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Integration

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Integration of herbal medicine into Western healthcare systems has ranged from the development of Western herbal medicine (WHM)[1] to the introduction of herbal medicine into medical school curricula.[2] The most common barriers to integration include expansion of treatment reliability[3], increased public awareness and advocacy[3], and standardized education of herbal medicine practitioners.[2]

WHM

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One form of herbal medicine integration is Western herbal medicine (WHM), which is “rooted in traditional explanatory models of health but is increasingly informed by biomedicine[4][5].” It is practiced in several Western regions, such as Europe, North America, Australia, and New Zealand.[1]

WHM has three distinct aspects within its practice[6]: liquified treatment, personalized care, and positive, emphatic physician care. WHM practitioners commonly prescribe medication in the form of “liquid extracts”[6] instead of pills, capsules, or tablets. The holistic approach to herbal medicine is translated into personalized care in the WHM setting, which provides value to a patient. Having a positive, empathetic practitioner promotes trust and creates a “meaning context” within the patient-physician relationship.[7][8]

These aspects distinguish herbal from biomedical medicine but also produce skepticism from the biomedical community. Critics state that the contextual implications[6] behind WHM treatment can induce the placebo effect within patients and influence health outcomes. The idea of “symbolic efficacy”[9] and chemosensory properties[9] in herbal medicine support this when considering that herbal liquids and teas retain the distinctive sensory characteristics (e.g., odor and taste) of whole herbs.[10]

Other advancements

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Homeopathy is another form of herbal medicine and plays a role in cancer treatment. Cancer patients who practice homeopathy have significant improvements in health.[11] Yet, there are both negative economic and physical implications to homeopathy. When considering the economic implications of homeopathy, outpatient care and productivity loss (measured by number of sick leave days) cause homeopathy to be significantly higher than the costs of regular cancer treatment.[12] Homeopathic aggravation is a transient worsening of the patients’ symptoms before an expected improvement occurs.[13] When homeopathy practitioners mistake a patient’s adverse effects for homeopathic aggravation, it can lead to dangerous health outcomes.[13]

The University of Arizona Center for Integrative Medicine[2] was created to educate physicians on integrative medicine. This process included teaching traditional Chinese medicine, Ayurveda, homeopathy, manual medicine, and energy medicine”[2] and incorporating meditation and other traditional practices into the curriculum. There were several barriers to development, including an expected “measure of competence” in order to gain recognition from the public and biomedical community. Now, with around 40% of US medical schools associated with the Academic Consortium for Integrative Medicine and Health[2], authors Maizes, V. et al predict that soon all medical students will receive foundational training in the principles of IM [Integrative Medicine].[2]

