Acceptance and use of complementary and alternative medicine among medical specialists: a 15-year systematic review and data synthesis

Background Complementary and Alternative Medicine (CAM) has gained popularity among the general population, but its acceptance and use among medical specialists have been inconclusive. This systematic review aimed to identify relevant studies and synthesize survey data on the acceptance and use of CAM among medical specialists. Methods We conducted a systematic literature search in PubMed and Scopus databases for the acceptance and use of CAM among medical specialists. Each article was assessed by two screeners. Only survey studies relevant to the acceptance and use of CAM among medical specialists were reviewed. The pooled prevalence estimates were calculated using random-effects meta-analyses. This review followed both PRISMA and SWiM guidelines. Results Of 5628 articles published between 2002 and 2017, 25 fulfilled the selection criteria. Ten medical specialties were included: Internal Medicine (11 studies), Pediatrics (6 studies), Obstetrics and Gynecology (6 studies), Anesthesiology (4 studies), Surgery (3 studies), Family Medicine (3 studies), Physical Medicine and Rehabilitation (3 studies), Psychiatry and Neurology (2 studies), Otolaryngology (1 study), and Neurological Surgery (1 study). The overall acceptance of CAM was 52% (95%CI, 42–62%). Family Medicine reported the highest acceptance, followed by Psychiatry and Neurology, Neurological Surgery, Obstetrics and Gynecology, Pediatrics, Anesthesiology, Physical Medicine and Rehabilitation, Internal Medicine, and Surgery. The overall use of CAM was 45% (95% CI, 37–54%). The highest use of CAM was by the Obstetrics and Gynecology, followed by Family Medicine, Psychiatry and Neurology, Pediatrics, Otolaryngology, Anesthesiology, Internal Medicine, Physical Medicine and Rehabilitation, and Surgery. Based on the studies, meta-regression showed no statistically significant difference across geographic regions, economic levels of the country, or sampling methods. Conclusion Acceptance and use of CAM varied across medical specialists. CAM was accepted and used the most by Family Medicine but the least by Surgery. Findings from this systematic review could be useful for strategic harmonization of CAM and conventional medicine practice. Systematic review registration PROSPERO CRD42019125628 Graphical abstract

Pandemiebedingter Rückgang von Rehabilitationsanträgen

Eine aktuelle in den Archives of Physical Medicine and Rehabilitation veröffentliche Studie beziffert den pandemiebedingten Rückgang von Rehabilitationsanträgen in Deutschland für April bis Dezember 2020 mit 14,5%. Für die Studie wurden mehr als 3 Millionen bei den Rentenversicherungsträgern in den Jahren 2019 und 2020 eingereichte Rehabilitationsanträge ausgewertet.

Perspectives of physical medicine and rehabilitation specialists and rheumatologists towards fibromyalgia syndrome in Turkey

Objective: Fibromyalgia syndrome (FMS) is a chronic disorder characterized by widespread, unexplained pain in the muscles, including the head, neck, and sides of the hips, and fatigue. We aimed to evaluate the familiarity of physical medicine and rehabilitation and rheumatology physicians with fibromyalgia syndrome (FMS) in Turkey by means of a survey and to determine if these physician groups followed the 1990 FMS diagnostic criteria and 2010 FMS classification criteria for diagnosis. Material and Methods: The survey questions consisted of two parts; the first part consisted of 10 questions about demographics and professional experience, as well as the number of patients who had been diagnosed, treated, and followed up with in the prior 3 months by physicians. The second part consisted of 15 questions about perspectives on the 1990 FMS diagnostic criteria and 2010 FMS classification criteria. Results: One hundred and seventy one physicians participated in this survey. The majority of physicians 105 (99.1%) from physical medicine and rehabilitation and 59 (90.8%) rheumatologists could diagnose FMS. The rate of diagnosis and the rate of follow-up for FMS patients were significantly higher with physical medicine and rehabilitation specialists than with rheumatologists (p= 0.013 and p = 0.000; respectively) and were statistically significant. Conclusion: Differences in the awareness and descriptions of as well as approaches to FMS by physical medicine rehabilitation physicians and rheumatologists were examined in this study.

PHYSICAL MEDICINE AND REHABILITATION APPROACHES IN THROMBOSIS ASSOCIATED WITH COVID-19

An increasing number of publications have supported the determination of thrombosis associated with coronavirus disease 2019 (COVID-19). Despite prophylactic drug applications, post-COVID-19 thrombosis cannot be completely prevented. Thrombosis becomes a complex problem that is difficult to avoid, particularly in intensive care patients. It is also possible to see cases of thromboembolism secondary to quarantine and home isolation. In addition to the classical pathophysiological mechanisms in Virchow’s triad, more complex processes specific to COVID-19 may also trigger thrombosis. The aims of this review were to describe physical medicine and rehabilitation practices that can be applied in addition to medical recommendations for thrombosis in COVID-19 patients, and to explain the specific features and mechanism of action of these methods. This process, which starts with education sessions, should continue to reduce immobility as much as possible. Personalized exercise programs should be recommended after evaluating the individual’s condition, exercise history, risk of falling, and comorbid diseases. In parallel with technological progress, more innovative devices have been developed and thus mechanical compression methods and neuromuscular electrical stimulation have become available for this purpose. The most important features of physical medicine and rehabilitation practices are the relatively low cost and the low incidence of complications.