Despite the popularity of complementary and alternative medicine among older persons, its use within this subpopulation is still not fully understood. This study aimed to explore the perceptions of older persons residing in communities in Ebonyi State as pertains the use of complementary and alternative medicine. Qualitative data collection was by focus group discussions (FGDs), in four communities, two urban and two rural, in Ebonyi state, Nigeria. A total of 12 FGDs involving 96 participants, each consisting of 8 males or females respectively were conducted using a synthesized FGD guide. A thematic analysis of data was performed with the aid of NVivo software. The Leventhal's self-regulatory model (SRM) was utilised as it provides a flexible framework for understanding the use of complementary and alternative medicine among older persons. Majority of the participants expressed belief in the inherent benefits of complementary and alternative medicine, which were categorized into medical and non-medical reasons. Febrile illness, including malaria, typhoid fever, and hepatitis; respiratory; haematological; and dermatological conditions were reported as the common health conditions for which participants used CAM. Additionally, participants mentioned using CAM for chronic conditions, such as diabetes mellitus, hypertension, and arthritis, as well as for general health promotion and wellbeing. Preference for CAM was influenced by belief in its effectiveness, perceived lower cost when compared to conventional treatments, delays in hospital diagnoses and treatments, and belief in the spiritual origins of diseases. Safety concerns regarding CAM use included a lack of information on dosing, directions for safe use, and potential side effects. The findings indicate a strong belief among participants in the benefits of complementary and alternative medicine which they believe offer both medical and non-medical advantages. However, despite these perceived benefits, safety concerns were also raised by some participants. Efforts to promote education and awareness about CAM, improve access to reliable information, and ensure the safe and effective use of CAM therapies are crucial for supporting the health and well-being of older persons who choose to incorporate CAM into their healthcare practices.
Insomnia is a prevalent sleep disorder characterized by difficulty initiating or maintaining sleep, resulting in significant daytime impairment and frequently co-occurring with depression and anxiety. Although cognitive-behavioral therapy for insomnia is the standard intervention, its accessibility remains limited. Consequently, complementary and alternative medicine (CAM) therapies including yoga, Ayurveda, acupuncture, and melatonin have gained interest, despite the lack of robust supporting evidence. This study provides a scientometric evaluation of global research on CAM for insomnia, mapping publication trends, major contributors, and emerging research themes. A total of 2,204 articles and reviews published between 1970 and August 2024 were retrieved from the Scopus database. Data were analyzed using Scopus analytics, R, and VOSviewer to assess publication growth, subject areas, international collaborations, and contributions from journals, authors, and institutions. Publication output has steadily increased, with a marked rise since 1998. Research activity is primarily concentrated in medicine, pharmacology, and nursing. The USA leads global output and maintains extensive collaborations with the United Kingdom, China, and India. Harvard Medical School is a key institution, while the Journal of Alternative and Complementary Medicine serves as a major outlet. Emerging research foci include Ayurveda, yoga, and acupuncture, particularly in relation to cancer and chronic pain management. Overall, CAM research for insomnia continues to expand and shows potential; however, rigorous, high-quality clinical trials are still needed to establish efficacy and safety. Enhanced collaboration and increased funding are essential to further advance this field.
Complementary and alternative medicine (CAM) is increasingly utilized by cancer patients seeking additional ways to manage their health. Understanding how patient activation influences CAM usage and interest can guide more effective patient-centered care approaches. This study aims to explore the relationship between patient activation and the utilization and interest in CAM among cancer patients, employing both linear and non-linear regression analyses to assess these dynamics. A total of 195 cancer patients completed an online survey assessing their level of patient activation, CAM usage, and interest in CAM. Data were analyzed using linear and non-linear regression models to examine the effects of patient activation on CAM usage and interest. There were only weak associations found between patient activation, CAM use, and interest in CAM, and the discovered relationships were curvilinear with low explanatory and predictive values. Linear regression analysis revealed a very small and non-significant relationship between patient activation and CAM use (R² = .013), whereas a small but significant positive relationship was found between patient activation and interest in CAM (R² = .025). Non-linear regression analysis revealed a curvilinear relationship between patient activation and CAM use, which tended to increase at lower to moderate levels of patient activation and then decreased at higher levels (R² = .044). The findings suggest that the relationship between patient activation and CAM usage among cancer patients is complex and non-linear. Future studies should utilize larger, more representative samples and apply multivariable methods to gain a deeper understanding of the factors influencing CAM-related decision-making in oncology populations.
