Search

Background: A large part of the population in Germany makes use of naturopathic, complementary and integrative medical treatments. There are now numerous scientific studies that provide evidence of efficacy for certain indications. At German medical faculties, selected procedures and their application are taught within the cross-sectoral unit called QB 12 and some elective courses, with a focus on specific aspects are offered. So far, however, there has been no structured curriculum that longitudinally anchors teaching across medical studies and enables all students to consider naturopathic and complementary medical options for patient care later on and to integrate them effectively into the diagnostic and treatment process. Objective: The aim of this position paper is to show the relevance of this topic for medical education, to clarify terminology and to present core competencies and possible implementation options for training. Method: The Integrative Medicine and Perspective Pluralism Committee of the German Association for Medical Education developed this position paper in a multi-stage consensual process, in cooperation with the Forum of University Work Groups on Naturopathic Treatment and Complementary Medicine. Results: First, different umbrella terms were discussed and an existing definition of integrative medicine and health was chosen for subsequent use. Building on this step, the status of education and its scientific foundation in Germany was considered in an international context. In the next step, a competency profile for medical training, consisting of seven areas of competency, was developed and described in detail with regard to naturopathic, complementary and integrative medicine. Implementation options were identified using possible starting points in the curriculum and using established examples of best practice. Conclusion: Despite different priorities at each faculty, it was possible to find an agreement on the development of competencies and anchoring them in medical education on the basis of a common definition of terms. Currently, the implementation in the mandatory and elective areas is very heterogeneous. As part of the current revision of the Medical Licensure Act, there are many possible starting points for the integration of naturopathic and complementary medical teaching content, especially in interprofessional and general practice courses. The implementation and accompanying research of targeted teaching settings should lay the foundations for a long-term and binding integration into medical education. Overall, it is clear that medical education in the field of naturopathy and complementary and integrative medicine has the potential to develop comprehensive core medical competencies., Hintergrund: Ein großer Anteil der Bevölkerung in Deutschland nimmt naturheilkundliche, komplementär- und integrativmedizinische Therapieverfahren in Anspruch. Mittlerweile existieren zahlreiche wissenschaftliche Studien, die einen Wirksamkeitsnachweis bei bestimmten Indikationen liefern. An deutschen Medizinischen Fakultäten werden ausgewählte Verfahren und deren Anwendung im Rahmen des Querschnittsbereichs 12 gelehrt, an einigen werden Wahlfächer mit eigenen Schwerpunktsetzungen angeboten. Bislang fehlt jedoch ein strukturiertes Curriculum, welches longitudinal die Lehre über das Medizinstudium hinweg verankert und alle Studierende befähigt, naturheilkundliche und komplementärmedizinische Optionen in der späteren Patientenversorgung zu berücksichtigen und wirksam in den Diagnostik- und Therapieprozess einzubinden. Zielsetzung: Ziel dieses Positionspapiers ist, die Relevanz des Themas für die medizinische Ausbildung darzustellen, begriffliche Klarheit zu schaffen sowie Kernkompetenzen und mögliche Implementierungsmöglichkeiten für die Ausbildung vorzustellen. Methode: Der Ausschuss Integrative Medizin und Perspektivenpluralismus der Gesellschaft für Medizinische Ausbildung erarbeitete in Zusammenarbeit mit dem Forum universitärer Arbeitsgruppen Naturheilverfahren und Komplementärmedizin das vorliegende Positionspapier in einem mehrstufigen konsensualen Prozess. Ergebnisse: Zunächst wurden unterschiedliche Oberbegriffe diskutiert und für die weitere Arbeit eine bestehende Definition für Integrative Medizin und Gesundheit ausgewählt. Darauf aufbauend wurde der Stand der Ausbildung und deren wissenschaftliche Fundierung in Deutschland im internationalen Kontext reflektiert. In einem weiteren Schritt wurde ein Kompetenzprofil für die medizinische Ausbildung, bestehend aus sieben Kompetenzbereichen, entwickelt und im Hinblick auf Naturheilverfahren, komplementäre und integrative Medizin detailliert dargestellt. Implementierungsmöglichkeiten wurden anhand möglicher Anknüpfungspunkte im Curriculum sowie anhand bereits etablierter Best-Practice-Beispiele aufgezeigt. Schlussfolgerung: Trotz unterschiedlicher Schwerpunktsetzungen an den einzelnen Fakultäten ist es gelungen, auf Grundlage einer gemeinsamen Begriffsdefinition eine Übereinkunft über die mögliche Kompetenzentwicklung und Verankerung in der medizinischen Ausbildung zu finden. Aktuell ist die Umsetzung in den Pflicht- und Wahlbereichen sehr heterogen. Im Rahmen der aktuellen Überarbeitung der Approbationsordnung bieten sich vielfache Anknüpfungspunkte für eine Einbindung naturheilkundlicher und komplementärmedizinischer Lehrinhalte insbesondere bei interprofessionellen und allgemeinmedizinischen Lehrangeboten. Durch die Implementierung und Begleitforschung zielgerichteter Lehr-Settings sollten die Grundlagen für eine langfristige und verbindliche Integration in die medizinische Ausbildung gelegt werden. Insgesamt wird deutlich, dass die Lehre im Bereich Naturheilverfahren und komplementäre und integrative Medizin das Potential zur Entwicklung umfangreicher ärztlicher Kernkompetenzen hat.

