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Chen B, Wang CC, Lee KH, Xia JC, Luo Z. Efficacy and safety of acupuncture for depression: A systematic review and meta-analysis. Res Nurs Health 2023; 46:48-67. [PMID: 36509453 PMCID: PMC10108109 DOI: 10.1002/nur.22284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 10/27/2022] [Accepted: 11/25/2022] [Indexed: 12/15/2022]
Abstract
Acupuncture is widely accepted as a therapeutic option for managing depression. However, evidence from clinical trials remains controversial. This review aims to synthesize the best available evidence on the efficacy and safety of acupuncture in managing depression. The review was performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. Five databases and the relevant trial registries were searched from the inception to October 2021. Randomized clinical trials of acupuncture for managing depression, published in English, were selected for inclusion. The quality of included studies was assessed using the Cochrane risk of bias tool. Netmeta and dmetar of R packages were used to conduct a network meta-analysis. Twenty-two trials with 2391 participants were eligible and included in the analysis. This review found evidence that electroacupuncture (EA) plus antidepressant achieved superior outcomes compared with the waitlist (standardized mean difference = -8.86, 95% confidence interval: -14.78 to -2.93). The treatment ranking of different interventions in improving depression symptoms indicated that EA plus antidepressant with a probability of 0.8294, followed by manual acupuncture (MA) plus antidepressant (0.6470) and MA (0.5232). Acupuncture, either in isolation or as an adjunct to pharmacological treatment, has clinical benefits and can be considered a safe option for managing depression.
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Affiliation(s)
- Binglei Chen
- School of Nursing and MidwiferyEdith Cowan UniversityJoondalupWestern AustraliaAustralia
| | - Carol Chunfeng Wang
- National School of Nursing, Midwifery, Health Science & PhysiotherapyThe University of Notre Dame AustraliaFremantleWestern AustraliaAustralia
| | - Khui Hung Lee
- School of ScienceEdith Cowan UniversityJoondalupWestern AustraliaAustralia
| | - Jianhong Cecilia Xia
- School of Earth and Planetary SciencesCurtin UniversityPerthWestern AustraliaAustralia
| | - Zongting Luo
- School of NursingFujian University of Traditional Chinese MedicineFuzhouChina
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James PB, Wardle J, Steel A, Adams J, Bah AJ, Sevalie S. Traditional and complementary medicine use among Ebola survivors in Sierra Leone: a qualitative exploratory study of the perspectives of healthcare workers providing care to Ebola survivors. BMC Complement Med Ther 2020; 20:137. [PMID: 32375765 PMCID: PMC7201764 DOI: 10.1186/s12906-020-02931-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 04/22/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Considerable number of patients, including Ebola survivors, in Sierra Leone, are using traditional and complementary medicine (T&CM). Healthcare providers' (HCPs) views about T&CM is crucial in addressing the increased need for T&CM among patients. However, healthcare providers' views about T&CM in Sierra Leone is unknown. Our study explores healthcare providers' knowledge of and perception towards T&CM and how that influence their personal and professional T&CM use, communication with Ebola survivors about T&CM as well as its integration into the healthcare system in Sierra Leone. METHODS We employed a qualitative exploratory study design using semi-structured interviews to collect data from 15 conveniently sampled HCPs in all four geographical regions of Sierra Leone. We analysed our data using thematic network analysis framework. RESULTS Healthcare providers perceived their knowledge about T&CM to be low and considered T&CM to be less effective and less safe than conventional medicine as well as not evidence-based. HCPs perception of T&CM as non-scientific and their lack of knowledge of T&CM were the key barriers to HCPs' self-use and recommendation as well as their lack of detailed discussion about T&CM with Ebola survivors. HCPs are open to T&CM integration into mainstream healthcare in Sierra Leone although at their terms. However, they believe that T&CM integration could be enhanced by effective professional regulation of T&CM practice, and by improving T&CM evidenced-based knowledge through education, training and research. CONCLUSION Changing HCPs' negative perception of and increasing their knowledge about T&CM is critical to promoting effective communication with Ebola survivors regarding T&CM and its integration into the healthcare system in Sierra Leone. Strategies such as educational interventions for HCPs, conducting rigorous T&CM research, proper education and training of T&CM practitioners and effective professional regulation of T&CM practice could help in that direction.
