BMC Complementary Medicine and Therapies (Jul 2020)

Patients’ and clinicians’ expectations on integrative medicine Services for Diabetes: a focus group study

  • Kam Wa Chan,
  • Pak Wing Lee,
  • Crystal Pui Sha Leung,
  • Gary Chi Wang Chan,
  • Wai Han Yiu,
  • Hoi Man Cheung,
  • Bin Li,
  • Sarah Wing Yan Lok,
  • Hongyu Li,
  • Rui Xue,
  • Loretta Yuk Yee Chan,
  • Joseph Chi Kam Leung,
  • Tai Pong Lam,
  • Kar Neng Lai,
  • Sydney Chi Wai Tang

DOI
https://doi.org/10.1186/s12906-020-02994-5
Journal volume & issue
Vol. 20, no. 1
pp. 1 – 11

Abstract

Read online

Abstract Background Difference of perspective between patients and physicians over integrative medicine (IM) research and service provision remains unclear despite significant use worldwide. We observed an exceptionally low utilisation of IM and potential underreporting in diabetes. We aimed to explore the barriers and recommendations regarding service delivery and research of IM service among diabetes patients and physicians. Methods A 10-group, 50-participant semi-structured focus group interview series was conducted. Twenty-one patients with diverse severity of disease, comorbidities and education levels; and 29 physicians (14 conventional medicine (ConM) and 15 Chinese medicine (CM)) with diverse clinical experience, academic background and affiliation were purposively sampled from private and public clinics. Their perspectives were qualitatively analysed by constant comparative method. Results Seven subthemes regarding barriers towards IM service were identified including finance, service access, advice from medical professionals, uncertainty of service quality, uncertainty of CM effect, difficulty in understanding CM epistemology and access to medical records. Patients underreported the use of CM due to the concern over neutrality of medical advice among physicians. Inconvenience of service access, frequent follow-up, use of decoction and long-term financial burden were identified as key obstacles among patients. Regarding research design, ConM physicians emphasised standardisation and reproducibility while CM physicians emphasised personalisation. Some CM-related outcome measurements were suggested as non-communicable. Both physicians acknowledged the discordance in epistemology should be addressed by pragmatic approach. Conclusion Key obstacles of CAM clinical utilisation are different between patients. Further assessment on IM should be pragmatic to balance between standardisation, reproducibility and real-world practice. Evidence-based IM programs and research should merge with existing infrastructure.

Keywords