Regulatory environment for complementary and alternative medicine in Georgia—a health policy analysis

Nadareishvili, Ilia; Pkhakadze, Giorgi; Japiashvili, Nato; Lunze, Karsten

doi:10.1002/hpm.3142

Cited by 4 publications

(2 citation statements)

References 16 publications

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“…While the literature points to continuing interest in and use of T&CM in LMICs (91,296-298) and HICs (299)(300)(301)(302)(303), studies suggest that T&CM practitioners continue to struggle for institutional recognition of their practice and to engage conventional practitioners in collaborative practice. In LMICs, studies show efforts to better harness indigenous medicine practitioners to deliver primary care and meet public health goals, with statutory registration a vehicle to lift the status of indigenous medicine practitioners and facilitate their integration into mainstream health systems (297,298,304,305).…”

Section: Regulation Of Traditional and Complementary Medicine Practit...mentioning

confidence: 99%

Design, operation and strengthening of health practitioner regulation systems: A rapid integrative review

Leslie

Bourgeault

Carlton

et al. 2022

Preprint

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Background: In addition to promoting patient safety, health practitioner regulation (HPR) systems are increasingly recognized as playing an important role in supporting health workforce availability, accessibility, quality, and sustainability. This review aimed to identify the evidence on the design, delivery and effectiveness of HPR systems to inform policy decisions by policymakers and regulators. Methods: A rapid review approach was adopted to conduct an integrative analysis of literature published between 2010 and 2021. Fourteen databases were searched according to a standardized strategy. Data were extracted and synthesized through an integrative approach and categorized according to a modified Donabedian framework. Results We identified 410 academic and 426 grey literature sources. Key themes included HPR structures (regulatory governance systems, regulatory institutions, and system linkages), processes (registration and monitoring of continuing competence of practitioners, accreditation of entry-to-practice education programs, regulating scopes of practice, managing complaints and discipline, and regulating traditional and complementary medicine) and outcomes (impact of HPR structures and processes on health system and workforce outcomes). More evidence was found on HPR structures and processes than outcomes, though over 99% of studies were descriptive (and evidence, accordingly, of very low certainty). Synthesis was constrained by the lack of common terminology. Discussion: Trends on regulatory structures and processes emerged from this analysis. The evidence base limitations, particularly on HPR outcomes, warrant caution in the interpretation, generalizability, and applicability of these findings. Standardized terminology and more evidence on regulatory outcomes (on both workforce and health systems) could inform decisions on regulatory design and implementation.

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Section: Regulation Of Traditional and Complementary Medicine Practit...mentioning

confidence: 99%

Design, operation and strengthening of health practitioner regulation systems: A rapid integrative review

Leslie

Bourgeault

Carlton

et al. 2022

Preprint

View full text Add to dashboard Cite

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“…Integrative medicine is a method of treating patients that integrates conventional medicine with CAMs to find healthcare solutions (8). It is also approved to be safe and effective by the World Health Organization (9). Herbal medications are one form of CAMs that have been used to treat a variety of disorders since ancient times (10).…”

mentioning

confidence: 99%

Cell cytotoxicity and pro-apoptosis on MCF-7 cells using polyherbal formulation, MAT20

Tarigopula,

Narayan,

Vijaykumar Kasture

et al. 2023

J Emerg Invest

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Today, standard of care cancer treatment includes chemotherapy, radiation, and surgery, which have serious side effects. A different option for medication could be using standard of care treatments in conjunction with herbal adjuvants. This integrated approach reduces the dosage, and the side effects of chemotherapy could lead to a better prognosis. The purpose of this study was to test the anti-cancer properties and pro-apoptotic effects of the polyherbal formulation MAT20 as a complementary treatment. Moringa oleifera (Moringa), Phyllanthus emblica (Amla) and Ocimum sanctum (Tulsi), these 3 herbs were used to formulate MAT20, which contain phytochemicals that are known to display anti-cancer properties. In this study, we hypothesized that MCF-7 breast cancer cells treated with MAT20 would show increased cytotoxicity compared to its individual plant extracts. MAT20 showed significantly lower IC50 values were found for both 24-hour (33.01µg/mL) and 48-hour (21.09 µg/mL) exposure compared to any of the other individual extracts for the given exposure duration. MAT20 did not show a significantly lower IC50 value compared to the chemotherapeutic drug Paclitaxel. Additionally, staining methods (DAPI, Hoechst, Dual staining) showed that MAT20 treated cells caused 49.6% cell death after 24 hours and 51% cell death after 48 hours of exposure, indicating successful drug activity in inducing apoptosis.

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Design, delivery and effectiveness of health practitioner regulation systems: an integrative review

Leslie,

Bourgeault,

Carlton

et al. 2023

Hum Resour Health

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Background Health practitioner regulation (HPR) systems are increasingly recognized as playing an important role in supporting health workforce availability, accessibility, quality, and sustainability, while promoting patient safety. This review aimed to identify evidence on the design, delivery and effectiveness of HPR to inform policy decisions. Methods We conducted an integrative analysis of literature published between 2010 and 2021. Fourteen databases were systematically searched, with data extracted and synthesized based on a modified Donabedian framework. Findings This large-scale review synthesized evidence from a range of academic (n = 410) and grey literature (n = 426) relevant to HPR. We identified key themes and findings for a series of HPR topics organized according to our structures–processes–outcomes conceptual framework. Governance reforms in HPR are shifting towards multi-profession regulators, enhanced accountability, and risk-based approaches; however, comparisons between HPR models were complicated by a lack of a standardized HPR typology. HPR can support government workforce strategies, despite persisting challenges in cross-border recognition of qualifications and portability of registration. Scope of practice reform adapted to modern health systems can improve access and quality. Alternatives to statutory registration for lower-risk health occupations can improve services and protect the public, while standardized evaluation frameworks can aid regulatory strengthening. Knowledge gaps remain around the outcomes and effectiveness of HPR processes, including continuing professional development models, national licensing examinations, accreditation of health practitioner education programs, mandatory reporting obligations, remediation programs, and statutory registration of traditional and complementary medicine practitioners. Conclusion We identified key themes, issues, and evidence gaps valuable for governments, regulators, and health system leaders. We also identified evidence base limitations that warrant caution when interpreting and generalizing the results across jurisdictions and professions. Themes and findings reflect interests and concerns in high-income Anglophone countries where most literature originated. Most studies were descriptive, resulting in a low certainty of evidence. To inform regulatory design and reform, research funders and governments should prioritize evidence on regulatory outcomes, including innovative approaches we identified in our review. Additionally, a systematic approach is needed to track and evaluate the impact of regulatory interventions and innovations on achieving health workforce and health systems goals.

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Regulatory environment for complementary and alternative medicine in Georgia—a health policy analysis

Cited by 4 publications

References 16 publications

Design, operation and strengthening of health practitioner regulation systems: A rapid integrative review

Design, operation and strengthening of health practitioner regulation systems: A rapid integrative review

Cell cytotoxicity and pro-apoptosis on MCF-7 cells using polyherbal formulation, MAT20

Design, delivery and effectiveness of health practitioner regulation systems: an integrative review

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