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Affiliation(s)
- Peter Bai James
- Australian Research Centre in Complementary and Integrative Medicine, School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, Sydney, NSW 2007 Australia
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Connaught Teaching Hospital Freetown, First floor Administrative Building, Freetown, Sierra Leone
| | - Jon Wardle
- Australian Research Centre in Complementary and Integrative Medicine, School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, Sydney, NSW 2007 Australia
- National Centre for Naturopathic Medicine, Southern Cross University, Lismore, NSW 2480 Australia
| | - Amie Steel
- Australian Research Centre in Complementary and Integrative Medicine, School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, Sydney, NSW 2007 Australia
| | - Jon Adams
- Australian Research Centre in Complementary and Integrative Medicine, School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, Sydney, NSW 2007 Australia
| | - Abdulai Jawo Bah
- Faculty of Basic Medical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
- Institute for Global Health and Development, Queen Margaret University Edinburg, Musselburgh, Scotland, UK
| | - Stephen Sevalie
- Faculty of Basic Medical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
- Joint Medical Unit, Republic of Sierra Leone Armed Forces, 34 Military Hospital Wilberforce Freetown, Freetown, Sierra Leone
- Sustainable Health Systems, Freetown, Sierra Leone
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Bauer M, McDonald JL, Saunders N. Is acupuncture dose dependent? Ramifications of acupuncture treatment dose within clinical practice and trials. Integr Med Res 2020; 9:21-27. [PMID: 32195114 PMCID: PMC7078379 DOI: 10.1016/j.imr.2020.01.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Indexed: 12/26/2022] Open
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Ooi SL, McLean L, Pak SC. Naturopathy in Australia: Where are we now? Where are we heading? Complement Ther Clin Pract 2018; 33:27-35. [PMID: 30396623 DOI: 10.1016/j.ctcp.2018.07.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 07/27/2018] [Accepted: 07/27/2018] [Indexed: 12/31/2022]
Abstract
Naturopathy is the general practice of natural therapies. It emphasizes prevention, treatment, and promotion of optimal health through therapeutic modalities which encourage the self-healing process of the body. Formalized in the 19th century by the hydrotherapy and nature cure movement in Austria and Germany, naturopathy was introduced to Australia at the turn of the 20th century. It became popular since the 1970s due to social and cultural change characterized by the post-modern philosophy, as well as government policies highlighting individual responsibility and freedom of choice. Naturopathy is one of the most popular forms of complementary medicine in Australia today with naturopaths received 4.9 million consultations annually. Naturopathic consultations are sought for a variety of conditions and, in some areas, as a form of primary care, especially by middle-aged women who have a higher education level and a higher annual income. The number of Australian naturopaths was estimated to be over 4000 in 2017 and expects to grow to over 4600 by 2022, although this number is likely to be an underestimation. Australian naturopaths, as a predominantly female profession, work mainly in private clinical practice with nutritional medicine, herbal medicine, homeopathy, as well as massage therapies being the most common modalities used. There are also signs of greater integration with community pharmacies and integrative medicine clinics in major cities. The Bachelor's degree programs in Naturopathy has just become the only accredited entry-level qualification since late 2015. Currently, there are only 5 private colleges offering naturopathic education, a far cry from the 40 over in mid-2000. The profession continues to be self-regulated. There is no barrier of entry to practice and unqualified practitioners of naturopathy can potentially do harm to the public. The registration of naturopaths remains unresolved due to fragmented representation under many professional associations, disunity among the profession, and objections by certain health care lobbyists. There is a dearth of research demonstrating efficacy of the whole practice of naturopathy in Australia, which has directed the government's decision to withdraw it from private health insurance coverage from 2019. Moving forward, the whole system research of naturopathy in Australia will be in focus with the recent establishment of a practice-based research network and an international research consortium. With increasing scrutiny from evidence-based medicine, the present and future challenge to Australian naturopaths is centered on the integration of both scientific and traditional evidence to form the foundation of a person-centered, evidence-informed practice.
