Nidhi Tomar*
Department of Nursing, Shri Swami Bhumanand College of Nursing, Haridwar-249407, India.
*Corresponding Author E-mail: nidhi.tomar9@gmail.com
ABSTRACT:
Objectives: This systematic review aims to assess the knowledge, attitude and practices of Complementary and alternative medicine therapies and its perspectives among healthcare professionals. Methods: PubMed/Medline, Google scholar, online data base were searched for relevant data from 2010 to 2021 in English language by using keywords of Complementary therapies, alternative medicine, healing science, soul healing therapies, allied therapies, energy healing science etc. The Preferred Reporting Items for Systematic review and Meta-Analysis Protocols 2015 guideline and Patient, Intervention, Comparison, Outcomes, Study Design model were used in analyzing the studies. Results: This review included 13 studies included within the last 10 years that investigated knowledge, attitude and practices regarding CAM.Finding suggested that Folk medicines (46%) and ayurvedic medicines (45%) were most commonly used CAM. Advice from friends/relatives was the commonest source of information. None of the respondents had knowledge of adverse effects of CAM used by them and about 70% did not inform their doctor about use of CAM. 61.5% of the HCPs were aware that CAM includes AYUSH. 53% of the HCPs used CAM for self, especially for respiratory disorders (28.3%) and chronic painful conditions (21.6%). The common adverse effects attributed to use of CAM among patients which required consultation of the HCPs were hepatic (42.5%) and renal impairment (32.5%), allergy (10%), relapse Conclusion: This systematic review revealed that CAM treatments depends on various factors working at multiple levels viz., personal factors, disease’ characteristics, perceived treatment characteristics (positive attributes of CAM and negative attributes of BM) and external facilitators. Furthermore, the analysis also identifies the role of two underlining forces–push and pull–in motivating CAD patients to choose CAM treatments. The push force comprises factor that participants found to have a repelling nature, whereas pull forces were regarded as advantageous for CAM usage.
KEYWORDS: Complementary therapies, Energy Science, Aura Healing, Psychotherapy, Healing through thoughts and emotions, Indigenous therapies.
INTRODUCTION:
Complementary and alternative healthcare and medical practices (CAM) is a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine.
Today, CAM practices may be grouped within five major domains: alternative medical systems, mind-body interventions, biologically-based treatments, manipulative and body-based methods and energy therapies.1
India has a rich tradition of use of ayurvedic medicines and has a government department for CAM which is named as ‘AYUSH’ (Ayurveda, Yoga, Naturopathy, Unani, Sidha and Homeopathy.2
Literature shows that complementary and alternative medicine has been used primarily in chronic conditions and only a few studies show complementary and alternative medicine use in acute condition leading to hospitalization3
Globally, the uses of complementary and alternative therapies are emerging trend in the health care system. In India, with the constant increase in ageing population and chronic diseases most people prefer complementary and alternative medicines. The reasons include lack of local health services, financial crisis and non-availability of drugs. The common alternative medicines are ayurveda, siddha, unani, naturopathy and homeopathy, other than that the latest form of complementary therapies include hydrotherapy, music therapy, humour therapy, colour therapy and light therapy.4
In a systematic review of use of CAM in the world, a total of 13 studies were shortlisted in a prisma table after review of literature. In developing countries, the World Health Organization reports that approximately 80% of the world populations rely on traditional medicines mainly of herbal sources, in their primary healthcare. Surveys on the use of CAM among doctors have shown variation in physicians’ beliefs and practices with respect to CAM. Many doctors view CAM therapies as not part of legitimate medical practice. Although many have a positive attitude towards CAM, they discourage CAM therapies among patients because of their lack of knowledge about the safety and efficacy of CAM treatments.
NEED OF THE STUDY:
Despite the recognition by the Government of India and easy availability of CAM including the Indian systems of medicine in India, CAM is still not a part of the conventional medical curriculum in majority of medical colleges in India. As a result the medical graduate may lack awareness about CAM. Although CAM has been practiced in India for thousands of years, there is limited literature available on the extent of use, attitude and perception of patients utilizing CAM services and none among doctors in India. Since practitioners of modern medicines may have to encounter patients using CAM, it would be useful to know their attitude and perception towards CAM.
Hence, this study is done to assess the extent of use of CAM among doctors and patients utilizing the same allopathic healthcare facility (a teaching, tertiary care, government hospital) and to examine their perception and attitude towards CAM.5
The WHO report of 2002 states that at least 70% of the world population still believes in alternative medicine, and therapies which include homeopathy, Ayurveda, Siddha, Unani, Amchi, acupuncture, aromatherapy, herbal medicine in general, dietary supplements, nutraceuticals, Yoga, mindbody techniques, spirituality and faith healing, and massage. The current trend is indicative of a continuing demand for CAM therapies which will definitely have its impact on health care delivery in the future.6
Evidence-Based Complementary and Alternative Medicine of medicine, CAM should be able to complement the goals of PHC per se. To support and facilitate this endeavour, there is a need, as well as potential for an improved public health mandate, to monitor and promote the integration of CAM with PHC.7
DELIMITATIONS:
The included studies of systematic review were only delimited to patients, doctors and other healthcare professionals using or practicing some sort of CAM theray.
Research approach:
Quantitative research approach
Research design:
Systematic review design
Study participants:
Patients and doctors prescribing or using or practicing CAM.
