Health consumer and health provider preferences for an integrative healthcare service delivery model: A national cross-sectional study

Abstract

This is first known study to translate HC and HCP attitudes and preferences into an operational framework for IHC. A logical next step of this work will be to ascertain the feasibility of this model in primary care.

The effectiveness of integrative healthcare for chronic disease: A systematic review

“…Was the interaction between service providers non‐hierarchical, communicative and respectful? And, was there an evidence‐base to support the inclusion of service providers in the model of care? Hence, it is not certain whether the interventions reported in this review represent IHC, or multidisciplinary care …”

“…Thus, it is possible that some conditions may respond better to an IHC approach than others. Indeed, the findings of a recent survey of Australian health providers and health consumers suggest that an IHC approach may be most appropriate for managing chronic conditions (eg diabetes), but less so for terminal (eg breast cancer) and acute conditions (eg stroke) . Differences in risk of bias may also explain to some extent the inconsistent findings between studies.…”

“…Part of the reason for this variability in models of care has been that until very recently, there has not been a universal definition of IHC. This lack of agreement on IHC is further exemplified by the large number of studies excluded from this review, which misconstrued integrative medicine (ie the concurrent use of conventional biomedical and complementary treatments) for integrative healthcare (ie the provision of collaborative and co‐ordinated biomedical, allied health and complementary medicine services) . While the interventions in all included studies met the core criterion for IHC (ie the provision of both CAM and conventional healthcare services), it was not clear if these interventions addressed other criteria for IHC; such as, was healthcare delivery collaborative, person‐centred and holistic?…”

“…In particular, the need to examine the impact of IHC on both patient‐ and service‐related outcomes in chronic disease populations, over longer periods of time (eg ≥12 months). Also apparent is the requirement to ensure IHC interventions align with the definition/principles of integrative healthcare; such that the care provided is service‐oriented, client‐centred, co‐ordinated, holistic, evidence‐based, interdisciplinary and health‐, healing‐ and wellness‐focussed . With all studies carrying an uncertain/high risk of bias across at least three domains of the Cochrane risk of bias tool, there is a clearly a need for future studies to focus on developing robust methodology that limits bias, particularly in relation to allocation concealment and blinding.…”

“…Indeed, the findings of a recent survey of Australian health providers and health consumers suggest that an IHC approach may be most appropriate for managing chronic conditions (eg diabetes), but less so for terminal (eg breast cancer) and acute conditions (eg stroke). 28 Differences in risk of bias may also explain to some extent the inconsistent findings between studies. The publications reporting in favour of IHC were more likely to have uncertain/high risk of bias ratings across most domains than publications reporting no differences between groups, or effects in favour of usual care.…”