Progressive legalization and increasing utilization of medical cannabis open up potential new applications, including for inflammatory bowel disease (IBD). This study aimed to collect current figures on the use of and experience with cannabis among IBD patients in Germany. A 71-item questionnaire was mailed to a randomly selected representative sample of 1000 IBD patients. Questionnaires were returned by 417 patients (mean age 49.1 ± 17.0 years; 55.8 % women; 43.4 % ulcerative colitis and 54.7 % Crohn's disease). Seventy-three respondents (17.5 %) stated past cannabis use for recreational purposes, while 12 users mentioned usage at the time the questionnaire was completed (2.9 %). Seventeen patients (4.1 %) indicated past use of cannabis, and 18 participants (4.3 %) reported current use of cannabis to treat IBD. Perceived benefits of cannabis use by its users included reduced abdominal pain, improved sleep quality, and relief of unease and worry. They reported lower quality of life and higher levels of anxiety or depression than non-users. Of notice, 52.9 % of cannabis users obtained their cannabis from the black market. A total of 76.5 % of former and 50 % of current users did not report their cannabis use to the physician. This survey reveals the largest data set on cannabis use among IBD patients in Germany, with the potential for further research. Cannabis is mainly procured from the black market, with unknown quality.Die fortschreitende Legalisierung und zunehmende Nutzung von medizinischem Cannabis eröffnet potenzielle neue Anwendungsgebiete, z. B. im Bereich der entzündlichen Darmerkrankungen (CED). Ziel dieser Studie war es, aktuelle Zahlen über den Gebrauch von und die Erfahrungen mit Cannabis bei IBD-Patienten in Deutschland zu erheben. Ein 71 Punkte umfassender Fragebogen wurde an eine zufällig ausgewählte repräsentative Stichprobe von 1000 CED-Patienten verschickt. Die Fragebögen wurden von 417 Patienten zurückgeschickt (Durchschnittsalter 49,1 ± 17,0 Jahre, 55,8 % Frauen, 43,4 % Colitis ulcerosa und 54,7 % Morbus Crohn). 73 Befragte (17,5 %) gaben an, in der Vergangenheit Cannabis zu Freizeitzwecken konsumiert zu haben, während 12 Nutzer den Konsum zum Zeitpunkt des ausfüllens des Fragebogens erwähnten (2,9 %). 17 Patienten (4,1 %) gaben einen früheren Cannabiskonsum an, und 18 Teilnehmer (4,3 %) berichteten über einen aktuellen Cannabiskonsum zur Behandlung von CED. Zu den von den Nutzern wahrgenommenen Vorteilen des Cannabiskonsums gehörten: eine Reduzierung der Bauchschmerzen, eine Verbesserung der Schlafqualität und eine Linderung von Unruhe und Ängsten. Sie berichteten über eine geringere Lebensqualität und ein höheres Maß an Ängsten oder Depressionen als Nicht-Konsumenten. Auffällig war, dass 52,9 % der Cannabiskonsumenten ihr Cannabis vom Schwarzmarkt bezogen. Insgesamt 76,5 % der ehemaligen und 50 % der aktuellen Konsumenten meldeten ihren Cannabiskonsum nicht dem behandelnden Arzt. Diese Umfrage zeigt die größte Erhebung in Deutschland zum Thema Cannabiskonsum bei CED-Patienten, mit Potenzial für weitere Forschung. Cannabis wird hauptsächlich auf dem Schwarzmarkt beschafft, mit unbekannter Qualität.

