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Towards the Evidence-Based Integration of Complementary Medicines into Hospital Settings

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The use of complementary medicine products offers potential benefits to hospital patients, yet very little is currently known about their use in Western hospitals or the extent of their potential risks and benefits. Hospital patients may be at higher risk from adverse events from complementary medicines than the general population because they take more pharmaceutical preparations, have poorer health and are at much higher risk of bleeding complications. The potential risks associated with complementary medicine use in hospital patients raises concerns for patient safety, yet it appears that hospital patients often fall into the divide created between community use of complementary medicines, which is widespread, and the hospital system, which does not support this use. Very few hospitals have well developed policies or guidelines on complementary medicine use, and few hospital staff have the necessary training to evaluate the use of complementary medicines and make appropriate recommendations to patients. This is compounded by the fact that complementary therapists generally do not have practice rights within most hospitals and patient disclosure of complementary medicine use to hospital staff appears to be poor.

There are a number of recommendations that may minimise risks and facilitate the evidence-based use of complementary medicines in hospital settings. Recommendations include (a) all hospital medical staff and general practitioners should ask patients about their use of complementary medicines, and this use should be documented in the medical record and care plans; (b) complementary medicine use in hospitals should be recorded on the medication chart and included in discharge summaries; and (c) adequate training is required to ensure hospital staff have the appropriate skill to advise patients about the safe and appropriate use of complementary medicines, and appropriate resources should be available to all staff members. If hospital medical staff advise against the use of complementary medicine, reasons for this recommendation should be clearly communicated to the patient and their carers and documented in the patient’s medical record. Hospitals should appoint a dedicated staff member, ideally with both mainstream and complementary medicine qualifications, to take a leadership role regarding maintaining and disseminating information about complementary medicine use. Where appropriate, hospital staff should communicate with patients’ usual healthcare practitioners, including naturopaths and herbalists, at admission and discharge. In cases where patients want to continue or initiate use of complementary medicine while in hospital, they should have access to an appropriately trained practitioner who is able to ensure their needs are met in a safe and appropriate way.

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  1. 1.

    Kaye AD, Clarke RC, Sabar R, et al. Herbal medicines: current trends in anesthesiology practice: a hospital survey. J Clin Anesth 2000; 12(6): 468–71

  2. 2.

    Norred CL. Complementary and alternative medicine use by surgical patients. AORN J 2002; 76(6): 1013–21

  3. 3.

    Leung JM, Dzankic S, Manku K, et al. The prevalence and predictors of the use of alternative medicine in presurgical patients in five California hospitals. Anesth Analg 2001; 93(4): 1062–8

  4. 4.

    Silverstein DD, Spiegel AD. Are physicians aware of the risks of alternative medicine? J Community Health 2001; 26(3): 159–74

  5. 5.

    Norred CL, Zamudio S, Palmer SK. Use of complementary and alternative medicines by surgical patients. AANA J 2000; 68(1): 13–8

  6. 6.

    Adusumilli PS, Ben-Porat L, Pereira M, et al. The prevalence and predictors of herbal medicine use in surgical patients. J Am Coll Surg 2004; 198(4): 583–90

  7. 7.

    Dooley MJ, Marriott J. Practitioners sources of clinical information on complementary and alternative medicine in oncology. Support Care Cancer 2004; 12: 114–9

  8. 8.

    Liu EH, Turner LM, Lin SX, et al. Use of alternative medicine by patients undergoing cardiac surgery. J Thorac Cardiovasc Surg 2000; 120(2): 335–41

  9. 9.

    Tsen LC, Segal S, Pothier M, et al. Alternative medicine use in presurgical patients. Anesthesiology 2000; 93(1): 148–51

  10. 10.

    Welch SA. The use of complementary medicines by inpatients at St Vincent’s Hospital Sydney. Aust J Hosp Pharm 2001; 31(2): 111–3

  11. 11.

    Braun L, Cohen M. Herbs and natural supplements: an evidence-based guide. Melbourne: Elsevier Science, 2004

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There were no funding sources involved with the preparation of this article and no known conflicts of interest.

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Correspondence to Professor Marc Maurice Cohen.

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Cohen, M.M., Braun, L.A. Towards the Evidence-Based Integration of Complementary Medicines into Hospital Settings. Evid-Based-Integrative-Med 1, 241–244 (2004).

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  • Hospital Patient
  • Hospital Staff
  • Complementary Medicine
  • Discharge Summary
  • Hospital Pharmacist