One in three complementary medicine (CM) users do not disclose their CM use to their medical providers, according to the first international systematic review conducted by researchers at the Australian Research Centre in Complementary and Integrative Medicine. This poses significant direct and indirect risks of adverse effects and harm due to unsafe concurrent use of CM and conventional medicine use.
The findings provide an update on the prevalence and characteristics of disclosure of CM use to medical providers since previous research conducted in 2003.
“This figure has hardly changed since the last review of the topic 13 years ago. This is despite the fact that the authors of every paper included in our review called for improved communication between doctors and patients to facilitate better disclosure,” said lead author and PhD candidate Hope Foley.
disclosure of CM use to medical providers is influenced by the providers’ communication style
The study found that disclosure of CM use to medical providers is influenced by the providers’ communication style. Perceived provider knowledge of CM use was reported to be a barrier to discussions about CM use in clinical consultations.
When the actual response of the provider to disclosure of CM use was explored by researchers, negative or discouraging responses were reported by less than 20 per cent of disclosers or were not reported at all. Positive or encouraging responses to disclosure of CM use by a medical doctor were reported by a substantial proportion of respondents and neutral responses from medical providers were also common.
More than 67 per cent of participants agreed that disclosure was important.
“Patient autonomy and preference are important features of person-centered care to be considered by medical providers alongside safety and treatment outcomes in their patient management,” the authors write.
On a global public health level, the World Health Organisation recognises the importance of integrated care which encompasses CM. Yet public health policies and procedures often create barriers to effective integration, limiting appropriate management of concurrent use and access to the recognised benefits of integrated care.”
“As CM becomes more separate from mainstream health services, disclosure is only going to become more and more important for public safety.”
The researchers conclude that in the context of contemporary person-centered health care models, discussions and subsequent disclosure of CM use may be facilitated by direct inquiry about CM use by providers.
“This is a topic which should be treated with gravity,” they said. “Disclosure of CM use is central to wider patient management and care in contemporary clinical settings, particularly for primary care providers acting as gatekeeper in their patients’ care.”