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Affiliation(s)
- Soo Liang Ooi
- School of Biomedical Sciences, Charles Sturt University, Bathurst, NSW, 2795, Australia
| | - Lisa McLean
- School of Health & Biomedical Sciences, RMIT University, Bundoora, VIC, 3083, Australia
| | - Sok Cheon Pak
- School of Biomedical Sciences, Charles Sturt University, Bathurst, NSW, 2795, Australia.
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Wardle J, Steel A, Lauche R, Adams J. Collaborating with medicine? Perceptions of Australian naturopaths on integrating within the conventional medical system. J Interprof Care 2017; 31:734-743. [DOI: 10.1080/13561820.2017.1351424] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- J. Wardle
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - A. Steel
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
- Office of Research, Endeavour College of Natural Health, Fortitude Valley, QLD, Australia
| | - R. Lauche
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - J. Adams
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
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Joyce P, Wardle J, Zaslawski C. Medical student attitudes towards complementary and alternative medicine (CAM) in medical education: a critical review. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2017; 13:333-345. [PMID: 27451996 DOI: 10.1515/jcim-2014-0053] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 05/21/2016] [Indexed: 11/15/2022]
Abstract
Background This paper aims to remedy a gap in the knowledge by presenting the first critical review of the literature on major themes relating to medical students perceptions and attitudes towards the exponentially growing field of complementary and alternative medicine (CAM). MethodsAfter a comprehensive database search of the literature, 21 papers were chosen as suitable for the review. The results from these papers were tabled and discussed. ResultsThe results indicated that medical students lacked knowledge of CAM and are generally positive towards CAM education (especially in the preclinical years, if it provided evidence of efficacy and post-placement). Medical students thought that CAM should generally be incorporated into the medical curriculum mainly so they can confidently undertake referral to CAM practitioners. Being able to communicate with future patients about their CAM use was a major motivation for medical students to learn about CAM and a factor for medical student support of further incorporation of CAM content in the medical curricula. Educational exposure to CAM in many forms and in many papers was shown to significantly affect medical student attitudes to CAM. This may be reflective of the fact that, outside direct CAM training, there may be limited accessible opportunities for medical students and if integration is to occur, educational exposure is most important. ConclusionsThe rise of CAM as a social and clinical phenomenon necessitates consideration of further inclusion of these topics in the medical curriculum, if future physicians are to be able to fully discharge their role as care providers in an increasingly medically pluralistic world. However, the inclusion of CAM needs to be done in an objective and critical manner, which is relevant to the learner.
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Engel RM, Beirman R, Grace S. An indication of current views of Australian general practitioners towards chiropractic and osteopathy: a cross-sectional study. Chiropr Man Therap 2016; 24:37. [PMID: 27822360 PMCID: PMC5088656 DOI: 10.1186/s12998-016-0119-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Accepted: 08/08/2016] [Indexed: 01/14/2023] Open
Abstract
Background While the role of complementary medicine therapies such as chiropractic and osteopathy is yet to be clearly delineated in the Australian context, demand for these services remains high. The attitudes of general practitioners towards chiropractors and osteopaths may have played a part in producing this outcome. However, this view is based on data that were more than 10 years old. Current anecdotal evidence suggests that the previous level of support may be declining in sections of the Australian medical profession. An assessment of the current views of general practitioners towards chiropractors and osteopaths is called for. The results being reported here represent the first stage of this assessment. Methods This cross-sectional study was designed as a quantitative descriptive study using an anonymous online survey that included closed and open-ended questions with opportunities provided for free text. The target population was Australian general practitioners. Inclusion criteria included current medical registration, membership of the Royal Australian College of General Practitioners and currently practicing as a general practitioner in Australia. The data being reported here were collected between May and December, 2014. Results There were 630 respondents to the online survey during this period representing a