Perceptions of traditional, complementary and alternative medicine among conventional healthcare practitioners in Accra, Ghana: Implications for integrative healthcare

doi:10.1016/S2095-4964(16)60273-X

Abstract

Objective

Integrative medicine refers to ongoing efforts to combine the best of conventional and evidence-based complementary therapies. While this effort for collaboration is increasing, traditional complementary and alternative medicine (TM-CAM) remains poorly integrated into the current healthcare system of Ghana. At present, it is not clear if practitioners of mainstream medicine favor integrative medicine. The present study, therefore, sought to explore the perceptions of conventional healthcare professionals on integrative medicine.

Methods

A qualitative design composed of semi-structured interviews was conducted with 23 conventional healthcare professionals comprising pharmacists, physicians, nurses and dieticians from two quasi-government hospitals in Accra, Ghana.

Results

Participants' knowledge of TM-CAM was low, and although they perceived alternative medicine as important to current conventional healthcare in Ghana, they expressed anxieties about the potential negative effects of the use of TM-CAM. This paradox was found to account for the low levels of use among these professionals, as well as the low level of recommendation to their patients. The practitioners surveyed recommended that alternative medicine could be integrated into mainstream allopathic healthcare in Ghana through improving knowledge, training as well as addressing concerns of safety and efficacy. These findings are discussed under the themes: the knowledge gap, the paradox of TM-CAM, experience of use and prescription, and guided integration. We did not observe any differences in views among the participants.

Conclusion

The conventional healthcare professionals were ready to accept the idea of integrative medicine based on knowledge of widespread use and the potential role of TM-CAM products and practices in improving healthcare delivery in the country. However, to achieve an institutional integration, practitioners' understanding of TM-CAM must be improved, with specific attention to issues of safety, regulation and evidence-based practice of TM-CAM products and services in Ghana.

Key words: Perceptions, Integrative medicine, Medicine, Traditional, Complementary therapies, Healthcare qualitative research, Ghana

Irene A. Kretchy, Harry A. Okere, Joseph Osafo, Barima Afrane, Joseph Sarkodie, Philip Debrah. Perceptions of traditional, complementary and alternative medicine among conventional healthcare practitioners in Accra, Ghana: Implications for integrative healthcare. Journal of Integrative Medicine, 2016, 14(5): 380-388.

