Research on Integrative Healthcare: Context and Priorities

Memorial Sloan-Kettering Cancer Center, 1429 First Avenue, New York, NY 10021, USA.
EXPLORE The Journal of Science and Healing (Impact Factor: 1). 05/2010; 6(3):143-58. DOI: 10.1016/j.explore.2010.03.007
Source: PubMed


It is important that integrative healthcare research be conducted to optimize the effectiveness, safety, costs, and social and economic impact of prospective, personalized, patient-centered, comprehensive, and holistic healthcare that focuses on well-being as well as disease management, and that the research itself be well understood. The scope of this research extends beyond evaluation of specific therapies, to include evaluations of multimodality whole system intervention, practitioner-patient relationships, patient goals and priorities, promoting self-care and resilience, personalized diagnostic and therapeutic measures, practitioner well-being, the comparative effectiveness of different educational and outreach strategies in improving health and healthcare, and the environmental/social causes and consequence of health and healthcare. In this paper, we describe the state of the science of research on integrative healthcare, research needs, and opportunities offered by cutting-edge research tools. We propose a framework for setting priorities in integrative health research, list areas for discussion, and pose a few questions on a future research agenda.

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Available from: Kathi J Kemper, Aug 12, 2014
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    • "However, many IM clinics do not use standardised patient reported outcome (PRO) questionnaires as part of their service evaluation [5] [6] [7]. IM aims to provide holistic, individualised, and patientcentred care [8] [9] [10] [11] [12] [13]. In the primary care setting, IM practitioners and clinics manage acute and chronic illness with a focus on disease prevention and health promotion. "
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    ABSTRACT: IntroductionIncreasingly, primary care clinics are offering integrative medicine (IM). These clinics, besides treating illness, emphasise holistic health care, health promotion and enhancing well-being. However, very few such clinics are evaluating their services or patient outcomes.MethodsA systematic review was undertaken to identify, appraise and shortlist the best available patient-reported questionnaires to measure outcomes in IM primary care clinics. As well as patient health outcomes, questionnaires measuring proxy outcomes such as lifestyle risk factors, medication use and health services outcomes were included. The internet and Medline, CINAHL and Allied and Complementary Medicine databases were first searched to identify English web-databases listing potential questionnaires. Publication databases were then searched to identify questionnaires measuring underrepresented topics. Potential questionnaires were evaluated using modified guidelines from the Medical Outcomes Trust.ResultsTen web-based databases were identified that cited over 4000 questionnaires. There was a plethora of mental health and quality-of-life questionnaires from which to choose. However, individualised patient-centred questionnaires along with those measuring wellness, holistic health and health promotion/lifestyle activities were lacking. A final shortlist of 71 questionnaires met the inclusion criteria.Conclusions The majority of the questionnaires had not been tested in the IM primary care setting. The distribution of scores of many popular questionnaires makes them useless when seeking to differentiate or detect changes and improvement in health and wellbeing in healthier populations. Further evaluation is needed to confirm their suitability.
    Full-text · Article · Jun 2013 · European Journal of Integrative Medicine
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    • "For example, Bann et al. described empowerment and patient-centeredness as key qualities which distinguish CAM from COM [25]. Striking in this context is a recent review of Deng et al. [27] emphasizing the importance of the practitioner–patientrelationship in integrative medicine ''to achieve optimal healing through shared decision making''. However, context factors affecting the implementation of SDM (e.g. "
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    ABSTRACT: To explore differences between conventional medicine (COM) and complementary and alternative medicine (CAM) regarding the attitude toward and the perceived use of shared decision-making (SDM) from the health professional perspective. Thirty guideline-based interviews with German GPs and nonmedical practitioners were conducted using qualitative analysis for interpretation. The health professional-patient-relationship in CAM differs from that in COM, as SDM is perceived more often. Reasons for this include external context variables (e.g., longer consultation time) and internal provider beliefs (e.g., attitude toward SDM). German health care policy was regarded as one of the most critical factors which affected the relationship between GPs and their patients and their practice of SDM. Differences between COM and CAM regarding the attitude toward and the perceived use of SDM are attributable to diverse concepts of medicine, practice context variables and internal provider factors. Therefore, the perceived feasibility of SDM depends on the complexity of different occupational socialization processes and thus, different value systems between COM and CAM. Implementation barriers such as insufficient communication skills, lacking SDM training or obedient patients should be reduced. Especially in COM, contextual variables such as political restrictions need to be eliminated to successfully implement SDM.
    Full-text · Article · Feb 2012 · Patient Education and Counseling

  • No preview · Article · Dec 2010 · European Journal of Integrative Medicine
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