response rate of 2.6 %. Results were not uniform for the two professions. More general practitioners believed chiropractic education was not evidence-based compared to osteopathic education (70 % and 50 % respectively) while scope of practice was viewed as similar for both professions. A majority of general practitioners had never referred a patient to either profession (chiropractic: 60 %; osteopathy: 66 %) with approximately two-thirds not interested in learning more about their education (chiropractors: 68 %; osteopaths: 63 %). Conclusions This study provides an indication of the current views of Australian general practitioners towards chiropractors and osteopaths. The findings suggest that attitudes may have become less favourable with a growing intolerance towards both professions. If confirmed, this has the potential to impact health service provision. The results from this cross-sectional study suggest that obtaining representative general practitioner views using online surveys is difficult and another approach is needed to supplement or replace the current recruitment strategy.' Electronic supplementary material The online version of this article (doi:10.1186/s12998-016-0119-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Roger M Engel
- Department of Chiropractic, Macquarie University, Sydney, NSW 2109 Australia
| | - Robyn Beirman
- School of Medical and Applied Sciences, Central Queensland University, Sydney, Australia
| | - Sandra Grace
- School of Health & Human Sciences, Southern Cross University, Lismore, Australia
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Wardle J. More integrative research is needed: But where will it come from? ADVANCES IN INTEGRATIVE MEDICINE 2016. [DOI: 10.1016/j.aimed.2016.07.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Regulatory and legislative protections for consumers in complementary medicine: Lessons from Australian policy and legal developments. Eur J Integr Med 2014. [DOI: 10.1016/j.eujim.2014.03.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Wardle J(JL, Adams J. Indirect and non-health risks associated with complementary and alternative medicine use: An integrative review. Eur J Integr Med 2014. [DOI: 10.1016/j.eujim.2014.01.001] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Wardle JL, Sibbritt DW, Adams J. The interface with naturopathy in rural primary health care: a survey of referral practices of general practitioners in rural and regional New South Wales, Australia. Altern Ther Health Med 2014; 14:238. [PMID: 25015794 PMCID: PMC4226969 DOI: 10.1186/1472-6882-14-238] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Accepted: 06/30/2014] [Indexed: 11/21/2022]
Abstract
Background Naturopathy forms an increasingly significant part of the Australian healthcare setting, with high utilisation of naturopaths by the Australian public and a large therapeutic footprint in rural and regional Australia. However, despite these circumstances, there has been little exploration of the interface between naturopathy providers and conventional primary health care practitioners in rural and regional Australia. The study reported here examined the referral practices and factors that underlie referral to naturopaths amongst a sample of rural and regional Australian general practitioners (GPs). Methods A 27-item questionnaire was sent to all 1,486 GPs currently practising in rural and regional Divisions of General Practice in New South Wales, Australia. Results A total of 585 GPs responded to the questionnaire, with 49 questionnaires returned as "no longer at this address" (response rate: 40.7%). One-quarter of GPs (25.8%) referred to a naturopath at least a few times per year while nearly half (48.8%) stated that they would not refer to a naturopath under any circumstances. GPs were more likely to refer to a naturopath if the GP: was not initially from a rural area (OR=1.78; 95% CI: 0.95, 3.33); believes in the efficacy of naturopathy (OR=5.62; 95% CI: 2.42, 11.36); has seen positive results from naturopathy previously (OR=2.61; 95% CI: 1.35, 5.05); perceives a lack of other treatment options for their patient (OR=5.25; 95% CI: 2.42; 11.36); uses peer-reviewed literature as their major source of CAM information (OR=3.03; 95% CI: 1.65, 5.55); uses CAM practitioners as a major source of CAM information (OR=6.09; 95% CI: 2.91, 12.72); and does not have an existing relationship with any CAM provider (OR=3.03; 95% CI: 1.53, 6.25). Conclusions There is little interaction (both via referrals as well as the development of professional relationships) between the naturopathic and GP communities in rural and regional Australia, with significant levels of both support and opposition for naturopathic referral amongst GPs. The significant presence and high utilisation of naturopathy in rural primary health care, which appears to work in parallel to conventional medical care rather than in conjunction with it, should serve as an impetus for increased research into naturopathy practice, policy and regulation in rural and regional health.
