University of Sussex, Falmer, Brighton, UK.
Complement Ther Med. 2012 Feb-Apr;20(1-2):38-44. doi: 10.1016/j.ctim.2011.10.004. Epub 2011 Nov 29.
In the UK, patients frequently choose complementary (CAM) therapies, particularly for chronic painful musculoskeletal conditions. It is widely agreed that better integration of complementary and traditional healthcare is desirable. We piloted the Benefits and Risks of Treatment Questionnaire to compare the views of different healthcare practitioners about traditional and alternative approaches in one clinical scenario in order to assess barriers to effective integration.
A cross-sectional survey of healthcare practitioners (primary care practitioners, physiotherapists, pharmacists, osteopaths, chiropractors and acupuncturists) in the UK. The views of all healthcare providers were compared using the exemplar of neck, shoulder and upper arm pain to explore the perceived risks and benefits of different types of therapeutic intervention using a mathematical cluster approach.
448/1254 (36%) useable replies were received representing all six professions. A mean of 14.9 years of experience was reported by participants. The cluster analyses revealed distinct clusters of opinion of benefit: primary care physicians, physiotherapists and pharmacists were significantly more likely to rate a cluster including: anti-inflammatory drugs, steroid injections, steroids, physiotherapy, paracetamol and antidepressants as beneficial for neck, shoulder and upper arm pain. In contrast, osteopaths and chiropractors, but not physiotherapists were significantly more likely to rate a cluster including chiropractic, osteopathy and physiotherapy as beneficial.
The Beliefs about Risks and Benefits of Treatments Questionnaire can be applied using a postal approach and achieves similar response rates to other surveys amongst healthcare practitioners. Despite widespread agreement that increased integration of traditional and alternative approaches is desirable, the results of this study suggest that experienced practitioners show the strongest belief in the benefit of approaches closest to their own training and background and the most wariness of risk to those therapies furthest from their background.
在英国，患者经常选择补充（CAM）疗法，尤其是用于慢性疼痛的肌肉骨骼疾病。广泛认为，更好地整合补充和传统医疗保健是可取的。我们试用了治疗的益处和风险问卷，以比较不同医疗保健从业者对同一临床情况下传统和替代方法的看法，以评估有效整合的障碍。
对英国的医疗保健从业者（初级保健医生、物理治疗师、药剂师、整骨师、脊医和针灸师）进行了横断面调查。使用颈部、肩部和上臂疼痛的范例比较了所有医疗保健提供者的观点，以探索使用数学聚类方法不同类型治疗干预的感知风险和益处。
收到了来自 6 个专业的 448/1254 份（36%）可使用的回复。参与者报告的平均经验为 14.9 年。聚类分析显示出不同的受益观点群：初级保健医生、物理治疗师和药剂师更有可能将包括以下内容的群组评定为有益于颈部、肩部和上臂疼痛：抗炎药、类固醇注射、类固醇、物理治疗、扑热息痛和抗抑郁药。相比之下，整骨师和脊医，而不是物理治疗师，更有可能将包括整骨、脊骨疗法和物理治疗的群组评定为有益。
Beliefs about Risks and Benefits of Treatments Questionnaire 可以通过邮寄方式应用，并且在医疗保健从业者中的其他调查中达到类似的回复率。尽管广泛认为增加传统和替代方法的整合是可取的，但这项研究的结果表明，经验丰富的从业者最相信与自己的培训和背景最接近的方法的益处，并且对那些与自己的背景最不相符的治疗方法的风险最谨慎。