  1. ^ a b Niemeyer, Kathryn; Bell, Iris R.; Koithan, Mary (2013-09). "Traditional knowledge of Western herbal medicine and complex systems science". Journal of Herbal Medicine. 3 (3): 112–119. doi:10.1016/j.hermed.2013.03.001. PMC 3777424. PMID 24058898. {{cite journal}}: Check date values in: |date= (help)CS1 maint: PMC format (link)
  2. ^ a b c d e f Maizes, Victoria; Horwitz, Randy; Lebensohn, Patricia; McClafferty, Hilary; Dalen, James; Weil, Andrew (2015-11). "The evolution of integrative medical education: the influence of the University of Arizona Center for Integrative Medicine". Journal of Integrative Medicine. 13 (6): 356–362. doi:10.1016/S2095-4964(15)60209-6. {{cite journal}}: Check date values in: |date= (help)
  3. ^ a b Appiah, Bernard; Amponsah, Isaac Kingsley; Poudyal, Anubhuti; Mensah, Merlin Lincoln Kwao (2018-12). "Identifying strengths and weaknesses of the integration of biomedical and herbal medicine units in Ghana using the WHO Health Systems Framework: a qualitative study". BMC Complementary and Alternative Medicine. 18 (1). doi:10.1186/s12906-018-2334-2. ISSN 1472-6882. PMC 6196414. PMID 30348173. {{cite journal}}: Check date values in: |date= (help)CS1 maint: PMC format (link) CS1 maint: unflagged free DOI (link)
  4. ^ Braun, L.A.; Spitzer, O.; Tiralongo, E.; Wilkinson, J.M.; Bailey, M.; Poole, S.G.; Dooley, M. (2013-02). "Naturopaths and Western herbalists' attitudes to evidence, regulation, information sources and knowledge about popular complementary medicines". Complementary Therapies in Medicine. 21 (1): 58–64. doi:10.1016/j.ctim.2012.11.008. {{cite journal}}: Check date values in: |date= (help)
  5. ^ Evans, Sue (2008-12). "Changing the knowledge base in Western herbal medicine". Social Science & Medicine. 67 (12): 2098–2106. doi:10.1016/j.socscimed.2008.09.046. {{cite journal}}: Check date values in: |date= (help)
  6. ^ a b c Snow, James (2016-01). "Context Effects in Western Herbal Medicine: Fundamental to Effectiveness?". EXPLORE. 12 (1): 55–62. doi:10.1016/j.explore.2015.10.004. {{cite journal}}: Check date values in: |date= (help)
  7. ^ Moerman, Daniel E.; Jonas, Wayne B. (2002-03-19). "Deconstructing the Placebo Effect and Finding the Meaning Response". Annals of Internal Medicine. 136 (6): 471. doi:10.7326/0003-4819-136-6-200203190-00011. ISSN 0003-4819.
  8. ^ Blasi, Zelda Di; Harkness, Elaine; Ernst, Edzard; Georgiou, Amanda; Kleijnen, Jos (2001-03). "Influence of context effects on health outcomes: a systematic review". The Lancet. 357 (9258): 757–762. doi:10.1016/s0140-6736(00)04169-6. ISSN 0140-6736. {{cite journal}}: Check date values in: |date= (help)
  9. ^ a b Vits, Sabine; Cesko, Elvir; Enck, Paul; Hillen, Uwe; Schadendorf, Dirk; Schedlowski, Manfred (2011-06-27). "Behavioural conditioning as the mediator of placebo responses in the immune system". Philosophical Transactions of the Royal Society B: Biological Sciences. 366 (1572): 1799–1807. doi:10.1098/rstb.2010.0392. ISSN 0962-8436. PMC 3130401. PMID 21576137.{{cite journal}}: CS1 maint: PMC format (link)
  10. ^ Moerman, Daniel E. (2007-07). "Agreement and meaning: Rethinking consensus analysis". Journal of Ethnopharmacology. 112 (3): 451–460. doi:10.1016/j.jep.2007.04.001. {{cite journal}}: Check date values in: |date= (help)
  11. ^ Frass, Michael; Friehs, Helmut; Thallinger, Christiane; Sohal, Narinderjit Kaur; Marosi, Christine; Muchitsch, Ilse; Gaertner, Katharina; Gleiss, Andreas; Schuster, Ernst; Oberbaum, Menachem (2015-06). "Influence of adjunctive classical homeopathy on global health status and subjective wellbeing in cancer patients – A pragmatic randomized controlled trial". Complementary Therapies in Medicine. 23 (3): 309–317. doi:10.1016/j.ctim.2015.03.004. ISSN 0965-2299. {{cite journal}}: Check date values in: |date= (help)
  12. ^ Ostermann, Julia K.; Reinhold, Thomas; Witt, Claudia M. (2015-07-31). "Can Additional Homeopathic Treatment Save Costs? A Retrospective Cost-Analysis Based on 44500 Insured Persons". PLOS ONE. 10 (7): e0134657. doi:10.1371/journal.pone.0134657. ISSN 1932-6203.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  13. ^ a b Stub, Trine; Musial, Frauke; Kristoffersen, Agnete A.; Alræk, Terje; Liu, Jianping (2016-06). "Adverse effects of homeopathy, what do we know? A systematic review and meta-analysis of randomized controlled trials". Complementary Therapies in Medicine. 26: 146–163. doi:10.1016/j.ctim.2016.03.013. {{cite journal}}: Check date values in: |date= (help)
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