Complementary and alternative medicine (CAM) is widely used by cancer patients and increasingly shapes oncological care worldwide. This narrative review examines current evidence on utilization patterns, theoretical frameworks, clinical efficacy, and safety aspects of CAM in oncology. CAM use is primarily motivated by emotional distress, the desire for personal autonomy, and perceived limitations of conventional cancer treatments. Despite its prevalence, communication about CAM between patients and physicians remains insufficient, and potential risks, particularly herb-drug interactions, are often underestimated in clinical practice. Evidence indicates that selected CAM interventions, including acupuncture, ginger, and mind-body therapies, provide measurable clinical benefits and are supported by plausible biological mechanisms. In contrast, the majority of CAM modalities are characterized by heterogeneous evidence bases that frequently rely on preclinical data or methodologically limited clinical studies. Persistent challenges such as publication bias, inconsistent outcome measures, and inadequate standardization substantially limit the interpretability and generalizability of existing findings. These limitations complicate evidence-based decision making and hinder responsible clinical integration. Effective integration of CAM into oncology requires structured consultation models, systematic risk assessment strategies, and the inclusion of evidence-based CAM education within medical training. In parallel, coordinated research initiatives and regulatory frameworks are essential to improve methodological rigor and ensure patient safety. This review concludes that only through scientific discipline, transparent evaluation processes, and interdisciplinary collaboration can CAM transition from a fragmented adjunct to a validated and ethically grounded component of comprehensive cancer care. Beyond summarizing existing evidence, the review highlights underrecognized mechanistic links and system-level challenges that offer new perspectives on the future incorporation of CAM into modern oncology.
The use of complementary and alternative medicine (CAM) is common among elderly male cancer patients; however, evidence is limited on its prevalence, characteristics, and determinants in Korea. This study examined the prevalence, patterns, and reasons for CAM use, and identified factors associated with its use among elderly male cancer survivors. A cross-sectional survey was conducted with 420 cancer patients aged ≥65 years attending outpatient clinics of the Veterans Hospital System, a 1,000-bed secondary hospital in Seoul, Korea. Data on CAM utilization, modalities, reasons for use, and information sources were collected using structured questionnaires. Multivariate logistic regression was used to identify demographic and clinical factors associated with CAM use. Among participants, 60.0% reported using CAM. The most common modalities were exercise (brisk walking, 49.4%) and dietary interventions (42.9%). The primary reason for use was immune enhancement (61.6%), and family members or relatives were the main information source (42.1%). Multivariate analysis revealed that being married (OR 2.49, 95% CI 1.40-4.45), having prostate cancer (OR 2.14, 95% CI 1.36-3.35), and undergoing surgery (OR 1.62, 95% CI 1.07-2.45) were significantly associated with CAM use. CAM use is highly prevalent among elderly male Korean cancer patients, particularly among married men, prostate cancer patients, and those who have undergone surgery. Oncologists should incorporate discussions about CAM into survivorship care, and further studies are warranted to assess the impact of CAM modalities on quality of life and clinical outcomes.
Complementary, alternative, and integrative medicine (CAIM) has gained popularity among patients experiencing pain, used alongside conventional medical treatments. This study aimed to explore the perceptions of pain clinicians and researchers on CAIM interventions. An anonymous, online survey was distributed to 46,223 authors who had published pain-related research in MEDLINE-indexed journals. The survey included multiple-choice questions and open-ended sections to gather detailed opinions. A total of 1024 participants responded, 900 of which were eligible to participate; most identified as either pain researchers (n = 435/900, 48.33%) or both researchers and clinicians (n = 398/900, 44.22%). Many held senior positions (n = 549/892, 61.55%). Among the CAIM modalities, mind-body therapies such as meditation, yoga, and biofeedback were viewed as the most promising for pain prevention, treatment, and management, with 68.47% (n = 569/831) of participants endorsing these approaches. While (n = 341/777, 43.89%) of the respondents believed that most CAIM therapies are safe, only 25.55% (n = 198/775) disagreed with the idea that such therapies are effective. There was broad agreement on the need for more research into CAIM therapies, with 45.88% (n = 356/776) agreeing and 42.53% (n = 330/776) strongly agreeing that further investigation is valuable. Additionally, many respondents supported the inclusion of CAIM training in clinician education, either through formal programs (n = 361/778, 46.40%) or supplementary courses (n = 409/776, 52.71%). Mind-body therapies received the most positive feedback, while biofield therapies were met with the most skepticism. These findings highlight the interest in CAIM among pain researchers and clinicians and emphasize the need for more research and education tailored to this area.
