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Original Article
The Status of Nationwide Implementation of Integrative Medicine Programs by Japanese Local Government from a “Social Model” Viewpoint
Hui-Yu Chung, Masaki Moroi, Yasutaka Hojo, Fu-Shih Chen, Keiko Yukawa, Yoshiharu Motoo, Ichiro Arai
Perspect Integr Med. 2024;3(2):98-105.   Published online June 21, 2024
DOI: https://doi.org/10.56986/pim.2024.06.005
  • 650 View
  • 29 Download
Graphical AbstractGraphical Abstract AbstractAbstract PDF
Background
The world's demographics are transitioning, prompting governments globally to adopt diverse health promotion and disease prevention programs to enhance people's quality of life. While several integrative medicine (IM) programs, including traditional or alternative medicine, may be in place, the level of implementation nationwide is unknown. This research represents the first nationwide study in Japan, conducted in 2018 before local government health programs were cancelled due to the COVID-19 pandemic. The study examines the use of IM by local government in Japan and its safety and effectiveness as a “social model.”
Methods
IM programs for disease prevention and health promotion of all 1,944 Japanese local governments in 2018, were retrieved the using the Web Archive Project of the National Diet Library, which is a maintained website repository for all Japanese local government including IM and health programs.
Results
A total of 1,739 IM programs were implemented in 537 local governments (27.6% among all Japanese local governments). These included programs for Yoga (1,242; 71.4% of the projects), Qigong (211; 12.1%), and Aromatherapy (145; 8.3%). Among the providers of the programs, only 16 (0.9%) were national medical-related license holders. The purpose of disease prevention or health promotion was not described with scientific basis (safety and effectiveness).
Conclusion
Japanese local government conduct health-promoting IM programs, but untrained providers administer many of them. There needs to be more evidence to support the alleged health promotion objectives. Local governments require better support and evidence-based planning to rectify this situation.
Review Article
Addressing the Challenges of Traditional, Complementary, and Integrative Medicine Research: An International Perspective and Proposed Strategies Moving Forward
Maheen Raja, Holger Cramer, Myeong Soo Lee, L. Susan Wieland, Jeremy Y. Ng
Perspect Integr Med. 2024;3(2):86-97.   Published online June 21, 2024
DOI: https://doi.org/10.56986/pim.2024.06.004
  • 1,493 View
  • 48 Download
Graphical AbstractGraphical Abstract AbstractAbstract PDF
Traditional, complementary, and integrative medicine (TCIM) encompasses a broad range of healthcare practices beyond conventional Western medicine. Despite its use globally and increased research, many TCIM research challenges persist impeding its progress and integration into clinical practice. Key challenges involve financial constraints, insufficient research training and educational support, and the methodological barriers which arise from a lack of standardization. Financial limitations hinder investment into crucial research limiting both the quantity and quality of TCIM research. Inadequate training in research and educational support limit the development of TCIM research, hindering growth and recognition of TCIM in academic and clinical settings. The inherent dynamic nature of TCIM therapies poses additional challenges for applying standardized biomedical research models. These challenges not only impede the advancement of TCIM research but also perpetuate negative attitudes and biases within the healthcare and research communities. To overcome these challenges, a comprehensive strategy is necessary to increase funding, improve literacy, and the promotion of open science practices in TCIM. Addressing these confounding factors will enable well-informed TCIM research literacy and the development of TCIM skills and facilitate the integration of evidence based TCIM therapies into a more inclusive healthcare domain, ultimately reducing negative attitudes and biases towards TCIM.
Case Report
Complete Remission of Drug-Induced Acute Dizziness Using Eight Constitution Acupuncture and the Barbecue Maneuver: A Case Report
Younkuk Choi, Juhee Cho
Perspect Integr Med. 2024;3(1):51-56.   Published online February 22, 2024
DOI: https://doi.org/10.56986/pim.2024.02.007
  • 1,585 View
  • 55 Download
AbstractAbstract PDF
Dizziness, often symptomatic of underlying conditions, presents management challenges especially when dealing with drug-induced vestibular disorders. Complementary therapies like acupuncture, specifically, Eight Constitution Acupuncture (ECA), offers a potential alternative to other management therapies. A 74-year-old female, experiencing sudden dizziness from medication for back pain, underwent a detailed examination, constitutional diagnosis, and targeted acupuncture involving 26 insertions over 4 sessions. The treatment for dizziness, which focused on constitutional differences, integrated ECA and the barbecue maneuver which resulted in significant efficacy. A 50% reduction in the Numeric Rating Scale score from 10 to 5 was observed after the 1st session. Subsequent sessions of ECA combined with the barbecue maneuver significantly reduced symptoms of dizziness and ultimately alleviated symptoms. This case underscored the potential of ECA when combined with the application of the barbecue maneuver in treating drug-induced vestibular disorders and residual benign paroxysmal positional vertigo. The ECA's constitutional approach allows for precise targeting and symptom resolution, and integrating the principles of Traditional Asian Medicine with biological mechanisms. Notably, this is the 1st case report of the efficacy of ECA and the barbecue maneuver in addressing drug-induced vestibular disorders. A holistic approach, considering constitutional differences, can offer insights and tailored solutions to present a promising avenue for patients experiencing such conditions. Rigorous research studies are essential to validate these findings.
Review Article
Characteristics and Quality of Traditional Chinese Therapies and Integrative Medicine Clinical Practice Guidelines for Musculoskeletal Disorders Published in Mainland China
Xue-Feng Wang, Jing-Ling Zuo, Lin-Jian Li, Lan-Dan Xu, Xiao-Zhong Liu, Si-Si Ma, Jian-Ping Liu
Perspect Integr Med. 2024;3(1):7-17.   Published online February 22, 2024
DOI: https://doi.org/10.56986/pim.2024.02.002
  • 1,225 View
  • 22 Download
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary Material
Background
Musculoskeletal disorders are prevalent in adults. Traditional Chinese medicine (TCM) and integrative medicine (IM) are commonly used treatments which have clinical practice guidelines (CPGs). This study aimed to determine the characteristics and quality of these CPGs.
