Traditional and complementary medicine perspectives of family physicians in Istanbul

Ali Timucin Atayoglu; Mahmut Tokaç; Sibel Doğan; Abdullah Güner; Erdoğan Kocayiğit; Muharrem Güner

doi:10.22391/fppc.1192917

Araştırma Makalesi

Traditional and complementary medicine perspectives of family physicians in Istanbul

Yıl 2023, Cilt: 8 Sayı: 1, 16 - 23, 07.02.2023

Ali Timucin Atayoglu , Mahmut Tokaç , Sibel Doğan , Abdullah Güner , Erdoğan Kocayiğit , Muharrem Güner

https://doi.org/10.22391/fppc.1192917

Cited By: 2

Öz

Introduction: The World Health Organization, within the scope of the Traditional Medicine Strategy for 2014-2023, recommends the development of integrated health policies, particularly in the area of primary healthcare. However, family physicians often report feeling insufficiently trained to effectively integrate these practices into patient care. This study aims to assess the views, understanding, and experiences of family physicians regarding the utilization of Traditional & Complementary Medicine (T&CM).

Methods: The family physicians employed by the Istanbul Health Directorate Public Health Services were solicited to participate in an 18-question online survey to assess their level of education in T&CM methods, their views on integration of T&CM into family medicine, and the impact of these practices on patient care.

Results: A total of 324 family physicians took part in the survey; 12.0% were specialists, 64.5% had worked in primary care for over 10 years, and 59.6% were in the age range of 31-50 years. Among the physicians, the majority (70.1%) reported a preference for integrating T&CM practices with conventional medicine (ConvM). The majority of the participants (71.6%) had no formal T&CM training, and 66.4% reported inquiring about T&CM in their patient consultations. Over half of the physicians (56.79%) believed that T&CM methods should be used in preventive medicine. The most widely recognized T&CM technique was cupping therapy (18.5%), which was also the most frequently recommended method by physicians.

Conclusion: Most of the family physicians who participated in the study expressed a desire for integrative medicine, despite acknowledging limited formal education in this field. Offering physicians training in evidence-based complementary medicine therapies could provide them with additional non-invasive treatment options. However, patients' diffidence to inform their family physicians about T&CM practices they undergo may pose significant risks. As a result, incorporating education on integrative medicine into formal medical education and residency training may be necessary.

Keywords: Family physician, complementary medicine, integrative medicine, traditional medicine

Anahtar Kelimeler

Family physician, complementary medicine, integrative medicine, traditional medicine

Teşekkür

The authors are thankful to the Istanbul Provincial Health Directorate for providing support for carrying out this research, and all the family physicians for their participation in the study. They are also grateful to Assoc. Prof. Onur Ozturk from Samsun Education and Research Hospital, Turkiye, and Dr. Hammad Khan from the University of California Davis, Department of Psychiatry & Behavioral Sciences, California, USA for their valuable feedback regarding the research paper. The authors would like to express their gratitude to Prof. Mustafa Tozun from the Department of Public Health and Prof. Ferhan Elmali from the Department of Biostatistics in Izmir Katip Celebi University for their insightful comments and consultancy in statistical methods.

