların ise %64,,4’tür (p<0,05). Sonuç: Aile hekimlerinin tamamlayıcı ve alternatif tedavilere karşı tutumlarını belirlemeye yönelik yapılmış olan bu çalışmada, aile hekimlerinin tamamlayıcı ve alternatif tedavi yöntemlerini kullanma ve güvenme yüzdesi birinci basamak hekimlerinde daha önce yapılan çalışmalar ile uyumlu olarak gözlenmiştir.
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Information about use and attitudes of GPs towards complementary medicine is required in order to inform the debate about its place within mainstream medicine. There is evidence that public use of complementary medicine is particularly high in the South-West of England. This study aimed to determine the use of, and attitudes towards, complementary medicine among GPs. A questionnaire survey was performed of all primary care physicians working in the health service in Devon and Cornwall. Replies were received from 461 GPs, a response rate of 47%. A total of 314 GPs (68%, range 32-85%) had been involved in complementary medicine in some way during the previous week. One or other form of complementary medicine was practised by 74 of the respondents (16%), the two most common being homoeopathy (5.9%) and acupuncture (4.3%). In addition, 115 of the respondents (25%) had referred at least one patient to a complementary therapist in the previous week, and 253 (55%) had endorsed or recommended treatment with complementary medicine. Chiropractic, acupuncture and osteopathy were rated as the three most effective therapies, and the majority of respondents believed that these three therapies should be funded by the health service. A total of 176 (38%) of respondents reported adverse effects, most commonly after manipulation. Over two-thirds of the GPs in Devon and Cornwall who responded to the survey had been involved with complementary medicine in some way during the previous week. This figure is higher than the national average. The majority of respondents believed that acupuncture, chiropractic and osteopathy were effective and should be funded by the NHS.
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In Western countries 13-14% of the population have some degree of disability. 1 The demand for rehabilitation services will increase as evidence accrues for their effectiveness and as more people survive longer with substantial disability. Current evidence strongly supports the provision of well organised, coordinated, multidisciplinary rehabilitation services based on a problem oriented approach. 2 In future, specific interventions will be more evidence based, leading to more appropriate use of interventions and more appropriate referrals to specialist services. Rehabilitation has recently seen many practical innovations and new evidence for specific interventions , but the major advances in rehabilitation are conceptual rather than practical. Firstly, the approach to patients has moved from a predominantly medical one to one in which psychological and sociocultural aspects are equally important. Secondly, the need for organised specialist rehabilitation services—for example , for neurological disabilities—is being recognised. Methods This review concentrates on the conceptual basis of rehabilitation and some emerging principles; the scope of rehabilitation is too large to cover all major advances. We chose topics and papers on the basis of our experience.
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To survey the use, cost, beliefs and quality of life of users of complementary and alternative medicine (CAM). A representative population survey conducted in 2004 with longitudinal comparison to similar 1993 and 2000 surveys. 3015 South Australian respondents over the age of 15 years (71.7% participation). In 2004, CAMs were used by 52.2% of the population. Greatest use was in women aged 25-34 years, with higher income and education levels. CAM therapists had been visited by 26.5% of the population. In those with children, 29.9% administered CAMs to them and 17.5% of the children had visited CAM therapists. The total extrapolated cost in Australia of CAMs and CAM therapists in 2004 was AUD$1.8 billion, which was a decrease from AUD$2.3 billion in 2000. CAMs were used mostly to maintain general health. The users of CAM had lower quality-of-life scores than non-users. Among CAM users, 49.7% used conventional medicines on the same day and 57.2% did not report the use of CAMs to their doctor. About half of the respondents assumed that CAMs were independently tested by a government agency; of these, 74.8% believed they were tested for quality and safety, 21.8% for what they claimed, and 17.9% for efficacy. Australians continue to use high levels of CAMs and CAM therapists. The public is often unaware that CAMs are not tested by the Therapeutic Goods Administration for efficacy or safety.