The use of complementary and alternative medicine (CAM) is rapidly increasing for various non-communicable diseases, including cancer, presenting a complex challenge. However, few studies have examined CAM utilization in Nepal. A cross-sectional, quantitative, descriptive study design was conducted in a cancer-specialized hospital in Nepal to determine the use of CAM using a 29-item survey questionnaire designed to collect data on demographic and clinical characteristics and CAM utilization practices, based on the existing literature. Descriptive statistics and multivariate binary logistic regression were conducted in SPSS version 29 to identify significant influencing factors, with P-values < 0.05 considered statistically significant. Out of 101 participants, more than half (56.4%) used it for over a year. The commonly observed CAM was naturopathy and herbal products (such as amala, tulushi, aleovera, barley & wheat grass) (53.4%) and dietary supplements (43.6%). Majority of CAM users perceived it as effective (88.1%) and helpful in mostly alleviating nausea (76.4%). In multivariate analysis, only the use of yoga and meditation was independently associated with planning to continue CAM use (AOR: 8.939; 95% CI: 1.68-47.567). Majority of the patients with cancer were using CAM for more than a year, with naturopathy and herbal products among the highest modalities of CAM. The prolonged use of CAM among patients underscores the need to further educate patients on its long-term consequences, along with patient safety.
Biologically based complementary and alternative medicine (BBCAM) includes special diets, dietary supplement and herbal remedies, not prescribed by a doctor or dietitian. The use of BBCAM is common among cancer survivors. BBCAM can interact with conventional treatments, and unregulated products may cause harm. This study aimed to determine the prevalence, types, and motivations for BBCAM use among cancer survivors. A survey assessed clinical characteristics and BBCAM use in participants >18yrs who had received cancer treatment in Ireland from 2018-2022. Amongst 295 respondents (77% female, mean age 53yrs), BBCAM use increased from 28% pre-diagnosis to 34% post-diagnosis (p < 0.001). For BBCAM users (n = 97, 33%), 'daily-use' increased from 38% to 72% (p < 0.001) post-diagnosis. Common types included: mineral/vitamin supplements (84%), dietary supplements (e.g. turmeric, coenzyme-Q10) (78%), herbal remedies/botanicals (e.g. mistletoe, St. John's Wort, echinacea, ginseng) (50%), cannabis (21%), and other natural products (laetrile, shark cartilage, apricot kernels) (19%). Biological medicines (GcMAF, immuno-augmentative therapy) were used by 12% of BBCAM users. Special diets including dairy free (32%), gluten-free (19%), intermittent fasting (17%), ketogenic diet (15%), juicing/detox (10%) were also common. Perceived benefits included: improved well-being (63%) and reduced psychological stress (59%). BBCAM use increases after a cancer diagnosis. Patient perceived benefits highlight potential gaps in the current healthcare model, indicating a need for greater emphasis on safe survivorship care.
Recombinant biologics have transformed modern medicine but face persistent limitations, including high costs ($24,000-500,000 annually), injection burden, immunogenicity, manufacturing complexity ($200-500M in facility investments), and global barriers that limit access for billions worldwide. These challenges drive an urgent need for therapeutic alternatives. We evaluate six primary alternative modalities across FDA- and EMA-approved agents and pipeline candidates (2014-2025): oral small molecules targeting intracellular pathways, RNA therapeutics using gene silencing, CD36-mediated protein degraders (PROTACs), pharmacological chaperones, substrate-reduction therapies, and oral peptide formulations []. Clinical evidence from multiple FDA approvals demonstrates successful substitution: fitusiran achieves an 84-91% reduction in bleeding, iptacopan provides 61% transfusion independence, and deucravacitinib achieves 58.7% PASI-75 response. We identify four mechanistic principles-pathway convergence targeting, functional mimicry, allosteric modulation, and tissue-selective approaches-that can guide recombinant drug substitutions. Manufacturing analysis reveals potential for substantial cost advantages, although actual patient access requires policy intervention beyond market forces. Therapeutic alternatives represent a fundamental evolution in pharmaceutical medicine, with molecular targets rather than modalities determining potential. Success requires a mechanistic understanding, precision patient selection using pharmacogenomics (CYP2D6, CD36 expression), and modality-specific monitoring. While mRNA-based protein replacement currently faces dosing control challenges that limit its suitability for chronic diseases, advances in self-amplifying mRNA and modRNA with controllable expression kinetics may address these limitations. The future landscape will feature complementary modality use optimized for clinical scenarios, with AI-driven discovery and personalized selection potentially improving response rates from 30% to 60% to over 80%. Global access requires technology transfer, regulatory harmonization, and value-based pricing to bridge the gap between manufacturing cost advantages and realized patient benefits. Biologic medicines—complex proteins produced in living cells—have revolutionized treatment for conditions such as rheumatoid arthritis, cancer, and rare genetic diseases. However, these drugs