Kaynakça

1. Frass M, Strassl RP, Friehs H, Mullner M, Kundi M, Kaye AD. Use and acceptance of complementary and alternative medicine among the general population and medical personnel: A systematic review. Ochsner J. 2012;12(1):45-56. https://pubmed.ncbi.nlm.nih.gov/22438782/
2. Harris PE, Cooper KL, Relton C, Thomas KJ. Prevalence of complementary and alternative medicine (CAM) use by the general population: A systematic review and update. Int J Clin Pract. 2012;66(10):924-39. https://doi.org/10.1111/j.1742-1241.2012.02945.x
3. World Health Organization. Programme on Traditional Medicine. WHO traditional medicine strategy 2002-2005. World Health Organization; 2002. https://apps.who.int/iris/handle/10665/67163 (Access Date: October 24, 2022)
4. Ock SM, Choi JY, Cha YS, Lee JB, Chun MS, Huh CH, et al. The use of complementary and alternative medicine in a general population in South Korea: Results from a national survey in 2006. J Korean Med Sci. 2009;24(1):1-6. https://doi.org/10.3346/jkms.2009.24.1.1
5. Peltzer K, Pengpid S. Prevalence and determinants of traditional, complementary and alternative medicine provider use among adults from 32 countries. Chin J Integr Med. 2018;24(8):584-90. https://doi.org/10.1007/s11655-016-2748-y
6. Posadzki P, Watson LK, Alotaibi A, Ernst E. Prevalence of use of complementary and alternative medicine (cam) by patients/consumers in the UK: Systematic review of surveys. Clin Med J Royal College Physicians London. 2013;13(2):126-31. https://doi.org/10.7861/clinmedicine.13-2-126
7. Fjær EL, Landet ER, McNamara CL, Eikemo TA. The use of complementary and alternative medicine (CAM) in Europe. BMC Complement Med Ther. 2020;20(1):108. https://doi.org/10.1186/s12906-020-02903-w
8. Barnes PM, Bloom B, Nahin RL. Complementary and alternative medicine use among adults and children: United States. 2007. Natl Health Stat Report. 2009;(12):1-23. https://doi.org/10.1037/e623942009-001
9. Ng JY, Garber A, Luong M, Cooley K, Busse JW. No improvement in disclosure of natural health product use to primary care medical doctors in the last 15 years: A survey of naturopathic patients. Complement Ther Clin Pract. 2020;39:101106. https://doi.org/10.1016/j.ctcp.2020.101106
10. Trail-Mahan T, Mao CL, Bawel-Brinkley K. Complementary and alternative medicine: Nurses’ attitudes and knowledge. Pain Management Nursing. 2013;14(4):277-86. https://doi.org/10.1016/j.pmn.2011.06.001
11. Hall H, Brosnan C, Cant R, Collins M, Leach M. Nurses’ attitudes and behaviour towards patients’ use of complementary therapies: A mixed methods study. J Adv Nurs. 2018;74(7):1649-58. https://doi.org/10.1111/jan.13554
12. Ben-Arye E, Frenkel M, Klein A, Scharf M. Attitudes toward integration of complementary and alternative medicine in primary care: Perspectives of patients. physicians and complementary practitioners. Patient Educ Couns. 2008;70(3):395-402. https://doi.org/10.1016/j.pec.2007.11.019
13. Karahanci ON, Oztoprak UY, Ersoy M, Zeybek Unsal C, Hayirlidag M, Ornek Buken N. Comparison of traditional, complementary medicine draft regulations and regulations. Turk J Bioethics. 2015;2(2):117-26. https://doi.org/10.5505/tjob.2015.85856
14. World Health Assembly. WHO Traditional Medicine Strategy: 2014-2023. World Health Organization; 2013. http://www.who.int/medicines/publications/traditional/trm_strategy14_23/en/ (Access Date: October 24, 2022)
15. Joos S, Musselmann B, Szecsenyi J. Integration of complementary and alternative medicine into family practices in Germany: Results of a national survey. Evid Based Complement Alternat Med. 2011;2011:495813. https://doi.org/10.1093/ecam/nep019
16. Berretta M, Rinaldi L, Taibi R, Tralongo P, Fulvi A, Montesarchio V, et al. Physician Attitudes and Perceptions of Complementary and Alternative Medicine (CAM): A Multicentre Italian Study. Front Oncol. 2020;10:594. https://doi.org/10.3389/fonc.2020.00594
17. Furlow ML, Patel DA, Sen A, Liu JR. Physician and patient attitudes towards complementary and alternative medicine in obstetrics and gynecology. BMC Complement Altern Med. 2008;8:35. https://doi.org/10.1186/1472-6882-8-35
18. Lipman L, Dale J, MacPherson H. Attitudes of GPs towards the provision of acupuncture on the NHS. Complement Ther Med. 2003;11(2):110-4. https://doi.org/10.1016/S0965-2299(03)00042-6
19. Perkin MR, Pearcy RM, Fraser JS. A comparison of the attitudes shown by general practitioners. hospital doctors and medical students towards alternative medicine. J R Soc Med. 1994;87(9):523-5. https://doi.org/10.1177/014107689408700914
20. White AR, Resch KL, Ernst E. Complementary medicine: Use and attitudes among GPs. Fam Pract. 1997;14(4):302-6. https://doi.org/10.1093/fampra/14.4.302
21. Berman BM, Bausell RB, Lee WL. Use and referral patterns for 22 complementary and alternative medical therapies by members of the American College of Rheumatology: Results of a national survey. Arch Intern Med. 2002;162(7):766-70. https://doi.org/10.1001/archinte.162.7.766
22. Fountain-Polley S, Kawai G, Goldstein A, Ninan T. Knowledge and exposure to complementary and alternative medicine in paediatric doctors: A questionnaire survey. BMC Complement Altern Med. 2007;7:38. https://doi.org/10.1186/1472-6882-7-38
23. Tozun M, Kucukkefe Bag H, Pektas M, Soyacikgoz E, Tekindal MA. Knowledge. Attitudes. and Opinions of Health Professionals and Students on Traditional and Complementary Medicine Practices in Turkey: A Systematic Review and Meta-Analysis. EUR J ENV PUBLIC HLT. 2022;6(2):em0115. https://doi.org/10.21601/ejeph/12186

