School of Pharmacy, University of Auckland, 85 Park Rd, Grafton, Auckland, 1023, New Zealand.
He Ako Hiringa, Auckland, New Zealand.
Drug Saf. 2022 Jul;45(7):713-735. doi: 10.1007/s40264-022-01189-w. Epub 2022 Jul 5.
Traditional, complementary and alternative medicine (TCAM) refers to a broad range of health practices and products typically not part of the 'conventional medicine' system, and its use is substantial among the general population. TCAM products and therapies may be used in addition to, or instead of, conventional medicine approaches, and some have been associated with adverse reactions or other harms.
The aims of this systematic review were to identify and examine recently published national studies globally on the prevalence of TCAM use in the general population, to review the research methods used in these studies and to propose best practices for future studies exploring prevalence of use of TCAM.
MEDLINE, Embase, CINAHL, PsycINFO and AMED were searched to identify relevant studies published since 2010. Articles/reports describing the prevalence of TCAM use in a national study among the general population were included. The quality of included studies was assessed using a risk of bias tool developed by Hoy et al. Relevant data were extracted and summarised.
Forty studies from 14 countries, comprising 21 national surveys and one cross-national survey, were included. Studies explored the use of TCAM products (e.g. herbal medicines), TCAM practitioners/therapies, or both. Included studies used different TCAM definitions, prevalence time frames and data collection tools, methods and analyses, thereby limiting comparability across studies. The reported prevalence of use of TCAM (products and/or practitioners/therapies) over the previous 12 months was 24-71.3%.
The reported prevalence of use of TCAM (products and/or practitioners/therapies) is high, but may underestimate use. Published prevalence data varied considerably, at least in part because studies utilise different data collection tools, methods and operational definitions, limiting cross-study comparisons and study reproducibility. For best practice, comprehensive, detailed data on TCAM exposures are needed, and studies should report an operational definition (including the context of TCAM use, products/practices/therapies included and excluded), publish survey questions and describe the data-coding criteria and analysis approach used.
传统医学、补充医学和替代医学(TCAM)指的是广泛的健康实践和产品,通常不属于“常规医学”体系,在普通人群中大量使用。TCAM 产品和疗法可与常规医学方法联合使用或替代使用,其中一些与不良反应或其他危害有关。
本系统评价的目的是确定并研究全球最近发表的关于普通人群中 TCAM 使用情况的国家研究,审查这些研究中使用的研究方法,并为探索 TCAM 使用流行率的未来研究提出最佳实践。
检索 MEDLINE、Embase、CINAHL、PsycINFO 和 AMED,以确定自 2010 年以来发表的相关研究。纳入描述普通人群中全国性研究中 TCAM 使用流行率的文章/报告。使用 Hoy 等人开发的偏倚风险工具评估纳入研究的质量。提取并总结相关数据。
纳入了来自 14 个国家的 40 项研究,包括 21 项全国性调查和一项跨国调查,研究探索了 TCAM 产品(如草药)、TCAM 从业者/疗法或两者的使用情况。纳入的研究使用了不同的 TCAM 定义、流行时间框架以及数据收集工具、方法和分析,从而限制了研究之间的可比性。过去 12 个月 TCAM(产品和/或从业者/疗法)使用的报告流行率为 24-71.3%。
TCAM(产品和/或从业者/疗法)的报告使用流行率很高,但可能低估了使用情况。发表的流行数据差异很大,至少部分原因是研究使用了不同的数据收集工具、方法和操作定义,限制了跨研究比较和研究再现性。为了最佳实践,需要全面、详细的 TCAM 暴露数据,研究应报告操作定义(包括 TCAM 使用的背景、包含和排除的产品/实践/疗法),发布调查问题,并描述数据编码标准和使用的分析方法。