Methods
CPGs which recommended TCM/IM therapies in musculoskeletal conditions/diseases published in Chinese or English between January 2018 to December 2022 in mainland China were retrieved and analyzed for guideline classification, funding source, conflict of interest, and methodology. Appraisal of Guideline for Research and Evaluation Ⅱ including 6 domains, was applied to assess CPG quality.
Results
Of the 50 CPGs included, there were 19 TCM, 5 IM, and 26 western conventional medicine (WCM) guidelines of which osteoporosis (13, 26%), osteoarthritis (11, 22%) and rheumatoid arthritis (6, 12%) were the most frequent diseases. The TCM therapies recommended by the CPGs successively were acupuncture and moxibustion, Chinese patent medicine, and TCM decoction based on syndrome differentiation. Nearly half of the CPGs reported funding source (52%) and conflict of interest (48%). Thirty-six CPGs used the Grading of Recommendations, Assessment, Development, and Evaluations method to present summaries of evidence, the remaining did not report the method. Based on Appraisal of Guideline for Research and Evaluation Ⅱ scores, “clarity of presentation” scored the highest (55%), while “applicability” was the lowest (6%). No CPG was recommended without change, and 23 CPGs were not recommended.
Conclusion
The quality of CPGs for musculoskeletal conditions/diseases in China is generally low. Future CPGs should pay more attention to standardized developing procedures.
Editorial
A Pilot Trial of Integrative Medicine for Stroke Rehabilitation: Expert Recommendations for the Development and Sustainability of Integrative Medicine
Chihyoung Son, Go-Eun Lee, Joo-Hee Seo, Inae Youn, Jin-Won Kim
Perspect Integr Med. 2024;3(1):1-6.   Published online February 22, 2024
DOI: https://doi.org/10.56986/pim.2024.02.001
  • 1,570 View
  • 25 Download
Graphical AbstractGraphical Abstract AbstractAbstract PDF
Background
Strategies towards development and sustainability of integrative treatment in stroke rehabilitation medicine are needed. National expert recommendations based on the implementation of Integrative Medicine (IM) in stroke rehabilitation and IM outcomes would be invaluable.
Methods
A pilot study was performed and the effectiveness of combining Korean traditional medicine and Western conventional medicine in post-stroke patients (ischemic stroke n = 15 and hemorrhagic stroke n = 4) was evaluated, and recommendations were developed through consensus with physicians in national centers of rehabilitative medicine. Outcome measures [Korean Modified Barthel Index (K-MBI), Korean Mini Mental State Examination (K-MMSE), Modified Rankin Scale (mRS), and EuroQol 5-dimension 5-level (EQ-5D-5L) assessment were used at baseline, 4, 8 (K-MBI, K-MMSE, mRS, and EQ-5D-5L) and 12 weeks post treatment (EQ-5D-5L and mRS).
Results
Improvements were observed in functional and cognitive abilities at 8 weeks (K-MBI score p = 0.0062; K-MMSE score p = 0.046). Quality of life improvements (EQ-5D-5L) were observed but were not statistically significant. The disability assessment (mRS) indicated a gradual improvement from baseline to 12 weeks. No adverse events were reported. For effective, patient-centered IM treatment: (1) build a strong evidence base for IM as compared with Western medicine alone or traditional medicine alone; (2) active expert collaboration; (3) IM promotion in public medical institutions; and (4) continued government support.
Conclusion
Functional and cognitive abilities of stroke patients statistically significantly improved following 8 weeks of IM treatment. Strategies have been suggested towards the development and sustainability of IM treatment in stroke rehabilitation medicine.
Short Communication
Perspectives and Ideas to Advance Integrative Medicine and Healthcare: Proceedings of the 4th Annual Jaseng Academic Conference
Andrew Jang, Jinho Lee, Catherine Donahue, David Coggin-Carr, Mike Cummings, Kien Trinh, Myeong Soo Lee, Susan Wieland, Christopher Zaslawski, Lawrence Prokop, Joon Shik Shin
Perspect Integr Med. 2023;2(3):190-194.   Published online October 23, 2023
DOI: https://doi.org/10.56986/pim.2023.10.007
  • 745 View
  • 24 Download
AbstractAbstract PDF
The 4th Annual Jaseng Academic conference (August 13, 2023) in Seoul, South Korea, was a pivotal event in the realm of integrative medicine. Cohosted by Jaseng Hospital of Korean Medicine and Michigan State University College of Osteopathic Medicine, over 500 professionals including Korean medicine doctors, medical doctors, doctors of osteopathic medicine, acupuncturists, researchers, and students gathered at the conference. The theme, “Perspectives on Integrative Medicine,” marked a departure from previous conference themes and embraced a multidisciplinary approach to healthcare. The event highlighted the importance of holistic patient care and cross-disciplinary collaboration within healthcare. It offered a comprehensive overview of the current state of integrative medicine approaches in manual medicine, evidence-based acupuncture treatment, and acupuncture research. The Annual Jaseng Academic conference continues to serve as a platform for healthcare professionals to exchange ideas and perspectives, and bridges the gap between diverse medical systems to promote improved patient outcome and wellbeing.
Editorial
Strategy for Integration
Nicola Robinson
Perspect Integr Med. 2023;2(1):1-2.   Published online February 21, 2023
DOI: https://doi.org/10.56986/pim.2023.02.001
  • 920 View
  • 26 Download
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