are expensive (often $25,000–$500,000 per year), require injections or infusions, need refrigeration, and remain inaccessible to billions of people worldwide due to cost and infrastructure limitations. This review examines newer drug types that can replace biologics while offering essential advantages: many can be taken as pills, are easier to manufacture, more stable, and potentially more affordable. These alternatives include JAK inhibitors for inflammatory diseases, RNA-based therapies that silence disease-causing genes, drugs that help the body dispose of harmful proteins, and treatments that stabilize malfunctioning enzymes. We identify four scientific strategies that enable these substitutions: targeting shared cellular pathways rather than individual proteins, mimicking natural body processes, using novel drug-binding sites for greater precision, and designing drugs that concentrate in diseased tissues while sparing others. Clinical trials show that these alternatives can match or exceed the effectiveness of biologics—for example, achieving 60–90% improvement in bleeding disorders and skin conditions. While manufacturing costs are lower, patient prices often remain high, highlighting the need for policy changes to improve global access. These therapeutic alternatives represent a fundamental shift toward more accessible precision medicine.
Reiki is a non-invasive energy healing therapy originating in Japan. It is believed that a trained therapist can transmit energy to the patient to activate the body's capacity to heal itself, restore balance, and promote well-being. Despite a growing body of research supporting Reiki's efficacy, there are few international studies, and no studies in Australia, examining people's awareness of and use of Reiki. This study aimed to explore the prevalence and awareness of Reiki and energy healing in the Australian population and to see whether these findings reflected recent trends in the use of Complementary and Alternative Medicine (CAM). It also aimed to explore differences between health professions and the Australian community regarding the prevalence and use of this. This exploratory study used a quantitative cross-sectional design using an online, anonymous survey. From a sample of 457 Australians, nearly all were aware of Reiki (99%) and energy healing (98%), 78% had used energy healing and 69% had used Reiki. This suggests a higher-than-expected level of awareness and use, which may have been influenced by response bias. Despite this, only 43% were aware of any Reiki research, and 73% of the sample held beliefs about research on Reiki's efficacy that did not align with the current state of Reiki research. This was mainly due to an underestimation of the research on Reiki's efficacy (30%) or to having "no idea" (28%) of its current state. Differences between groups were discussed. Medical practitioners used Reiki, energy healing, and CAM less than other professions and the general community. Massage therapists and Nurses used CAM the most, and Massage Therapists used Reiki and Energy Healing the most. Most users of Reiki and energy healing were highly educated. More education about Reiki research and its current status is recommended.
This study aimed to systematically and comprehensively analyze global research trends, knowledge structure, and emerging hotspots in acupuncture for herpes zoster (HZ) and postherpetic neuralgia (PHN). Publications from January 1, 2015, to October 1, 2025 were retrieved from six major databases, including CNKI, Wanfang, Weipu, Web of Science Core Collection, PubMed, and Scopus. CiteSpace and VOSviewer were employed to perform co-authorship, co-citation, and keyword analyses, visualizing research collaborations, thematic evolution, and knowledge networks. A total of 2,309 publications (2,165 Chinese and 144 English) were included. In the Chinese databases, publication output peaked in 2018, while English-language publications steadily increased, surpassing 20 per year after 2022. All Chinese studies originated in China, whereas 21 countries contributed to the English-language literature, with China, the United States, Australia, and South Korea as the top contributors. Zhejiang Chinese Medical University, Guangzhou University of Chinese Medicine, and Chengdu University of Traditional Chinese Medicine were the most productive institutions. Co-authorship and citation analyses identified core authors and influential journals, including PAIN, Evidence-Based Complementary and Alternative Medicine, and J Pain Res. Keyword co-occurrence and clustering analyses revealed frequent topics in Chinese publications, such as PHN, acupuncture and cupping, fire needle, TCM, and Jiaji point, whereas English publications frequently addressed HZ, PHN, neuropathic pain, management, and acupuncture. Timeline and citation-burst analyses indicated shifts in research focus over time, with early studies emphasizing traditional techniques and clinical efficacy, and later studies increasingly addressing mechanisms, patient-reported outcomes, and systematic evidence synthesis. Global research on acupuncture for HZ and PHN has increasingly shifted toward precision and evidence-based approaches. Comparative analysis indicates that Chinese literature primarily emphasizes clinical applications and traditional Chinese medicine techniques, whereas international studies focus more on methodological rigor and mechanistic evidence, underscoring the need for strengthened international collaboration and high-quality multicenter trials to advance the field.