İstanbul’daki aile hekimlerinin geleneksel ve tamamlayıcı tıp bakış açıları

Yıl 2023, Cilt: 8 Sayı: 1, 16 - 23, 07.02.2023

Ali Timucin Atayoglu , Mahmut Tokaç , Sibel Doğan , Abdullah Güner , Erdoğan Kocayiğit , Muharrem Güner

https://doi.org/10.22391/fppc.1192917

Cited By: 2

Öz

Giriş: Dünya Sağlık Örgütü, 2014-2023 Geleneksel Tıp Stratejisi kapsamında, özellikle birinci basamak sağlık hizmetleri alanında entegre sağlık politikaları geliştirilmesini tavsiye etmektedir. Öte yandan, aile hekimleri genellikle bu uygulamaları hasta bakımına etkili bir şekilde entegre etmek için yetersiz eğitim aldıklarını hissettiklerini bildirmektedir. Bu çalışma, aile hekimlerinin Geleneksel ve Tamamlayıcı Tıp (GETAT) kullanımına ilişkin görüş, anlayış ve deneyimlerini değerlendirmeyi amaçlamaktadır.

Yöntem: İstanbul Sağlık Müdürlüğü Halk Sağlığı Hizmetleri’ne bağlı görev yapan aile hekimlerine 18 soruluk çevrimiçi bir anket uygulanarak GETAT yöntemleri konusundaki eğitim düzeyleri, GETAT uygulamalarının aile hekimliğine entegrasyonu ve hasta bakımı üzerine etkileri gibi konularla ilgili görüşleri değerlendirilmiştir.

Bulgular: Ankete toplam 324 aile hekimi katılmıştır; bunların %12,0'si uzman, %64,5'i 10 yıldan fazla birinci basamakta çalışmış ve %59,6'sı 31-50 yaş aralığındaydı. Hekimlerin %70,1'i GETAT uygulamalarının konvansiyonel tıp ile entegre edilmesini tercih ettiğini bildirdi. Katılımcıların büyük çoğunluğu (%71,6) formal bir GETAT eğitimi almamıştı ve %66,4'ü hasta konsültasyonlarında GETAT hakkında sorular sorduğunu bildirmiştir. Hekimlerin yarısından fazlası (%56,79) koruyucu hekimlikte GETAT yöntemlerinin kullanılması gerektiğine inanmaktadır. En çok tanınan T&CM tekniği, hekimler tarafından da en sık önerilen yöntem olan kupa tedavisi (%18,5) idi.

Sonuç: Çalışmaya katılan aile hekimlerinin çoğu, bu alandaki örgün eğitimlerinin sınırlı olduğunu kabul etmelerine rağmen, entegratif tıbba ilgi duyduklarını belirtmişlerdir. Kanıta dayalı tamamlayıcı tıp terapileri konusunda doktorlara eğitim vermek, onlara invaziv olmayan ek tedavi seçenekleri sağlayabilir. Öte yandan, hastaların başvurdukları GETAT uygulamaları hakkında aile hekimlerine bilgi verme konusundaki çekinceleri önemli riskler oluşturabilir. Sonuç olarak, tamamlayıcı tıp eğitimini resmi tıp eğitimi ve uzmanlık eğitimi ile birleştirmek gerekli olabilir.

Anahtar kelimeler: Aile hekimliği, tamamlayıcı tıp, entegratif tıp, geleneksel tıp