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French SD, Charity MJ, Forsdike K, Gunn JM, Polus BI, Walker BF, Chondros P, Britt HC. Chiropractic Observation and Analysis Study (COAST): providing an understanding of current chiropractic practice. Med J Aust 2014; 199:687-91. [PMID: 24237100 DOI: 10.5694/mja12.11851] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Accepted: 09/19/2013] [Indexed: 11/17/2022]
Abstract
OBJECTIVES COAST (Chiropractic Observation and Analysis Study) aimed to describe the clinical practices of chiropractors in Victoria, Australia. DESIGN Cross-sectional study using the BEACH (Bettering the Evaluation and Care of Health) methods for general practice. SETTING AND PARTICIPANTS 180 chiropractors in active clinical practice in Victoria were randomly selected from the list of 1298 chiropractors registered on Chiropractors Registration Board of Victoria. Twenty-four chiropractors were ineligible, 72 agreed to participate, and 52 completed the study. MAIN OUTCOME MEASURES Each participating chiropractor documented encounters with up to 100 consecutive patients. For each chiropractor-patient encounter, information collected included patient health profile, patient reasons for encounter, problems and diagnoses, and chiropractic care. RESULTS Data were collected on 4464 chiropractor-patient encounters from 52 chiropractors between 11 December 2010 and 28 September 2012. In most (71%) encounters, patients were aged 25-64 years; 1% of encounters were with infants (age < 1 year; 95% CI, 0.3%-3.2%). Musculoskeletal reasons for encounter were described by patients at a rate of 60 per 100 encounters (95% CI, 54-67 encounters) and maintenance and wellness or check-up reasons were described at a rate of 39 per 100 encounters (95% CI, 33-47 encounters). Back problems were managed at a rate of 62 per 100 encounters (95% CI, 55-71 encounters). The most frequent care provided by the chiropractors was spinal manipulative therapy and massage. CONCLUSIONS A range of conditions are managed by chiropractors in Victoria, Australia, but most commonly these conditions are musculoskeletal-related. These results can be used by stakeholders of the chiropractic profession in workforce development, education and health care policy.
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Affiliation(s)
- Simon D French
- General Practice and Primary Health Care Academic Centre, University of Melbourne, Melbourne, VIC, Australia.
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Wardle JL, Sibbritt D, Adams J. Acupuncture Referrals in Rural Primary Healthcare: A Survey of General Practitioners in Rural and Regional New South Wales, Australia. Acupunct Med 2013; 31:375-82. [DOI: 10.1136/acupmed-2013-010393] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background Acupuncture services form a significant part of the Australian healthcare setting, with national registration of acupuncture practitioners, public subsidies for acupuncture services and high use of acupuncture by the Australian public. Despite these circumstances, there has been little exploration of the interface between acupuncture providers and conventional primary healthcare practitioners in rural and regional Australia. Methods A 27-item questionnaire was sent by post in the second half of 2010 to all 1486 general practitioners (GPs) currently practising in rural and regional Divisions of General Practice in New South Wales, Australia to explore their practices and attitudes to a variety of complementary and alternative medicine (CAM) practices. Their responses on other therapies have been published previously; this report covers acupuncture. Results A total of 585 GPs completed the questionnaire; 49 were returned as ‘no longer at this address’, resulting in an adjusted response rate of 40.7%. Two-thirds of GPs (68.3%) referred patients to an acupuncturist at least a few times per year, while only 8.4% stated that they would not refer patients to an acupuncturist under any circumstances. GPs being older (OR=6.08), GPs being women (OR=2.94), GPs practising in a rural rather than remote area (OR=6.25), GPs having higher levels of self-reported knowledge of acupuncture (OR=5.54), the use of complementary medicine (CAM) by a GP for their personal health (OR=2.37), previous prescription of CAM to other patients (OR=2.99), lack of other treatment options (OR=4.31) and GPs using CAM practitioners as the major source of their CAM information (OR=3.05) were all predictive of increased referral to acupuncture among rural GPs. Conclusions There is a significant interface between acupuncture and Australian rural and regional general practice, with generally high levels of support for acupuncture.
