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ABSTRACT: Background
Difference of perspective between patients and physicians over integrative medicine (IM) research and service provision remains unclear despite significant use worldwide. We observed an exceptionally low utilisation of IM and potential underreporting in diabetes. We aimed to explore the barriers and recommendations regarding service delivery and research of IM service among diabetes patients and physicians.Methods
A 10-group, 50-participant semi-structured focus group interview series was conducted. Twenty-one patients with diverse severity of disease, comorbidities and education levels; and 29 physicians (14 conventional medicine (ConM) and 15 Chinese medicine (CM)) with diverse clinical experience, academic background and affiliation were purposively sampled from private and public clinics. Their perspectives were qualitatively analysed by constant comparative method.Results
Seven subthemes regarding barriers towards IM service were identified including finance, service access, advice from medical professionals, uncertainty of service quality, uncertainty of CM effect, difficulty in understanding CM epistemology and access to medical records. Patients underreported the use of CM due to the concern over neutrality of medical advice among physicians. Inconvenience of service access, frequent follow-up, use of decoction and long-term financial burden were identified as key obstacles among patients. Regarding research design, ConM physicians emphasised standardisation and reproducibility while CM physicians emphasised personalisation. Some CM-related outcome measurements were suggested as non-communicable. Both physicians acknowledged the discordance in epistemology should be addressed by pragmatic approach.Conclusion
Key obstacles of CAM clinical utilisation are different between patients. Further assessment on IM should be pragmatic to balance between standardisation, reproducibility and real-world practice. Evidence-based IM programs and research should merge with existing infrastructure.
SUBMITTER: Chan KW
PROVIDER: S-EPMC7331247 | biostudies-literature | 2020 Jul
REPOSITORIES: biostudies-literature
Chan Kam Wa KW Lee Pak Wing PW Leung Crystal Pui Sha CPS Chan Gary Chi Wang GCW Yiu Wai Han WH Cheung Hoi Man HM Li Bin B Lok Sarah Wing Yan SWY Li Hongyu H Xue Rui R Chan Loretta Yuk Yee LYY Leung Joseph Chi Kam JCK Lam Tai Pong TP Lai Kar Neng KN Tang Sydney Chi Wai SCW
BMC complementary medicine and therapies 20200702 1
<h4>Background</h4>Difference of perspective between patients and physicians over integrative medicine (IM) research and service provision remains unclear despite significant use worldwide. We observed an exceptionally low utilisation of IM and potential underreporting in diabetes. We aimed to explore the barriers and recommendations regarding service delivery and research of IM service among diabetes patients and physicians.<h4>Methods</h4>A 10-group, 50-participant semi-structured focus group ...[more]