Anahtar Kelimeler

Aile hekimliği, tamamlayıcı tıp, entegratif tıp, geleneksel tıp

Kaynakça

1. Frass M, Strassl RP, Friehs H, Mullner M, Kundi M, Kaye AD. Use and acceptance of complementary and alternative medicine among the general population and medical personnel: A systematic review. Ochsner J. 2012;12(1):45-56. https://pubmed.ncbi.nlm.nih.gov/22438782/
2. Harris PE, Cooper KL, Relton C, Thomas KJ. Prevalence of complementary and alternative medicine (CAM) use by the general population: A systematic review and update. Int J Clin Pract. 2012;66(10):924-39. https://doi.org/10.1111/j.1742-1241.2012.02945.x
3. World Health Organization. Programme on Traditional Medicine. WHO traditional medicine strategy 2002-2005. World Health Organization; 2002. https://apps.who.int/iris/handle/10665/67163 (Access Date: October 24, 2022)
4. Ock SM, Choi JY, Cha YS, Lee JB, Chun MS, Huh CH, et al. The use of complementary and alternative medicine in a general population in South Korea: Results from a national survey in 2006. J Korean Med Sci. 2009;24(1):1-6. https://doi.org/10.3346/jkms.2009.24.1.1
5. Peltzer K, Pengpid S. Prevalence and determinants of traditional, complementary and alternative medicine provider use among adults from 32 countries. Chin J Integr Med. 2018;24(8):584-90. https://doi.org/10.1007/s11655-016-2748-y
6. Posadzki P, Watson LK, Alotaibi A, Ernst E. Prevalence of use of complementary and alternative medicine (cam) by patients/consumers in the UK: Systematic review of surveys. Clin Med J Royal College Physicians London. 2013;13(2):126-31. https://doi.org/10.7861/clinmedicine.13-2-126
7. Fjær EL, Landet ER, McNamara CL, Eikemo TA. The use of complementary and alternative medicine (CAM) in Europe. BMC Complement Med Ther. 2020;20(1):108. https://doi.org/10.1186/s12906-020-02903-w
8. Barnes PM, Bloom B, Nahin RL. Complementary and alternative medicine use among adults and children: United States. 2007. Natl Health Stat Report. 2009;(12):1-23. https://doi.org/10.1037/e623942009-001
9. Ng JY, Garber A, Luong M, Cooley K, Busse JW. No improvement in disclosure of natural health product use to primary care medical doctors in the last 15 years: A survey of naturopathic patients. Complement Ther Clin Pract. 2020;39:101106. https://doi.org/10.1016/j.ctcp.2020.101106
10. Trail-Mahan T, Mao CL, Bawel-Brinkley K. Complementary and alternative medicine: Nurses’ attitudes and knowledge. Pain Management Nursing. 2013;14(4):277-86. https://doi.org/10.1016/j.pmn.2011.06.001
11. Hall H, Brosnan C, Cant R, Collins M, Leach M. Nurses’ attitudes and behaviour towards patients’ use of complementary therapies: A mixed methods study. J Adv Nurs. 2018;74(7):1649-58. https://doi.org/10.1111/jan.13554
12. Ben-Arye E, Frenkel M, Klein A, Scharf M. Attitudes toward integration of complementary and alternative medicine in primary care: Perspectives of patients. physicians and complementary practitioners. Patient Educ Couns. 2008;70(3):395-402. https://doi.org/10.1016/j.pec.2007.11.019
13. Karahanci ON, Oztoprak UY, Ersoy M, Zeybek Unsal C, Hayirlidag M, Ornek Buken N. Comparison of traditional, complementary medicine draft regulations and regulations. Turk J Bioethics. 2015;2(2):117-26. https://doi.org/10.5505/tjob.2015.85856
14. World Health Assembly. WHO Traditional Medicine Strategy: 2014-2023. World Health Organization; 2013. http://www.who.int/medicines/publications/traditional/trm_strategy14_23/en/ (Access Date: October 24, 2022)
15. Joos S, Musselmann B, Szecsenyi J. Integration of complementary and alternative medicine into family practices in Germany: Results of a national survey. Evid Based Complement Alternat Med. 2011;2011:495813. https://doi.org/10.1093/ecam/nep019
16. Berretta M, Rinaldi L, Taibi R, Tralongo P, Fulvi A, Montesarchio V, et al. Physician Attitudes and Perceptions of Complementary and Alternative Medicine (CAM): A Multicentre Italian Study. Front Oncol. 2020;10:594. https://doi.org/10.3389/fonc.2020.00594
17. Furlow ML, Patel DA, Sen A, Liu JR. Physician and patient attitudes towards complementary and alternative medicine in obstetrics and gynecology. BMC Complement Altern Med. 2008;8:35. https://doi.org/10.1186/1472-6882-8-35
18. Lipman L, Dale J, MacPherson H. Attitudes of GPs towards the provision of acupuncture on the NHS. Complement Ther Med. 2003;11(2):110-4. https://doi.org/10.1016/S0965-2299(03)00042-6
19. Perkin MR, Pearcy RM, Fraser JS. A comparison of the attitudes shown by general practitioners. hospital doctors and medical students towards alternative medicine. J R Soc Med. 1994;87(9):523-5. https://doi.org/10.1177/014107689408700914
20. White AR, Resch KL, Ernst E. Complementary medicine: Use and attitudes among GPs. Fam Pract. 1997;14(4):302-6. https://doi.org/10.1093/fampra/14.4.302
21. Berman BM, Bausell RB, Lee WL. Use and referral patterns for 22 complementary and alternative medical therapies by members of the American College of Rheumatology: Results of a national survey. Arch Intern Med. 2002;162(7):766-70. https://doi.org/10.1001/archinte.162.7.766
22. Fountain-Polley S, Kawai G, Goldstein A, Ninan T. Knowledge and exposure to complementary and alternative medicine in paediatric doctors: A questionnaire survey. BMC Complement Altern Med. 2007;7:38. https://doi.org/10.1186/1472-6882-7-38
23. Tozun M, Kucukkefe Bag H, Pektas M, Soyacikgoz E, Tekindal MA. Knowledge. Attitudes. and Opinions of Health Professionals and Students on Traditional and Complementary Medicine Practices in Turkey: A Systematic Review and Meta-Analysis. EUR J ENV PUBLIC HLT. 2022;6(2):em0115. https://doi.org/10.21601/ejeph/12186