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BACKGROUND Complementary/alternative cancer treatments are believed to be prevalent. However, reliable prevalence rates do not exist. The aim of this review was to summarize the existing data on this topic.METHODSA series of computerized literature searches was performed to locate all published studies documenting the prevalence of complementary and/or alternative therapy (CAM) use among patients with cancer.RESULTSA total of 26 surveys from 13 countries, including 4 studies of pediatric patients, was retrieved. The use of CAM therapies in adult populations ranged from 7-64%. The average prevalence across all adult studies was 31.4%.CONCLUSIONS This large degree of variability most likely is due to different understandings of "complementary/alternative medicine" on the part of both investigators and patients. It is likely that the results of the current study reflect the primarily adjunctive use of CAM treatments. Future studies should use a standardized protocol to determine the true prevalence of these therapies more closely. Cancer 1998;83:777-782. © 1998 American Cancer Society.
Article
BACKGROUND Complementary/alternative cancer treatments are believed to be prevalent. However, reliable prevalence rates do not exist. The aim of this review was to summarize the existing data on this topic.METHODSA series of computerized literature searches was performed to locate all published studies documenting the prevalence of complementary and/or alternative therapy (CAM) use among patients with cancer.RESULTSA total of 26 surveys from 13 countries, including 4 studies of pediatric patients, was retrieved. The use of CAM therapies in adult populations ranged from 7-64%. The average prevalence across all adult studies was 31.4%.CONCLUSIONS This large degree of variability most likely is due to different understandings of "complementary/alternative medicine" on the part of both investigators and patients. It is likely that the results of the current study reflect the primarily adjunctive use of CAM treatments. Future studies should use a standardized protocol to determine the true prevalence of these therapies more closely. Cancer 1998;83:777-782. © 1998 American Cancer Society.
Article
BACKGROUND The prevalence of complementary and alternative medicine (CAM) is increasing worldwide because of the growing public interest in natural or holistic therapies and because of the flow of information through the Internet. However, there is a lack of communication between cancer patients and their physicians on topics relating to CAM. The authors performed a cross-sectional survey to evaluate the perceptions and attitudes of Japanese clinical oncologists toward cancer CAM.METHODS The CAM questionnaires were sent to 2118 clinical oncologists. The questionnaires gathered data on background (age, gender, years in practice, specialty, and knowledge of cancer CAM), perception (effectiveness/ineffectiveness, scientific evidence, and drug interactions), and attitude (experience with and response to CAM users). Questions about oncologists' perceptions and attitudes to CAM were limited to herbs and other natural products that were sold over the counter.RESULTSOne hundred sixty-six questionnaires were returned as undeliverable. Of the remaining questionnaires, 751 were returned (a response rate of 39%). Two-thirds of the responders were surgical oncologists and most of the remaining responders were medical oncologists. The majority of oncologists (82%) believed that CAM products were ineffective against cancer. The main reason for this belief was a lack of reliable information (as cited by 85% of oncologists). Only 13% of oncologists had experienced CAM-associated disease improvement in their cancer patients. Of all the oncologists, 84% considered the possibility of drug interactions between anticancer drugs and CAM products. The majority of oncologists (80%) replied that they could neither promote the use of CAM products nor recommend quitting the products, when they were asked about the use of CAM products by cancer patients.CONCLUSIONS Negative perceptions of CAM products persist among clinical oncologists. A lack of proven effectiveness of CAM products and concerns about drug interactions with anticancer treatment suggest a need for both accurate information on CAM products and clinical trials. Cancer 2003;97:2861–8. © 2003 American Cancer Society.DOI 10.1002/cncr.11402
Article
