According to researchers from China and New Zealand who analysed 11 studies regarding the use of CAM, about 25% of general practitioners practise CAM, and 82.3% refer patients to CAM practitioners.
CAM is an umbrella terms describing health systems, modalities, and practices that are not generally considered part of conventional medicine.
These include acupuncture, massage, aromatherapy, chiropractic, herbal medicines, homeopathy, hypnosis, naturopathy, osteopathy, reflexology, spiritual healing, traditional Chinese Medicine, traditional Māori Medicine, and traditional Pacific Island Medicine.
Reasons for using CAM therapies typically include failure of conventional treatment, patient request, past positive experience, and to complement the existing treatment.
Similar to other countries, public interest in CAM in New Zealand is increasing. An old national health survey (2006–2007) found that nearly one in five adults visited a CAM practitioner in the previous 12 months.
However, data and research on CAM remains largely limited in New Zealand.
In this study, researchers wanted to assess New Zealand healthcare professionals’ practice, attitude, and knowledge towards CAM.
“This gap in the literature is particularly important given that conventional healthcare professionals are often reported to be reluctant or lacking in confidence to advise patients on the use of CAM, and therefore issues such as safety, effectiveness, and practicality of CAM use may be overlooked,” researchers wrote in BMC Complementary Medicine and Therapies.
“This information will be of importance to further CAM development in New Zealand, in order to develop effective policies based on effectiveness, safety, regulation and integration.”
This study involved 2060 healthcare professionals including GPs, nurses, midwives, pharmacists, physiotherapists, and medical specialists.
Literature search was conducted in four databases (AMED, CINAHL, EMBASE, MEDLINE), and 11 studies were selected.
Of the 11 studies, there were eight surveys and three qualitative studies (two interviews and one focus group study).
Use of CAM
The prevalence of CAM practice ranged from 20.3% to 30.1% among GPs, and 48.4% among physiotherapists when treating women during pregnancy.
Approximately 26% of GPs and specialists use CAM to treat their own ailments. The proportion of professionals reporting CAM referrals ranged from 37.3% to 94.7%.
The majority of GPs would consider recommending CAM to patients with musculoskeletal problems, pain, back problems, and for women’s health.
The use of CAM in New Zealand is similar to those of UK where 20.6% of physicians use CAM, and in Australia, where 84% of physicians would refer patients to CAM practitioners.
Attitudes and views
Among the healthcare professionals, about seven studies reported an overall positive attitude towards CAM use, although some had concerns with the perceived lack of evidence, regulation, side effects, and financial costs.
Five studies showed that on average 45.3% of healthcare professionals have concerns over the safety of CAM therapies.
Approximately 85% of GPs would like to see better regulation of CAM practitioners and products.
Surveys focusing on GPs showed that the majority insist on the need for an evidence base for CAM therapies, and encourage more scientific testing of CAM therapies before being used to complement conventional medicine.
Knowledge and education
Of the 11 studies included in this review, four reported healthcare professionals’ knowledge about CAM therapies.
Acupuncture is the most well-known CAM therapy among GPs, while majority of them are unfamiliar with rongoā Māori and traditional Pacific Island medicine.
The two therapies in which GPs were the most interested in receiving training were acupuncture, and herbal medicine.
Findings also indicated that approximately one quarter of GPs have received formal training in CAM.
Interest in CAM continues to grow among New Zealand healthcare professionals, as 58% of GPs and Plunket nurses expressed their wish to receive further education on CAM.
Plunket nurses are registered child health nurses working in the community.
Up to 66.7% GPs supported the idea that an overview of CAM should be included into medical curriculums.
In order to better manage CAM in New Zealand’s clinical settings, there is a need to invest in CAM research, education and enhance CAM regulation, the paper noted.
More support from the government and private sector is also needed to enhance the evidence base of CAM therapies.
“It may not be pragmatic to set CAM as a priority for New Zealand funding bodies in the short term, but establishing open and non-judgemental perspectives on CAM research is encouraged,” wrote the researchers.
Source: BMC Complementary Medicine and Therapies
“Complementary and alternative medicine - practice, attitudes, and knowledge among healthcare professionals in New Zealand: an integrative review”
Authors: Lizhou Liu, et al.