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Affiliation(s)
- Jonathan Lee Wardle
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
- Network of Researchers in the Public Health of Complementary and Alternative Medicine (NORPHCAM), Ultimo, New South Wales, Australia
| | - David Sibbritt
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
- Network of Researchers in the Public Health of Complementary and Alternative Medicine (NORPHCAM), Ultimo, New South Wales, Australia
| | - Jon Adams
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
- Network of Researchers in the Public Health of Complementary and Alternative Medicine (NORPHCAM), Ultimo, New South Wales, Australia
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Integrating complementary and alternative medicine into medical intern teaching: Preliminary findings from an Australian Hospital. Complement Ther Clin Pract 2013; 19:237-42. [DOI: 10.1016/j.ctcp.2013.06.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Revised: 04/30/2013] [Accepted: 06/06/2013] [Indexed: 11/18/2022]
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Wardle J, Adams J. Are the CAM professions engaging in high-level health and medical research? Trends in publicly funded complementary medicine research grants in Australia. Complement Ther Med 2013; 21:746-9. [PMID: 24280483 DOI: 10.1016/j.ctim.2013.09.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2013] [Revised: 08/01/2013] [Accepted: 09/03/2013] [Indexed: 10/26/2022] Open
Abstract
INTRODUCTION Developing research capacity is an essential part of professional development in the health professions, as well as essential to improving health care delivery. CAM is one area in which the importance of research capacity has been previously highlighted. METHODS To determine whether academic and research CAM practitioners were actively engaged in high-level CAM research in Australia successful National Health and Medical Research Council grants data for projects starting between 2000 to present (2013) were collated and analyzed. RESULTS CAM practitioners are not involved in most NHMRC-funded research, with non-clinical academics leading nearly half of all NHMRC-funded CAM grants. Conventional medical practitioners led the majority of CAM grants headed by clinicians. Only Chinese medicine and naturopathy practitioners appear to be building capacity, with NHMRC-funded CAM grants led by these practitioner groups increasing. University CAM faculties are for the most part not engaging in high level research, with most NHMRC-funded CAM projects being led by groups outside these faculties. Even the majority NHMRC-funded research led by CAM clinicians is administered outside university CAM faculties. CONCLUSIONS The CAM professions have a low level of engagement with high-level health and medical research in Australia. Current levels of engagement appear to be dependent more on individual clinician involvement rather than professional strategy. Failure to engage with high-level health and medical research may pose challenges for the CAM professions, unless research engagement is improved. This requires an active and concerted effort from within CAM ranks to build research capacity in the CAM professions.
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Affiliation(s)
- J Wardle
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, 235-253 Jones St, Ultimo, NSW 2007, Australia; Network of Researchers in the Public Health of Complementary and Alternative Medicine (NORPHCAM), Australia.
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Wardle J, Adams J, Sibbritt D. Homeopathy in rural Australian primary health care: a survey of general practitioner referral and practice in rural and regional New South Wales, Australia. HOMEOPATHY 2013; 102:199-206. [PMID: 23870380 DOI: 10.1016/j.homp.2013.03.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2012] [Revised: 03/02/2013] [Accepted: 03/13/2013] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Homeopathy has attracted considerable recent attention from the Australian conventional medical community. However, despite such increased attention there has been little exploration of the interface between homeopathy and Australian conventional medical practice. This article addresses this research gap by exploring homeopathic practice and referral by rural and regional Australian general practitioners (GPs). MATERIALS AND METHODS A 27-item questionnaire was sent to all 1486 GPs currently practising in rural and regional New South Wales, Australia (response rate 40.7%). RESULTS Few GPs in this study utilised homeopathy in their personal practice, with only 0.5% of GPs prescribing homeopathy in the past 12 months, and 8.5% referring patients for homeopathic treatment at least a few times over the past 12 months. Nearly two-thirds of GPs (63.9%) reported that they would not refer for homeopathy under any circumstances. Being in a remote location, receiving patient requests for homeopathy, observing positive responses from homeopathy previously, using complementary and alternative medicine (CAM) practitioners as information sources, higher levels of knowledge of homeopathy, and being interested in increasing CAM knowledge were all independently predictive of increased referral to homeopathy amongst GPs in this study. GPs in this study were less likely to refer to homeopathy if they used peer-reviewed literature as the major source of their information on CAM. CONCLUSIONS Homeopathy is not integrated significantly in rural general practice either via GP utilisation or referral. There is significant opposition to homeopathy referral amongst rural and regional GPs, though some level of interaction with homeopathic providers exists.