Many people use unconventional therapies for health problems, but the extent of this use and the costs are not known. We conducted a national survey to determine the prevalence, costs, and patterns of use of unconventional therapies, such as acupuncture and chiropractic. We limited the therapies studied to 16 commonly used interventions neither taught widely in U.S. medical schools nor generally available in U.S. hospitals. We completed telephone interviews with 1539 adults (response rate, 67 percent) in a national sample of adults 18 years of age or older in 1990. We asked respondents to report any serious or bothersome medical conditions and details of their use of conventional medical services; we then inquired about their use of unconventional therapy. One in three respondents (34 percent) reported using at least one unconventional therapy in the past year, and a third of these saw providers for unconventional therapy. The latter group had made an average of 19 visits to such providers during the preceding year, with an average charge per visit of $27.60. The frequency of use of unconventional therapy varied somewhat among socio-demographic groups, with the highest use reported by nonblack persons from 25 to 49 years of age who had relatively more education and higher incomes. The majority used unconventional therapy for chronic, as opposed to life-threatening, medical conditions. Among those who used unconventional therapy for serious medical conditions, the vast majority (83 percent) also sought treatment for the same condition from a medical doctor; however, 72 percent of the respondents who used unconventional therapy did not inform their medical doctor that they had done so. Extrapolation to the U.S. population suggests that in 1990 Americans made an estimated 425 million visits to providers of unconventional therapy. This number exceeds the number of visits to all U.S. primary care physicians (388 million). Expenditures associated with use of unconventional therapy in 1990 amounted to approximately $13.7 billion, three quarters of which ($10.3 billion) was paid out of pocket. This figure is comparable to the $12.8 billion spent out of pocket annually for all hospitalizations in the United States. The frequency of use of unconventional therapy in the United States is far higher than previously reported. Medical doctors should ask about their patients' use of unconventional therapy whenever they obtain a medical history.
Article
Complementary/alternative cancer treatments are believed to be prevalent. However, reliable prevalence rates do not exist. The aim of this review was to summarize the existing data on this topic. A series of computerized literature searches was performed to locate all published studies documenting the prevalence of complementary and/or alternative therapy (CAM) use among patients with cancer. A total of 26 surveys from 13 countries, including 4 studies of pediatric patients, was retrieved. The use of CAM therapies in adult populations ranged from 7-64%. The average prevalence across all adult studies was 31.4%. This large degree of variability most likely is due to different understandings of "complementary/alternative medicine" on the part of both investigators and patients. It is likely that the results of the current study reflect the primarily adjunctive use of CAM treatments. Future studies should use a standardized protocol to determine the true prevalence of these therapies more closely.
Article
This research investigated the use of alternative therapies by individuals with physical disabilities. A telephone survey of a cross-sectional convenience sample of people with disabilities. An urban, outpatient rehabilitation facility specializing in vocational services. A convenience sample of 401 working-age individuals. Self-reported use of alternative therapy. More of this sample of individuals with physical disabilities than a randomized, national sample of the general population used alternative therapies (57.1% vs 34%) and saw providers of those therapies (22% vs 10%). Among individuals in the current sample, significant positive relationships between use of alternative therapies and education and income levels were discovered. The use of alternative therapies by this sample, however, was not associated with racial identity, gender, or age. Compared with the general population, this study's respondents reported a higher proportion of chronic pain (14% vs 8%) and depression (14% vs 8%), and a lower proportion of severe headache (9.2% vs 13%). Alternative therapies were chosen more often than conventional therapies by those with physical disabilities for pain (51.8% vs 33.9%), depression (33.9% vs 25%), anxiety (42.1% vs 13.1%), insomnia (32.3% vs 16.1%), and headaches (51.4% vs 18.9%). Physically disabled individuals are more likely to use alternative therapies than the general population and to see providers for them, have their use recommended by their physicians, and be reimbursed by their health insurance for them. A high prevalence of dysphoria is found among those with disabilities, for which a combination of alternative and conventional therapies is often used.