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References

1 Bodeker G, Kronerberg F.A public health agenda for traditional, complementary, and alternative medicine.Am J Public Health. 2002; 92(10): 1582-1591.
2 Ernst E, Fugh-Berman A.Complementary and alternative medicine: what is it all about?Occup Environ Med. 2002; 59(2): 140-144.
3 Kim YH, Lichtenstein G, Waalen J.Distinguishing complementary medicine from alternative medicine.Arch Intern Med. 2002; 162(8): 943.
4 Miller FG, Emanuel EJ, Rosenstein DL, Straus SE.Ethical issues concerning research in complementary and alternative medicine.JAMA. 2004; 291(5): 599-604.
5 Frass M, Strassl RP, Friehs H, Müllner 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.
6 Ernst E.Prevalence of use of complementary/alternative medicine: a systematic review.Bull World Health Organ. 2000; 78(2): 258-266.
7 Harris P, Rees R.The prevalence of complementary and alternative medicine use among the general population: a systematic review of the literature.Complement Ther Med. 2000; 8(2): 88-96.
8 Fischer FH, Lewith G, Witt CM, Linde K, von Ammon K, Cardini F, Falkenberg T, Fønnebø V, Johannessen H, Reiter B, Uehleke B, Weidenhammer W, Brinkhaus B. High prevalence but limited evidence in complementary and alternative medicine: guidelines for future research.BMC Complement Altern Med. 2014; 14: 46.
9 Harris P, Cooper K, Relton C, Thomas K.Prevalence of complementary and alternative medicine (CAM) use by the general population: a systematic review and update.Int J Clin Pract. 2012; 66(10): 924-939.
10 Peltzer K.Utilization and practice of traditional/ complementary/alternative medicine (TM/CAM) in South Africa.Afr J Tradit Complement Altern Med. 2009; 6(2): 175-185.
11 Kretchy IA, Owusu-Daaku F, Danquah S.Patterns and determinants of the use of complementary and alternative medicine: a cross-sectional study of hypertensive patients in Ghana.BMC Complement Altern Med. 2014; 14: 44.
12 Jones RP, Utz S, Wenzel J, Steeves R, Hinton I, Andrews D, Murphy A, Oliver N.Use of complementary and alternative therapies by rural African Americans with type 2 diabetes. Altern Ther Health Med. 2006; 12(5): 34-38.
13 Debas HT, Laxminarayan R, Straus SE.Complementary and alternative medicine. In: Jamison DT, Breman JG, Measham AR, Alleyne G, Claeson M, Evans DB, Jha P, Mills A, Musgrove P. Disease control priorities in developing countries. 2nd ed. Washington (DC): World Bank and Oxford University Press. 2006: 1281-1292.
14 Annan K.Ghana herbal pharmacopoeia. 3rd ed. Accra: Science and Technology Policy Research Institute. 2015.
15 Barrett B, Marchand L, Scheder J, Plane MB, Maberry R, Appelbaum D, Rakel D, Rabago D.Themes of holism, empowerment, access, and legitimacy define complementary, alternative, and integrative medicine in relation to conventional biomedicine.J Altern Complement Med. 2003; 9(6): 937-947.
16 Caspi O, Sechrest L, Pitluk HC, Marshall CL, Bell IR, Nichter M.On the definition of complementary, alternative, and integrative medicine: societal mega-stereotypesvs. the patients’ perspectives. Altern Ther Health Med. 2003; 9(6): 58-62.
17 Abdullahi AA.Trends and challenges of traditional medicine in Africa.Afr J Tradit Complement Altern Med. 2011; 8(5 Suppl): 115-123.
18 Sato A.Does socio-economic status explain use of modern and traditional health care services?Soc Sci Med. 2012; 75(8): 1450-1459.
19 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.
20 Astin JA, Soeken K, Sierpina VS, Clarridge BR.Barriers to the integration of psychosocial factors in medicine: results of a national survey of physicians.J Am Board Fam Med. 2006; 19(6): 557-565.
21 Eisenberg DM, Kessler RC, Foster C, Norlock FE, Calkins DR, Delbanco TL.Unconventional medicine in the United States. Prevalence, costs, and patterns of use.N Engl J Med. 1993; 328(4): 246-252.
22 Leach MJ.Public, nurse and medical practitioner attitude and practice of natural medicine.Complement Ther Nurs Midwifery. 2004; 10(1): 13-21.
23 Kwan D, Hirschkorn K, Boon H.US and Canadian pharmacists’ attitudes, knowledge, and professional practice behaviors toward dietary supplements: a systematic review.BMC Complement Altern Med. 2006; 6: 31.
24 Koh HL, Teo HH, Ng HL.Pharmacists’ patterns of use, knowledge, and attitudes toward complementary and alternative medicine.J Altern Complement Med. 2003; 9(1): 51-63.
25 Adib-Hajbaghery M, Hoseinian M.Knowledge, attitude and practice toward complementary and traditional medicine among Kashan health care staff, 2012.Complement Ther Med. 2014; 22(1): 126-132.
26 Al SI, Ismail MF, Yousuf WA, Salama RE.Knowledge, attitudes and practice of general practitioners towards complementary and alternative medicine in Doha, Qatar.East Mediterr Health J. 2010; 16(5): 522-527.
27 Tabi MM, Powell M, Hodnicki D.Use of traditional healers and modern medicine in Ghana.Int Nurs Rev. 2006; 53(1):52-58.
28 Bahall M, Edwards M.Perceptions of complementary and alternative medicine among cardiac patients in South Trinidad: a qualitative study.BMC Complement Altern Med.2015; 15: 99.
29 Willig C.Introducing qualitative research in psychology. 3^rd ed. Berkshire: McGraw-Hill Education. 2013. 30 Vaismoradi M, Turunen H, Bondas T. Content analysis and thematic analysis: implications for conducting a qualitative descriptive study. Nurs Health Sci. 2013; 15(3): 398-405.
31 Yeo AS, Yeo JC, Yeo C, Lee CH, Lim LF, Lee TL.Perceptions of complementary and alternative medicine amongst medical students in Singapore—a survey.Acupunct Med. 2005; 23(1): 19-26.
32 Uzun O, Tan M.Nursing students’ opinions and knowledge about complementary and alternative medicine therapies.Complement Ther Nurs Midwifery. 2004; 10(4): 239-244.
33 AlBedah AM, El-Olemy AT, Khalil MK. Knowledge and attitude of health professionals in the Riyadh region, Saudi Arabia, toward complementary and alternative medicine.J Family Community Med. 2012; 19(2): 93-99.
34 Yildirim Y, Parlar S, Eyigor S, Sertoz OO, Eyigor C, Fadiloglu C, Uyar M.An analysis of nursing and medical students’ attitudes towards and knowledge of complementary and alternative medicine (CAM).J Clin Nurs. 2010; 19(7-8): 1157-1166

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