Systematic Review of Integrative Health Care Research: Randomized Control Trials, Clinical Controlled Trials, and Meta‐Analysis

Abstract

A systematic review was conducted to assess the level of evidence for integrative health care research. We searched PubMed, Allied and Complementary Medicine (AMED), BIOSIS Previews, EMBASE, the entire Cochrane Library, MANTIS, Social SciSearch, SciSearch Cited Ref Sci, PsychInfo, CINAHL, and NCCAM grantee publications listings, from database inception to May 2009, as well as searches of the “gray literature.” Available studies published in English language were included. Three independent reviewers rated each article and assessed the methodological quality of studies using the Scottish Intercollegiate Guidelines Network (SIGN 50). Our search yielded 11,891 total citations but 6 clinical studies, including 4 randomized, met our inclusion criteria. There are no available systematic reviews/meta-analyses published that met our inclusion criteria. The methodological quality of the included studies was assessed independently using quality checklists of the SIGN 50. Only a small number of RCTs and CCTs with a limited number of patients and lack of adequate control groups assessing integrative health care research are available. These studies provide limited evidence of effective integrative health care on some modalities. However, integrative health care regimen appears to be generally safe.

The Evolution of Complementary and Alternative Medicine (CAM) in the USA over the Last 20 Years

“…That is, the integration of conventional (allopathic) medicine and CAM, involving shared management of the patient, shared patient care, shared practice guidelines, and shared common values and goals to treat the well-being of the whole person' [40]. We will see if this definition becomes widely adopted [41,42].…”

The Integrative Medicine Team—Is Biomedical Dominance Inevitable?

“…17 Although only a small number of studies have been published, biomedical dominance has also been observed in the IM setting. 3,9 There is a tendency for biomedical doctors to control patient care and use biomedical language as the main form of communication between practitioners. 18,19 Research confirms the significant impact biomedical practitioners' attitudes and knowledge of TCAM have on the style of IM practiced and the level of integration.…”

“…1 Professional bodies and researchers have proposed a range of definitions for and approaches to integrative medicine (IM); however, a final definition is likely to emerge and settle only as the practice of IM develops. [1][2][3][4][5][6][7] IM teams and health care models Given the diversity of descriptions of IM, it is not surprising that clinics claiming to offer IM also provide health care using different team arrangements and service models.…”

Integrating Complementary and Conventional Care Using Quality Use of Medicines as a Framework

“…These IM definitions and dimensions reinforce the fact that IM does not aim to reject or replace either CAM or conventional therapies: it advocates combining both types of therapies when the combination is relevant to the individual's needs and is safe and evidence-based (Kotsirilos et al 2010). Khorsan et al (2011) undertook a systematic review of IM and identified an extensive and increasing body of literature on the subject that can be used to support practice. However, because IM is an emerging field in many countries, there may be less evidence for IM than for individual CAM.…”