Article
To describe Victorian general practitioners' attitudes towards and use of a range of complementary therapies. A self-administered postal survey sent to a random sample of 800 general practitioners (GPs) in Victoria in July 1997. 488 GPs (response rate, 64%). GPs' knowledge; opinions about harmfulness and effectiveness; appropriateness for GPs to practise; perceived patient demand; need for undergraduate education; referral rates to complementary practitioners; and training in and practice of each therapy. Acupuncture, hypnosis and meditation are well accepted by the surveyed GPs, as over 80% have referred patients patients to practitioners of these therapies and nearly half have considered using them. General practitioners have trained in various therapies--meditation (34%), acupuncture (23%), vitamin and mineral therapy (23%), hypnosis (20%), herbal medicine (12%), chiropractic (8%), naturopathy (6%), homoeopathy (5%), spiritual healing (5%), osteopathy (4%), aroma-therapy (4%), and reflexology (2%). A quarter to a third were interested in training in chiropractic, herbal medicine, naturopathy and vitamin and mineral therapy. General practitioners appear to underestimate their patients' use of complementary therapies. There is evidence in Australia of widespread acceptance of acupuncture, meditation, hypnosis and chiropractic by GPs and lesser acceptance of the other therapies. These findings generate an urgent need for evidence of these therapies' effectiveness.
Article
To document the prevalence and patterns of knowledge about, referrals to, training in, and practice of complementary and alternative medical therapies and their perceived effectiveness by a sample of Canadian physiatrists. Cross-sectional survey by written questionnaire. Physiatrists in the province of Ontario, Canada. All 116 physiatrist/rehabilitation specialists listed in the Ontario Medical Association directory. Data were obtained from 98 respondents. Statistical analysis of responses in these areas: attitudes, knowledge, and recommendations about alternative therapies, and clinical approach including referral pattern, training, and practice of alternative medicine. Of the respondents, 72% reported referring patients for alternative medicine therapies, and 20% had training in and 20% practiced some form of alternative medicine. The therapies rated highest in usefulness were acupuncture (85%), biofeedback (81%), and chiropractic (80%). Sixty-three percent believed that alternative medicine had ideas and methods that would be of benefit to physiatrists. Only 9% believed it to be a threat to public health. A greater proportion of physiatrists who refer were women, were younger, had graduated more recently, and scored higher in their ratings of more useful alternative medicine therapies. Previous training in alternative medicine was correlated with a higher practice rate but not with referral rate. Practice profile and academic affiliation were not associated with greater or less use of alternative medicine. In Ontario, physiatrists report greater knowledge of and more use of alternative medicine therapies than do general practitioners. The most commonly used therapies are acupuncture, biofeedback, and manipulation (chiropractic, osteopathy). It is recommended that these approaches be taught in physiatry residency training and be the focus of future research. Incorporating such therapies into practice will help to meet the public demand for such approaches in the decade to come.
Article
The aim of this systematic review was to summarize the evidence about the risks of spinal manipulation. Articles were located through searching three electronic databases (MEDLINE, EMBASE, Cochrane Library), contacting experts (n =9), scanning reference lists of relevant articles, and searching departmental files. Reports in any language containing data relating to risks associated with spinal manipulation were included, irrespective of the profession of the therapist. Where available, systematic reviews were used as the basis of this article. All papers were evaluated independently by the authors. Data from prospective studies suggest that minor, transient adverse events occur in approximately half of all patients receiving spinal manipulation. The most common serious adverse events are vertebrobasilar accidents, disk herniation, and cauda equina syndrome. Estimates of the incidence of serious complications range from 1 per 2 million manipulations to 1 per 400,000. Given the popularity of spinal manipulation, its safety requires rigorous investigation.