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Affiliation(s)
- J Wardle
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, 235-253 Jones Street, Ultimo, NSW 2007, Australia.
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Wardle JL, Sibbritt DW, Adams J. Referral to Chinese medicine practitioners in Australian primary care: a survey of New South Wales rural and regional general practitioners. Chin Med 2013; 8:8. [PMID: 23566291 PMCID: PMC3655835 DOI: 10.1186/1749-8546-8-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Accepted: 04/01/2013] [Indexed: 11/17/2022] Open
Abstract
Background Chinese medicine practitioners (CMPs) play an important part in rural and regional Australian healthcare. A survey was conducted to investigate referral practices between Chinese medicine (CM) and conventional primary health care practitioners in this region. Methods A 27-item questionnaire was sent to all 1486 general practitioners (GPs) currently practising in rural and regional Divisions of General Practice in New South Wales, Australia. This survey explored GP opinions, perceptions and practices in relation to complementary and alternative medicine or Chinese medicine specifically. Results A total of 585 GPs completed the questionnaire. Forty-nine were returned as ‘no longer at this address’, resulting in an adjusted response rate of 40.7%. One in ten GPs (9.9%) had referred their patients to CMPs at least a few times over the past 12 months, one in five GPs (17.4%) could not locate a CMP to refer to in their local area, and over one-third of GPs (37.7%) stated they would not refer to a CMP under any circumstances. GPs that had graduated from an Australian medical college (OR = 3.71; CI: 1.22, 11.23), GPs observing positive responses previously in patients using CM (OR = 2.53; 95% CI: 1.12, 8.58), GPs perceiving a lack of other options for patients (OR = 3.10; 95% CI: 1.12, 8.58), GPs reporting satisfactory or higher levels of CM knowledge (OR = 15.62; 95% CI: 5.47, 44.56), and GPs interested in increasing their complementary and alternative medicine knowledge (OR = 3.28; 95% CI: 1.17, 9.21) referred to CMPs more frequently than did other groups of GPs amongst the rural GPs included in this study. Conclusion There has been little interaction between CMPs and Australian rural and regional GPs.
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Affiliation(s)
- Jonathan L Wardle
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, 235-253 Jones St, Ultimo, NSW, Australia ; Network of Researchers in the Public Health of Complementary and Alternative Medicine (NORPHCAM
| | - David W Sibbritt
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, 235-253 Jones St, Ultimo, NSW, Australia ; Network of Researchers in the Public Health of Complementary and Alternative Medicine (NORPHCAM
| | - Jon Adams
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, 235-253 Jones St, Ultimo, NSW, Australia ; Network of Researchers in the Public Health of Complementary and Alternative Medicine (NORPHCAM
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Wardle JL, Sibbritt DW, Adams J. Referrals to chiropractors and osteopaths: a survey of general practitioners in rural and regional New South Wales, Australia. Chiropr Man Therap 2013; 21:5. [PMID: 23369205 PMCID: PMC3599860 DOI: 10.1186/2045-709x-21-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Accepted: 01/30/2013] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Chiropractic and osteopathy form a significant part of the healthcare setting in rural and regional Australia, with national registration of practitioners, public subsidies for services and high utilisation by the Australian public. However, despite their significant role in rural and regional Australia, there has been little exploration of the interface between chiropractic and osteopathy and conventional primary health care practitioners in this area. The study aim was to examine the referral practices and factors that underlie referral to chiropractors and osteopaths by rural and regional Australian general practitioners (GPs), by drawing on a sample of GPs in rural and regional New South Wales. METHODS A 27-item questionnaire was sent to all 1486 GPs currently practising in rural and regional Divisions of General