Determinants of Complementary Medicine Service Utilization in a Regional South Australian Population: A Cross-Sectional Study

Determinants of the Utilization of Recognized Traditional and Complementary Medicine Service in Malaysia: A Secondary Analysis of a Cross-Sectional Population-Based Survey

INTRODUCTION

The utilization of traditional and complementary medicine (T&CM) services has witnessed a global increase over the past decades. Currently, seven practice areas are recognized in Malaysia: traditional Malay medicine (TMM), traditional Chinese medicine (TCM), traditional Indian medicine, homeopathy, Islamic medical practice, chiropractic, and osteopathy. Many global studies have investigated the general determinants of T&CM service utilization. However, there has been no comprehensive study reporting specific determinants of recognized T&CM service utilization. This study aimed to examine the prevalence and specific determinants of recognized T&CM service utilization in Malaysia at a national level.

METHODS

This study is a secondary analysis of data from the National Health and Morbidity Survey (NHMS), a cross-sectional population-based survey conducted in Malaysia in 2015. A total of 6,207 respondents aged ≥18 years were included in this study. The associations of sociodemographic, health, and lifestyle factors with the utilization of the three T&CM service categories (TMM, TCM, and other T&CM) were examined using three separate logistic regression analyses.

RESULTS

The prevalence of recognized T&CM service utilization in the last 12 months was 19.3%, with 15.0% for TMM, 3.9% for TCM, and 1.5% for other T&CM. The determinants of TMM service utilization were female sex; age range of 18-29 years; married or widowed/divorced status; Malay, indigenous, or other ethnicities; high household income; and being overweight/obese. The determinants of TCM service utilization were the age range of 30-49 years, urban residential location, Chinese ethnicity, and adequate fruit and vegetable intake. No specific determinants were identified for other T&CM.

CONCLUSION

This study provided novel evidence of a strong ethnocultural ownership toward traditional medicine. User profiles were distinctively different between varied T&CM services. Customized approaches to regulate, develop, and institutionalize specific T&CM services are crucial for fulfilling the unique needs of diverse communities.

Prevalence of Complementary Medicine Use in Children and Adolescents: A Systematic Review

INTRODUCTION

The objective of this systematic review was to determine the global prevalence of complementary medicine (CM) use among children and adolescents.

METHOD

Seven databases and the reference lists of included studies were searched for pertinent observational studies. Studies were limited to those published in English from July 1, 2013. Included studies were appraised using the JBI checklist for prevalence studies.

RESULTS

Twenty studies were eligible for inclusion (385,527 participants). Most studies were assessed as having low risk of bias. Meta-analyses revealed a 23.0% (95% confidence interval, 0.226-0.234; 17 studies) short-term (≤ 12 month) prevalence and a 77.7% (95% confidence interval, 0.760-0.794; six studies) lifetime prevalence of CM use in children and adolescents. Differences in CM use were evident across countries and regions.

DISCUSSION

The findings of this review indicate that the use of CM in children and adolescents is high and widespread and may be increasing.

International prevalence of consultation with a naturopathic practitioner: a systematic review and meta-analysis

OBJECTIVES

Naturopathy is a traditional medicine system informed by codified philosophies and principles, and an emphasis on non-pharmacologic therapeutic interventions. While naturopathy is practised by approximately 75 000-100 000 000 naturopathic practitioners in at least 98 countries, little is known about the international prevalence of history of consultation with a naturopathic practitioner. This study reports a systematic review and meta-analysis of studies describing the global prevalence of history of consultation with a naturopathic practitioner by the general population.

SETTING

The included literature was identified through a systematic search of eight databases between September and October 2019, as well as the grey literature.

PARTICIPANTS

Studies were included if they reported the prevalence rate of consultations with a naturopathic practitioner by the general population.

INTERVENTIONS

Survey items needed to report consultations with a naturopathic practitioner as defined in the country where data was collected, and not combine naturopathic consultations with other health services or only report consulations for illness populations.

PRIMARY AND SECONDARY OUTCOME MEASURES

Primary measures used for the analysis was consultations in the previous 12 months. Other prevalence timeframes were reported as secondary measures.

METHODS

Meta-analysis of prevalence data was conducted using random effects models based on individual countries and WHO world regions.

RESULTS

The literature search identified eight manuscripts summarising 14 studies reporting prevalence for inclusion in the review. All included studies had a low risk of bias. Meta-analysis of the included studies by world region found the 12-month prevalence of history of naturopathy consultations ranged from 1% in the Region of the Americas to 6% in the European and Western Pacific Regions.

CONCLUSIONS

There are up to sixfold differences in the prevalence of naturopathy consults over 12 months between and within world regions, which may be driven by a range of policy, legislative and social factors.

PROSPERO REGISTRATION NUMBER

CRD42020145529.

Expressed Demand for Health Care Services in Regional South Australia: A Cross-sectional Study

PURPOSE

Accessibility and availability of health care services/providers is an increasing concern for many regional communities, particularly regional South Australia. Assessing the level of health service/provider utilization within a region (ie, expressed demand) can be useful in determining health care need and health service/workforce demand.

METHODS

The regional South Australia health (RESONATE) survey aimed to determine the expressed demand for health care services and the health workforce in a regional South Australian population. The study was open to adults living in regional South Australia and was promoted using a comprehensive multimodal recruitment campaign. Data were collected between April 2017 and March 2018 using the consumer utilization, expectations and experiences of healthcare instrument.

FINDINGS

A total of 3,926 adults completed the questionnaire. Participants reported using 47 different health care providers in the previous 12 months. Whilst almost all (92.9%) participants had seen a general practitioner in the past 12 months, yoga instructors, chiropractors, pharmacists, and physiotherapists were visited most frequently. Proportionally fewer participants in more remote locations received conventional services/treatments, though a significantly greater proportion of those in more remote locations had received complementary medicine services/treatments (relative to inner regional areas).

CONCLUSIONS

Findings of the RESONATE survey point to a high level of expressed demand for conventional and complementary health care services among study participants, possibly higher than that reported in the general population. Examining the extent to which the health needs of this and other regional populations are met should be the focus of further research to better inform future health workforce/services planning.