Article
Complementary and alternative medicine (CAM) is frequently employed by patients with cancer. An extensive survey was conducted among Brazilian cancer physicians to understand their attitude towards CAM. A questionnaire was sent to all 655 members of the Brazilian Cancer Society asking what is their opinion regarding CAM and if they would prescribe any CAM modality for their patients. They were also questioned regarding their degree of awareness of CAM self-administration by their patients. Overall, 119 questionnaires were returned to us (18%). Most oncologists knew at least one type of CAM (96.6%) and 76.7% had previously made use of at least one type of CAM for themselves. We observed that 76 (63.8%) of the oncologists used to ask their patients about CAM utilization and 37.8% described at least one reason to stimulate its use (68.8% as complementary treatment). Only 10% of the oncologists would prescribe at least one type of CAM and this attitude correlated significantly with previous physicians' use of CAM and with being a clinical oncologist as well as with having questioned patients about CAM use. Most oncologists (80.7%) would not indicate the use of CAM, mainly for lack of scientific proof of its efficacy (56.2%). Physicians knew many kinds of CAM and had frequently used some of them themselves, but only a minority of Brazilian oncologists would indicate them. As CAM use is very prevalent in our population, we believe that most of its utilization depends, probably, on patient's own and independent initiatives. However, these results should be viewed with caution because of the low response rate we observed in this study.
Article
This article has no abstract; the first 100 words appear below. This year, my clinic began inviting patients to use a secure Internet link to communicate with physicians and staff members. Self-preservation was high on our list of reasons for establishing online communication. Our patients had become accustomed to contacting us through myriad routes: the clinic telephone, our individual office lines, the hospital paging system, our cell phones, the clinic fax machine, and in some cases, our home telephones. Secure Web messaging about routine issues was an attempt to direct round-the-clock communication into a manageable channel. Even before we initiated such messaging within a broader model of e-medicine, many patients had . . . Source Information Dr. Stone, formerly director of the Vasculitis Center and an associate professor of medicine at Johns Hopkins University School of Medicine, Baltimore, is now a deputy editor for rheumatology at UpToDate, Waltham, MA.
Article
To study the perceptions and attitudes of primary care physicians concerning their patients' use of complementary medicine. A questionnaire was distributed to all 165 primary care physicians attending a routine continuing-medicine education program. Items included physicians' estimated rates of patient utilization of complementary medicine or herbal remedies and of patient reportage of such use; physicians' knowledge about side effects and interactions of herbal remedies; and frequency with which physicians questioned their patients on the use of complementary medicine and herbal remedies. The compliance rate was 90.0% (n=150). Sixty-eight percent of physicians estimated that up to 15% of their patients use complementary medicine; 58% always or often asked their patients about it; 50% estimated that 10% of patients report use of complementary medicine, and 60% estimated the same rate for herbal remedies; 51% believed that herbal remedies have no or only mild side effects; more than 70% claimed that they had little or no knowledge about what herbal remedies are; 24% never referred patients for complementary medicine, and 69% did so occasionally. Twenty-five percent had some training in complementary medicine, and 31% practiced some kind of complementary medicine. Most of the physicians believed that people turn to alternative methods when they are dissatisfied with conventional medicine. Physicians underestimate the rate of complementary medicine use by patients, suggesting that many patients do not report such use to their physician. Since alternative treatments are potentially harmful and may interact with conventional medications, physicians should be encouraged to communicate with patients about complementary medicine in general and herbal remedies in particular, and they should regularly include questions about their use when taking histories. They should also inform themselves about risks of alternative treatments particularly with herbal remedies, and have access to appropriate information systems.
Available from: http://www.racgp.org.au/ researchfoundation/awards/kotsirilos 8 Australian Government Department of Health and Aging. Therapeutic Goods Administration (TGA). [Cited 14
  • Vicki Kotsirilos Integrative Medicine
  • Grant
Vicki Kotsirilos Integrative Medicine Grant (RACGP). [Cited 14 May 2008.] Available from: http://www.racgp.org.au/ researchfoundation/awards/kotsirilos 8 Australian Government Department of Health and Aging. Therapeutic Goods Administration (TGA). [Cited 14 May 2008.] Available from URL: http://www.tga.gov.au/cm/ cmresponse.htm 9