Practice in New South Wales, Australia. RESULTS A total of 585 GPs responded to the questionnaire, with 49 questionnaires returned as "no longer at this address" (response rate: 40.7%). The majority of GPs (64.1%) referred to a chiropractor or osteopath at least a few times per year while 21.7% stated that they would not refer to a chiropractor or osteopath under any circumstances. Patients asking the GP about CAM (OR=3.59; CI: 1.12, 11.55), GP's use of CAM practitioners as a major source of information (OR=4.39; 95% CI: 2.04, 9.41), lack of other treatment options (OR=2.41; 95% CI: 1.18, 5.12), access to a wide variety of medical specialists (OR=12.5; 95% CI: 2.4, 50.0), GP's belief in the efficacy of chiropractic and osteopathy services (OR=3.39; 95% CI: 2.19, 5.25) and experiencing positive results from patients using these services previously (OR=1.67; CI: 1.02, 2.75) were all independently predictive of increased referral to chiropractic and osteopathy services amongst the rural GPs. CONCLUSIONS There is a significant interface between chiropractic and osteopathy and Australian rural and regional general practice in New South Wales. Although there is generally high support for chiropractic and osteopathy among Australian GPs, this was not absolute and the heterogeneity of responses suggests that there remain tensions between the professions. The significant interface between chiropractic and osteopathy may be due in part to the inclusion of these professions in the publicly subsidised national healthcare delivery scheme. The significant impact of chiropractic and osteopathy and general practice in rural and regional Australian healthcare delivery should serve as an impetus for increased research into chiropractic and osteopathy practice, policy and regulation in these areas.
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Affiliation(s)
- Jon L Wardle
- Faculty of Health, University of Technology Sydney, 235-253 Jones St, Ultimo, NSW, 2007, Australia
- Network of Researchers in the Public Health of Complementary and Alternative Medicine (NORPHCAM), http://www.norphcam.org
| | - Davi W Sibbritt
- Faculty of Health, University of Technology Sydney, 235-253 Jones St, Ultimo, NSW, 2007, Australia
- Network of Researchers in the Public Health of Complementary and Alternative Medicine (NORPHCAM), http://www.norphcam.org
| | - Jon Adams
- Faculty of Health, University of Technology Sydney, 235-253 Jones St, Ultimo, NSW, 2007, Australia
- Network of Researchers in the Public Health of Complementary and Alternative Medicine (NORPHCAM), http://www.norphcam.org
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Myers SP, Xue CC, Cohen MM, Phelps KL, Lewith GT. The legitimacy of academic complementary medicine. Med J Aust 2012; 197:69-70. [DOI: 10.5694/mja12.10491] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Stephen P Myers
- NatMed‐Research Unit, Southern Cross Plant Science, Southern Cross University, Lismore, NSW
| | - Charlie C Xue
- School of Health Sciences, RMIT University, Melbourne, VIC
| | - Marc M Cohen
- School of Health Sciences, RMIT University, Melbourne, VIC
- Australasian Integrative Medicine Association, Melbourne, VIC
| | - Kerryn L Phelps
- Australasian Integrative Medicine Association, Melbourne, VIC
- Faculty of Medicine, University of New South Wales, Sydney, NSW
| | - George T Lewith
- Primary Care and Population Sciences, University of Southampton Medical School, Southampton, UK
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Komesaroff PA, Moore A, Kerridge IH. Medicine and science must oppose intolerance and censorship. Med J Aust 2012; 197:82-3. [DOI: 10.5694/mja12.10500] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
| | - Amber Moore
- Department of Medicine, Monash University, Melbourne, VIC
- Three Lanterns, Melbourne, VIC
| | - Ian H Kerridge
- Royal North Shore Hospital, Sydney, NSW
- Centre for Values, Ethics and the Law in Medicine, University of Sydney, Sydney, NSW
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Hughes JD, Blott LA. Tertiary education institutions should not offer pseudoscientific medical courses. Med J Aust 2012; 196:566. [DOI: 10.5694/mja12.10484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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