Complementary and alternative medicine (CAM) is widely used by cancer patients, yet regional data from Qassim, Saudi Arabia, are lacking. This study assessed the prevalence, patterns, motivations, and predictors of CAM use among cancer patients in the region. A cross-sectional survey was conducted at Prince Faisal Cancer Center, Qassim, between February and August 2025. Eligible adults with confirmed cancer completed a culturally adapted version of the International CAM Questionnaire. CAM modalities were classified using the NCCIH/SIO framework. Descriptive statistics summarized prevalence, types, motivations, disclosure, benefits, harms, and costs. Predictors were assessed using chi-square tests and logistic regression. Among 258 participants (mean age 51.6 ± 15.1 years; 57.4% female), 145 (56.2%) reported CAM use. Most described CAM as complementary (91.0%), with 6.2% as alternative, and 2.8% as integrative. Common modalities included spiritual/faith-based (91.0%; Qur'an recitation, 74.3%; Zamzam water, 72.2%), biologically based (66.7%; olive oil, 41.7%; honey, 34.7%), and traditional remedies (53.5%; camel milk, 22.2%; camel urine, 13.9%). The main motivation was belief in a cure (91.0%). Perceived benefits were reported by 58.6% (most often improved mood, 33.8%); adverse effects were rare (6.9%) and mild. Only 23.4% disclosed CAM use to physicians, and 7.6% delayed conventional therapy. Female sex (aOR 2.29, 95% CI 1.04-5.01) and higher education (aOR 2.48, 95% CI 1.12-5.18) independently predicted CAM use. CAM use was highly prevalent among cancer patients in Qassim, with faith-based and traditional practices most common. Curative expectations were widespread, but disclosure to physicians was low, creating a critical communication gap. Addressing this gap requires proactive, culturally sensitive physician-patient dialogue and integration of safe, evidence-based supportive practices into cancer care.
In pediatric oncology, many families incorporate traditional and complementary medicine (T&CM) into their coping and caregiving practices. Although these approaches are intended to support treatment, lack of professional oversight may lead to harm, and evidence from African settings remains sparse. This study explored the extent of use and underlying reasons for T&CM among pediatric oncology patients in Uganda. A cross-sectional mixed-methods design was used. Children aged 0-17 years receiving care at the Uganda Cancer Institute were enrolled. Quantitative data were collected using a researcher-developed questionnaire informed by existing literature, and analyses identified factors associated with T&CM use. Qualitative interviews were examined through thematic analysis to capture families' experiences and motivations. Among 395 participating children, 276 (69.9%) reported using at least one form of T&CM. Spiritual practices (54.7%) and herbal remedies (44.8%) were most common. Most families initiated T&CM after diagnosis and used it alongside conventional treatment. Significant associations were found with household income of 50,000-100,000 UGX (adjusted prevalence ratio [APR]: 0.82; 95% confidence interval [CI]: 0.71-0.94), and experiencing treatment side effects (APR: 1.23; 95% CI: 1.09-1.40). Qualitative findings highlighted financial strain, limited access to timely care, high treatment costs, and burdensome side effects as key drivers of T&CM use. T&CM use is widespread among children with cancer in Uganda. Further efforts are needed to ensure that discussions about T&CM are routinely incorporated into clinical practice to support its safe integration within conventional care.
