Faculty of Health, University of Technology Sydney, Ultimo, Australia.
Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany.
Sci Rep. 2019 Feb 7;9(1):1573. doi: 10.1038/s41598-018-38279-8.
Concomitant complementary medicine (CM) and conventional medicine use is frequent and carries potential risks. Yet, CM users frequently neglect to disclose CM use to medical providers. Our systematic review examines rates of and reasons for CM use disclosure to medical providers. Observational studies published 2003-2016 were searched (AMED, CINAHL, MEDLINE, PsycINFO). Eighty-six papers reporting disclosure rates and/or reasons for disclosure/non-disclosure of CM use to medical providers were reviewed. Fourteen were selected for meta-analysis of disclosure rates of biologically-based CM. Overall disclosure rates varied (7-80%). Meta-analysis revealed a 33% disclosure rate (95%CI: 24% to 43%) for biologically-based CM. Reasons for non-disclosure included lack of inquiry from medical providers, fear of provider disapproval, perception of disclosure as unimportant, belief providers lacked CM knowledge, lacking time, and belief CM was safe. Reasons for disclosure included inquiry from medical providers, belief providers would support CM use, belief disclosure was important for safety, and belief providers would give advice about CM. Disclosure appears to be influenced by the nature of patient-provider communication. However, inconsistent definitions of CM and lack of a standard measure for disclosure created substantial heterogeneity between studies. Disclosure of CM use to medical providers must be encouraged for safe, effective patient care.
同时使用补充医学（CM）和常规医学很常见，且存在潜在风险。然而，CM 用户经常忽略向医疗服务提供者披露 CM 的使用情况。我们的系统评价检查了向医疗服务提供者披露 CM 使用情况的比率和原因。搜索了 2003 年至 2016 年发表的观察性研究（AMED、CINAHL、MEDLINE、PsycINFO）。审查了 86 篇报告向医疗服务提供者披露 CM 使用情况的比率和/或披露/不披露原因的论文。选择了 14 篇论文进行基于生物学的 CM 披露率的荟萃分析。总体披露率各不相同（7-80%）。荟萃分析显示，基于生物学的 CM 的披露率为 33%（95%CI：24%至 43%）。不披露的原因包括医疗服务提供者缺乏询问、担心提供者反对、认为披露不重要、认为提供者缺乏 CM 知识、缺乏时间以及认为 CM 是安全的。披露的原因包括医疗服务提供者的询问、相信提供者会支持 CM 的使用、相信披露对安全很重要以及相信提供者会提供关于 CM 的建议。披露似乎受到医患沟通性质的影响。然而，CM 的定义不一致以及缺乏披露的标准衡量标准导致研究之间存在很大的异质性。必须鼓励向医疗服务提供者披露 CM 的使用情况，以实现安全有效的患者护理。