Background Interprofessional education and complementary and integrative medicine (CIM) strive for patient-centred medical care. Combining both concepts in education seems promising to prepare students for future health care. This article explores the question of what should be considered in undergraduate interprofessional training on complementary and integrative medicine for students of medicine and other health care professions and what benefits can be expected. Methods A three-round Delphi study was conducted with experts from varied professional backgrounds who have experience in teaching and patient care to address CIM training in the above-mentioned setting. Presented here are the results of the third round, in which 40 experts were asked open questions about what benefits/opportunities and what barriers/challenges they expect when such training programmes are offered. The statements were inductively evaluated by content analysis, to develop categories and subcategories. Results The response rate was 90% (n = 36). The categories (and most frequently mentioned subcategories) were as follows: Regarding benefits: patient care (strengthening holistic and patient-centred care); teaching and learning (learning together); faculty development (opening up new perspectives); and regarding barriers: teaching and learning (uncritical teaching); faculty development (lack of acceptance); implementation (difficult scheduling). Conclusion Experts expect interprofessional teaching on CIM to have positive effects not only on holistic and team-oriented patient care but also on faculty development. It might be challenging to teach the topics in a critical manner and on a scientific basis to ensure high-quality teaching. The results of this study can be used to promote an appropriate implementation of such training programmes.

Introduction The aim of this study was to develop a criteria catalogue serving as a guideline for authors to improve quality of Reporting Experiments in Homeopathic Basic Research (REHBaR). Main focus was in the field of biochemical and biological experiments. So far, there was no guideline for scientists and authors available, unlike criteria catalogues common in clinical research. Methods A Delphi Process was conducted among experts who published experimental work within the last five years in this field. The process included a total of five rounds, three rounds of adjusting and phrasing plus two consensus conferences. Results A checklist of 23 items was achieved, augmented with detailed examples how to handle each item while compiling a publication. Background, objectives and possible hypotheses are necessary to be given in the part ‘introduction’. The section ‘materials and methods’ is the most important part, where a detailed description of chosen controls, object of investigation, experimental setup, replication, parameters, intervention, allocation, blinding, and statistical methods is mandatory. In the ‘results’ section sufficient details on analysed data, descriptive as well as inferential are needed. Moreover, authors should discuss their results and interpret them in the context of current evidence. REHBaR was compiled for authors when preparing their manuscripts, and to be used by scientific journals in the reviewing process. Conclusions Reporting experiments in basic research in homeopathy is an important issue to state the quality and validity of gained results. A guideline for REHBaR seemed to be the first step to come to a commitment what information is necessary to be given in a paper. More than that, the catalogue can serve as a statement what the standards in good basic research should be.

Background Reliable information regarding patient knowledge of home remedies and the types of health problems patients use them for is scarce. Nevertheless, anecdotal evidence indicates that home remedies are used by patients for managing minor health problems and that this can be sufficient for symptom management while the body recovers from minor health problems. The aim of the presented study was to explore patient use of home remedies in Germany. Methods A questionnaire was developed and pretested in a pilot study phase. The revised questionnaire was comprised of questions about general knowledge and experienced efficiency of home remedies, the use of home remedies for common health problems and socio-demographic data. Patients were recruited via randomly selected addresses of general practitioners (GPs) in three regions of Germany (Heidelberg, Erfurt and Hanover and surrounding areas). The questionnaire was handed out in the waiting area of GP practices. The data was analyzed descriptively. Results 480 of 592 patients from 37 GP practices were included, according to a response rate of 81%. Based on the survey results, home remedies were widely known and used by about 80% of our respondents (on average 22 different home remedies were used per person). The most frequently used home remedies were steam-inhalation, hot lemon drink, honey, chamomile tea and chicken soup. 80% of respondents tried home remedies before pharmaceutical options. Information about home remedies was most commonly gained from family members, rather than from written guides, media or GPs. Conclusions These results provide an initial overview on the use of home remedies from the patient’s perspective in a German context. Bearing in mind the high use of home remedies that was reported by patients in the study, it is highly likely that GPs in Germany may need to advise patients on their use of home remedies during consultations. To this end, given the scarcity of reliable information on home remedies, further research is needed.