G-J. Huang , J-C. Liao , C-S. Chiu , S-S. Huang , T-H. Lin , and J-S. Deng , "Anti-Inflammatory Activities of Aqueous Extract of Mesona procumbens in Experimental Mice," Journal of the Science of Food and Agriculture 92, no. 6 (2012): 1186-1193. https://doi.org/10.1002/jsfa.4682. The above article, published online on 1 December 2011 in Wiley Online Library (wileyonlinelibrary.com), has been retracted following the agreement of the journal's Editor-in-Chief, Sandra Schmöckel; and John Wiley & Sons Ltd. The retraction has been agreed following an investigation of the concerns raised by Actinopolyspora biskrensis on PubPeer [1], which identified several concerns related to Figure 5a. More specifically, the images of the paw oedema in the Control and Carr-treated groups share similar features with multiple other publications by the author group [2-5]. Further investigation has identified that the experimental conditions for the papers differ in the number of animals used and methods of image acquisition. As a result of the investigation, the data and conclusions of this article are considered unreliable and it is therefore retracted. The authors have been informed of this decision but did not provide a response. References: [1] Actinopolyspora biskrensis, "Anti-inflammatory activities of aqueous extract of Mesona procumbens in experimental mice," PubPeer, June 2024. https://pubpeer.com/publications/0D810458EAC96B6D2C482DFB060F33. [2] S-L. Liu , J-S. Deng , C-S. Chiu , W-C. Hou , S-S. Huang , W-C. Lin , J-C. Liao , and G-J. Huang , "Involvement of Heme Oxygenase-1 Participates in Anti-Inflammatory and Analgesic Effects of Aqueous Extract of Hibiscus taiwanensis," Evidence-Based Complementary and Alternative Medicine, vol. 2012 (2012). https://doi.org/10.1155/2012/132859. [3] J-C. Liao , J-S. Deng , C-S. Chiu , W-C. Hou , S-S. Huang , P-H. Shie , and G-J. Huang , "Anti-Inflammatory Activities of Cinnamomum cassia Constituents In Vitro and In Vivo," Evidence-Based Complementary and Alternative Medicine, vol. 2012 (2012). https://doi.org/10.1155/2012/429320. [4] S-S. Huang , C-S. Chiu , H-J. Chen , W-C. Hou , M-J. Sheu , Y-C. Lin , P-H. Shie , and G-J. Huang , "Antinociceptive Activities and the Mechanisms of Anti-Inflammation of Asiatic Acid in Mice," Evidence-Based Complementary and Alternative Medicine, vol. 2011 (2011). https://doi.org/10.1155/2011/895857. [5] T-N. Chang , J-S. Deng , Y-C. Chang , C-Y. Lee , J-C. Liao , M-M. Lee , H.P. Wen , S-S. Huang , and G-J. Huang , "Ameliorative Effects of Scopoletin from Crossostephium chinensis against Inflammation Pain and Its Mechanisms in Mice," Evidence-Based Complementary and Alternative Medicine, vol. 2012 (2012). https://doi.org/10.1155/2012/595603. © 2026 Society of Chemical Industry.
Central post-stroke pain (CPSP) severely impairs survivors' quality of life, and pharmacological therapies are often limited by resistance and safety. Acupuncture-related therapies (AT) shows potential, but evidence is fragmented. This umbrella review synthesizes existing systematic reviews/meta-analyses (SRs/MAs) to evaluate the efficacy and safety of AT for CPSP. This umbrella review included SRs/MAs of randomized controlled trials comparing AT with pharmacotherapy, placebo, or conventional therapy for CPSP. AT methods included traditional acupuncture methods such as manual acupuncture (MA) and electroacupuncture, as well as non‑pharmacological physical interventions such as repetitive transcranial magnetic stimulation (rTMS). The outcomes included pain, limb function, psychological status, quality of life, and adverse events (AEs). Methodological quality, reporting quality, risk of bias, and evidence certainty of the SRs/MAs were assessed using the AMSTAR 2, PRISMA-A, ROBIS, and GRADE tools. A total of 9 SRs/MAs were included in this review. The reporting quality was relatively complete overall (median PRISMA-A score: 23.5/27). The methodological quality and certainty of evidence were predominantly low or critically low, with publication bias and risk of bias as the major downgrading factors. In terms of efficacy, AT significantly reduced pain scores versus control therapies (e.g. Visual analogue scale/ Numeric rating scale, mean difference [MD]=-1.11, 95% confidence intervals[CI] [-1.41,-0.81], p<0.00001), improved limb function (e.g. Modified Rankin Scale, MD=-0.62, 95% CI [-0.92,-0.32], p<0.00001), and enhanced quality of life (e.g. MOS 36-Item short-form health survey score, MD=6.77, 95% CI [2.50,11.04], p=0.002). Psychological outcomes did not show consistent improvement (e.g. Hamilton anxiety scale, MD=-0.96, 95% CI [-2.94,1.02], p=0.34). AEs were mostly mild and transient, although rTMS was associated with the highest incidence (61.08%). AT can alleviate pain and improve limb function and quality of life in CPSP, though its effect on psychological symptoms remains unclear. The treatment is generally safe; however, rTMS carries a high risk of AEs. These findings require confirmation through rigorous, high-quality studies. We collected and analyzed the findings from nine published reviews of clinical trials on acupuncture-related therapies (one type of complementary and alternative medicine) for central post-stroke pain (CPSP)—a common and severe pain condition after stroke that greatly affects daily life. Our work showed that acupuncture-related therapies can meaningfully reduce pain, improve movement, and enhance quality of life for people with CPSP, although it does not appear to consistently help with emotional symptoms like anxiety or depression. Most (e.g. manual acupuncture, electroacupuncture, transcranial direct current stimulation) side effects were mild and short-lived, though one form of acupuncture-related therapies (repetitive transcranial magnetic stimulation) was linked to more side effects. While these results are promising, the overall quality of the existing evidence is still low. Our review highlights acupuncture as a generally safe and potentially useful option for survivors with CPSP, and calls for better-designed studies to provide clearer guidance for patients and clinicians in the future.