Inclusion criteria for studies:
· Duration: The year 2010 to 2021
· Database: PubMed, Wiley Online library within the English language, Medline, Google Scholar
· Study design: Review articles, original researches were added to the study.
Exclusion criteria:
· Paid studies with full text
· Unrelated Texts
Type of studies: Prospective, Systematic review (2), Meta-Analysis, Cross-sectional, Qualitative.
Total study participants: Nearly 5000 participants in 13 studies, articles in 2-3 studies.
Types of tools used:
Structured, semi-structured and researcher adapted Questionnaires, Interviews, Online, PRISMA, Boolean Search, PICOS,
DISCUSSION:
From the 13 papers studied, all papers reported significant improved results for those used CAM for their diseased conditions, lower side-effects, high morale and satisfaction, improved quality of life and social support. Among doctors, those who had utilized CAM themselves recommended CAM as a therapy to their patients.
Most patients who used CAM felt it to be more effective, safer, less costly and easily available in comparison to allopathic medicines. Folk medicines (46%) and ayurvedic medicines (45%) were most commonly used CAM. The common adverse effects attributed to use of CAM among patients which required consultation of the HCPs were hepatic (42.5%) and renal impairment (32.5%), allergy (10%), relapse.
LIMITATION:
One of the most important social factor found was ignorance, lack of formal information about CAM or a reluctance among healthcare practitioners about prescribing CAM as a first hand treatment. Very few people know about or believe in these therapies as a cure for their health issues. Source of Information in most cases are family or friends.
CONCLUSION:
Ayurveda (56%) was the most commonly used CAM therapy followed by homeopathy (34%). patients started using CAM on advice of a relative or friend. The most common advantages reported were complete cure, easy availability and no side-effects (69.6%), whereas disadvantages include food restriction, expensive medication, symptomatic relief and effective for limited diseases.
People used CAM to treat conditions including diabetes mellitus, headaches, arthritis and joint pains, stress, skin disorders, backaches, hypertension and nasal disorders. Half of the CAM users used allopathic medicines concurrently. Age, sex, marital status, religion, level of education and income were shown not to influence the use of CAM.
STRENGTHS AND LIMITATIONS:
It includes 13 studies, a major number of randomized controlled trials were included for finding conclusion out of it. This review is current evidence till 2021 on defined area among CAM users. Common findings and similar tools mainly questionnaires made the results quite similar.
REFERENCES:
1. Syed Amin Tabish, Complementary and Alternative Healthcare: Is it Evidence-based ? Int J Health Sci (Qassim). 2008 Jan; 2(1): V–IX. PMCID: PMC3068720PMID: 21475465
2. N. Vishnu, G. K. Mini and K. R. Thankappan Complementary and alternative medicine use by diabetes patients in Kerala, India online Published by Cambridge University Press: 15 May 2017
3. Mukesh Dhankar Complementary and Alternative Medicine: A Cross sectional Study in PediatricInpatients 2018 https:// doi.org/10.1177/ 2515690X18765119
4. Sujatha Shanmugasundaram2011 Journal of Cancer Pain and Symptom Palliation Complementary and Alternative Therapies in Palliative Care A Transition from Modern Medicine to Traditional Medicine in India, 2011; 1(4): 25-29, https://doi.org/10.3109/ J427v01n04_04
5. Vandana Roy V, Monica Gupta M, and Ghosh K R, Perception, attitude and usage of complementary and alternative medicine among doctors and patients in a tertiary care hospital in IndiaIndian J Pharmacol. 2015; 47(2): 137–142. doi: 10.4103/0253-7613.153418 PMCID
6. Kritika Subramanian1 and Inuka Midha2 2016 Prevalence and Perspectives of Complementary and Alternative Medicine among University Students in Atlanta, Newcastle upon Tyne, and New Delhi, 2016 https://doi.org/10.1155/2016/9309534
7. Annie Shirwaikar Raghavan Govindarajan Ajay Kumar Singh Rawat 2013 Integrating Complementary and Alternative Medicine with Primary Health Care, Volume 2013 |Article ID 948308 | https://doi.org/10.1155/2013/948308
8. Jayanti Ray DNB Debadatta Chakrabarty MD Rudrajit Paul MRCP Kunal Som MD Prevalence of the use of complementary and alternative medicine in an eastern Indian population with emphasis on tribal/ ethnic minority groups Journal of Taibah University Medical Sciences 2018; 13(4): 384-389 https:// doi.org/10.1016/j.jtumed.2018.04.001Get rights and content
9. Nayna J. Gohil, Varsha J. Patel Use of complementary and alternative medicines by patients with orthopaedic disorders in western part of India: a cross sectional study International journal of basic and clinical pharmacology, 2016; 5(5) doi : http:// dx.doi.org/10.18203/2319-2003.ijbcp20163206
10. Dharani Sundarmurthy, Vijayalakshmi Devarashetty, Narayana Reddy S. Complementary and alternative medicine: practice and perspective of allopathic doctors at a tertiary care hospital, 2016; 5(5) > Sundarmurthy DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20163225
Received on 07.09.2021 Modified on 16.10.2021
Accepted on 11.11.2021 ©A&V Publications All right reserved
Int. J. of Advances in Nur. Management. 2022; 10(1):50-52.
DOI: 10.52711/2454-2652.2022.00013