Toplam 23 adet kaynakça vardır.

Ayrıntılar

Birincil Dil	İngilizce
Konular	Klinik Tıp Bilimleri
Bölüm	Araştırma Makalesi (Original Article)
Yazarlar	Ali Timucin Atayoglu 0000-0003-4568-4234 Mahmut Tokaç 0000-0002-3051-0074 Sibel Doğan 0000-0003-4026-1419 Abdullah Güner 0000-0001-8624-4468 Erdoğan Kocayiğit 0000-0001-7197-9410 Muharrem Güner 0000-0002-4468-5254
Yayımlanma Tarihi	7 Şubat 2023
Gönderilme Tarihi	21 Ekim 2022
Kabul Tarihi	27 Aralık 2022
Yayımlandığı Sayı	Yıl 2023 Cilt: 8 Sayı: 1

Kaynak Göster

APA	Atayoglu, A. T., Tokaç, M., Doğan, S., Güner, A., vd. (2023). Traditional and complementary medicine perspectives of family physicians in Istanbul. Family Practice and Palliative Care, 8(1), 16-23. https://doi.org/10.22391/fppc.1192917
AMA	Atayoglu AT, Tokaç M, Doğan S, Güner A, Kocayiğit E, Güner M. Traditional and complementary medicine perspectives of family physicians in Istanbul. Fam Pract Palliat Care. Şubat 2023;8(1):16-23. doi:10.22391/fppc.1192917
Chicago	Atayoglu, Ali Timucin, Mahmut Tokaç, Sibel Doğan, Abdullah Güner, Erdoğan Kocayiğit, ve Muharrem Güner. “Traditional and Complementary Medicine Perspectives of Family Physicians in Istanbul”. Family Practice and Palliative Care 8, sy. 1 (Şubat 2023): 16-23. https://doi.org/10.22391/fppc.1192917.
EndNote	Atayoglu AT, Tokaç M, Doğan S, Güner A, Kocayiğit E, Güner M (01 Şubat 2023) Traditional and complementary medicine perspectives of family physicians in Istanbul. Family Practice and Palliative Care 8 1 16–23.
IEEE	A. T. Atayoglu, M. Tokaç, S. Doğan, A. Güner, E. Kocayiğit, ve M. Güner, “Traditional and complementary medicine perspectives of family physicians in Istanbul”, Fam Pract Palliat Care, c. 8, sy. 1, ss. 16–23, 2023, doi: 10.22391/fppc.1192917.
ISNAD	Atayoglu, Ali Timucin vd. “Traditional and Complementary Medicine Perspectives of Family Physicians in Istanbul”. Family Practice and Palliative Care 8/1 (Şubat 2023), 16-23. https://doi.org/10.22391/fppc.1192917.
JAMA	Atayoglu AT, Tokaç M, Doğan S, Güner A, Kocayiğit E, Güner M. Traditional and complementary medicine perspectives of family physicians in Istanbul. Fam Pract Palliat Care. 2023;8:16–23.
MLA	Atayoglu, Ali Timucin vd. “Traditional and Complementary Medicine Perspectives of Family Physicians in Istanbul”. Family Practice and Palliative Care, c. 8, sy. 1, 2023, ss. 16-23, doi:10.22391/fppc.1192917.
Vancouver	Atayoglu AT, Tokaç M, Doğan S, Güner A, Kocayiğit E, Güner M. Traditional and complementary medicine perspectives of family physicians in Istanbul. Fam Pract Palliat Care. 2023;8(1):16-23.