Nepal faces significant challenges in providing equitable healthcare due to limited infrastructure, high cost, and geographic barriers. Integrating Traditional, complementary and integrative medicine into the Nepalese healthcare system could address these challenges by offering affordable, culturally relevant, and holistic care. The analysis identifies both advantages, such as cost-effectiveness and cultural acceptance, and challenges, including regulation, standardization, and professional training needs. Recommendations include incorporating TCIM into primary healthcare, providing education and training for healthcare providers, establishing guidelines and regulatory frameworks, conducting research on safety and efficacy, and promoting community engagement. Integrating TCIM could strengthen healthcare delivery, reduce disparities, and support Nepal's progress toward universal health coverage and sustainable development goals.
The integration of traditional and complementary medicine (T&CM) into modern medical education remains a global challenge. Kampo medicine, a Japanese traditional pharmacotherapy, is recognized in the International Classification of Diseases, 11th Revision, and is widely used; however, no structured methodology exists for efficiently designing curricula within limited time and resources. To address this gap, this study proposes a methodological framework-illustrated through Kampo medicine but generalizable to other forms of T&CM-for organizing and visualizing curricular content to guide educational needs assessment and curriculum design. The objective of this study was to develop and illustrate a reproducible mapping framework that integrates (1) real-world clinical utilization frequency and (2) the accumulation of biomedical evidence to inform educational prioritization and stepwise curriculum design for T&CM, using Kampo medicine as an exemplar. A mapping approach was developed based on two perspectives: frequency of use in clinical training and level of biomedical evidence. Twelve years of outpatient prescription data from Kyoto University Hospital were analyzed to identify the most frequently prescribed Kampo formulas. For the 10 most common formulas, PubMed searches were conducted to determine the number of randomized controlled trials. Data were integrated using hierarchical clustering and plotted along frequency-evidence axes to produce an educational priority map, which informed a stepwise curriculum design grounded in adult learning theory. Prescription heat maps revealed substantial interdepartmental variation, and clustering identified distinct groups of formulas based on usage patterns. No statistically significant correlation was observed between prescription frequency and level of evidence (Pearson r=0.228, 95% CI -0.469 to 0.750; P=.53; Spearman ρ=0.498, 95% CI -0.308 to 0.926; P=.14). Integrating these two perspectives enabled interpretation of real-world prescription patterns and supported a transparent educational prioritization framework. This study presents a feasible and adaptable framework that links real-world clinical data with biomedical evidence to inform curriculum design in T&CM. Rather than prescribing specific content, the framework offers visual decision-making tools that align educational priorities with institutional practice patterns and can be readily adapted to complementary, alternative, and integrative medicine programs internationally.
To assess access to child-appropriate medicines in Albanian community pharmacies by applying a child-adapted version of sustainable development goal (SDG) indicator 3.b.3. Cross-sectional survey. Community pharmacies providing primary care medicines in six urban areas in Albania. Thirty community pharmacies were surveyed. Two predefined baskets of child-appropriate essential medicines were assessed: 24 medicines for children aged 1-59 months and 25 medicines for children aged 5-12 years. Medicines were selected from these child-adapted SDG 3.b.3 medicine baskets proposed at an international level and then matched to paediatric formulations registered nationally for application to Albania. Individual facility scores by age group and medicine type (originator brands (OBs) vs lowest-priced generics (LPGs)), as well as sensitivity analyses using alternative affordability thresholds. The SDG 3.b.3 indicator score was 0%, as no surveyed facility reached the 80% access threshold. Mean facility scores were 42.6% for medicines intended for children aged 1-59 months and 29.6% for those aged 5-12 years, indicating poorer access for older children. Scores for OBs were particularly low (11.8% and 13.6%, respectively), reflecting reliance on LPGs. In younger children, ibuprofen and hydroxycobalamin showed 0% availability, while in school-aged children, paracetamol, propranolol and budesonide were absent across surveyed facilities; benzylpenicillin was absent in both age groups, whereas ceftriaxone was consistently available in both. Although all surveyed medicines were affordable, limited availability remained the primary barrier to access. Application of the child-adapted SDG indicator 3.b.3 in Albania highlights substantial gaps in access to essential paediatric medicines in private community pharmacies, driven primarily by poor availability rather than affordability. The findings underscore the need for targeted supply-side policies. This study demonstrates the complementary value of composite SDG indicators and medicine-specific availability measures in monitoring progress toward universal health coverage for children.
Complementary and alternative medicine is gaining global attention in nursing education, particularly in traditional Chinese medicine (TCM). However, limited research has explored how nursing undergraduates perceive the value of TCM nursing and how their experiences can inform teaching practices. Therefore, this study aimed to investigate nursing students' perceived value of TCM nursing and to derive educational insights for curriculum improvement. A mixed-methods design was adopted. Quantitative data were collected from 172 nursing undergraduates in a Chinese university using a self-developed TCM Perceived Value Questionnaire. Descriptive statistical analyses were used to identify their perceptions and behaviors regarding TCM nursing. Comparisons of the proportion of correct responses between the two universities were performed using the chi-square test or Fisher's exact test. Qualitative data were obtained through semi-structured interviews with 14 students and analyzed using thematic analysis to explore their perceived value and educational implications for TCM education. Quantitative findings revealed a generally positive perception of TCM, with 93.6% of participants expressed interest in learning about TCM culture, 77.3% had prior experience with TCM treatments, and 53.3% were aware of national TCM talent policies. Qualitative themes included three key dimensions: (1) perceiving comprehensive impact of TCM nursing values; (2) expecting the effectiveness of TCM learning; (3) optimizing the learning experience of TCM nursing courses. Undergraduate nursing students demonstrated generally positive perceptions of TCM nursing, recognizing its cultural relevance and clinical potential. However, gaps in knowledge application and instructional delivery remain. To enhance students' engagement and learning outcomes, TCM nursing education should incorporate experiential teaching methods, strengthen clinical integration, and align content with students' cognitive, emotional, and behavioral needs. These findings offer practical implications for developing culturally responsive and pedagogically effective TCM nursing curricula.
Life satisfaction is a key patient-reported outcome in psychosocial oncology. Yet, how health literacy, nutritional behavior, eating-related symptoms, weight changes, and CAM use together influence life satisfaction remains poorly understood. We conducted a multicenter cross-sectional survey of 316 German oncology patients, assessing life satisfaction (L-1), health literacy, current food intake, eating-related symptoms, dietary frequency, weight change and CAM use. Analyses included descriptive statistics, Spearman correlations, nonparametric tests, and multivariate regression. Subjective health status emerged as the strongest independent predictor of life satisfaction. Higher food intake and fewer eating-related symptoms were also beneficial. Moderate unintentional weight loss (below a high threshold) was associated with somewhat higher self-perceived life satisfaction, whereas more pronounced weight loss (> 10 kg) related to lower life satisfaction. Health literacy showed a modest correlation with life satisfaction in unadjusted analyses, but lost independent significance in multivariate models, suggesting mediation via other factors. Complementary and alternative medicine use was not associated with life satisfaction. The final predictive model explained about 35.1% of the variance in life satisfaction. These findings suggest that subjective health perceptions and nutritional factors are central drivers of life satisfaction in cancer patients, whereas the effect of health literacy appears to be mediated indirectly. The results support a holistic, patient-centered approach addressing subjective health, nutrition, and health literacy to improve psychosocial outcomes and life satisfaction. The online version contains supplementary material available at 10.1186/s12885-026-15848-z.