Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Complementary Medicine and Therapies
Published in: BMC Complementary Medicine and Therapies 1/2013

Open Access 01-12-2013 | Research article

Individualised medicine from the perspectives of patients using complementarytherapies: a meta-ethnography approach

Authors: Brigitte Franzel, Martina Schwiegershausen, Peter Heusser, Bettina Berger

Published in: BMC Complementary Medicine and Therapies | Issue 1/2013

Login to get access

Abstract

Background

Personalised (or individualised) medicine in the days of genetic researchrefers to molecular biologic specifications in individuals and not to aresponse to individual patient needs in the sense of person-centredmedicine. Studies suggest that patients often wish for authenticallyperson-centred care and personal physician-patient interactions, and thatthey therefore choose Complementary and Alternative medicine (CAM) as apossibility to complement standard care and ensure a patient-centredapproach. Therefore, to build on the findings documented in thesequalitative studies, we investigated the various concepts of individualisedmedicine inherent in patients’ reasons for using CAM.

Methods

We used the technique of meta-ethnography, following a three-stage approach:(1) A comprehensive systematic literature search of 67 electronic databasesand appraisal of eligible qualitative studies related to patients’reasons for seeking CAM was carried out. Eligibility for inclusion wasdetermined using defined criteria. (2) A meta-ethnographic study wasconducted according to Noblit and Hare's method for translating key themesin patients’ reasons for using CAM. (3) A line-of-argument approachwas used to synthesize and interpret key concepts associated withpatients’ reasoning regarding individualized medicine.

Results

(1) Of a total of 9,578 citations screened, 38 studies were appraised with aquality assessment checklist and a total of 30 publications were included inthe study. (2) Reasons for CAM use evolved following a reciprocaltranslation. (3) The line-of-argument interpretations of patients’concepts of individualised medicine that emerged based on the findings ofour multidisciplinary research team were “personal growth”,“holism”, “alliance”, “integrativecare”, “self-activation” and “wellbeing”.

Conclusions

The results of this meta-ethnographic study demonstrate that patients’notions of individualised medicine differ from the current idea ofpersonalised genetic medicine. Our study shows that the“personal” patients’ needs are not identified with aspecific high-risk group or with a unique genetic profile in the sense ofgenome-based “personalised” or “individualised”medicine. Thus, the concept of individualised medicine should include thehumanistic approach of individualisation as expressed in concepts such as“personal growth”, “holistic” or “integrativecare”, doctor-patient “alliance”,“self-activation” and “wellbeing” needs. This shouldalso be considered in research projects and the allocation of healthcareresources.
Appendix
Available only for authorised users
Literature
1.
Heusser P, Neugebauer E, Berger B, Hahn E: Integrative and Personalized Health Care - Requirements for a TimelyHealth-Care System. Gesundheitswesen. 2013, 75 (3): 151-154.PubMed
2.
3.
4.
Hüsing B: Individualised medicine - potentials and need for action. Z Evid Fortbild Qual Gesundhwes. 2010, 104 (10): 727-731. 10.1016/j.zefq.2010.07.041.CrossRefPubMed
5.
6.
Verhoef MJ, Balneaves LG, Boon HS, Vroegindewey A: Reasons for and characteristics associated with complementary and alternativemedicine use among adult cancer patients: a systematic review. Integr Cancer Ther. 2005, 4 (4): 274-286. 10.1177/1534735405282361.CrossRefPubMed
7.
8.
Köntopp S: Wer nutzt Komplementärmedizin? PhD thesis. 2004, Essen: KVC Verlag
9.
Barbour RS: Checklists for improving rigour in qualitative research: a case of the tailwagging the dog?. BMJ. 2001, 322 (7294): 1115-1117. 10.1136/bmj.322.7294.1115.CrossRefPubMedPubMedCentral
10.
Reis S, Hermoni D, Van-Raalte R, Dahan R, Borkan JM: Aggregation of qualitative studies–From theory to practice: Patientpriorities and family medicine/general practice evaluations. Patient Educ Couns. 2007, 65 (2): 214-222. 10.1016/j.pec.2006.07.011.CrossRefPubMed
11.
Giacomini MK, Cook DJ: Users’ guides to the medical literature: XXIII. Qualitative research inhealth care A. Are the results of the study valid? Evidence-Based MedicineWorking Group. JAMA. 2000, 284 (3): 357-362. 10.1001/jama.284.3.357.CrossRefPubMed
12.
Broom A: Using qualitative interviews in CAM research: a guide to study design, datacollection and data analysis. Complement Ther Med. 2005, 13 (1): 65-73. 10.1016/j.ctim.2005.01.001.CrossRefPubMed
13.
Kania A, Porcino A, Vehoef MJ: Value of qualitative research in the study of massage therapy. Int J Ther Massage Bodywork. 2008, 1 (2): 6-10.PubMedPubMedCentral
14.
Ritenbaugh C, Nichter M, Nichter MA, Kelly KL, Sims CM, Bell IR, Castañeda HM, Elder CR, Koithan MS, Sutherland EG, Verhoef MJ, Warber SL, Coons SJ: Developing a patient-centered outcome measure for complementary andalternative medicine therapies I: defining content and format. BMC Complement Altern Med. 2011, 11: 135-10.1186/1472-6882-11-135.CrossRefPubMedPubMedCentral
15.
Noblit GW, Hare RD: Meta-Ethnography: Synthesizing Qualitative Studies. 1988, Newbury Park: Sage Publications, IncorporatedCrossRef
16.
White M, Verhoef M: Cancer as part of the journey: the role of spirituality in the decision todecline conventional prostate cancer treatment and to use complementary andalternative medicine. Integr Cancer Ther. 2006, 5 (2): 117-122. 10.1177/1534735406288084.CrossRefPubMed
17.
Evans MA, Shaw ARG, Sharp DJ, Thompson EA, Falk S, Turton P, Thompson T: Men with cancer: is their use of complementary and alternative medicine aresponse to needs unmet by conventional care?. Eur J Cancer Care (Engl). 2007, 16 (6): 517-525. 10.1111/j.1365-2354.2007.00786.x.CrossRef
18.
Nichol J, Thompson EA, Shaw A: Beliefs, decision-making, and dialogue about complementary and alternativemedicine (CAM) within families using CAM: a qualitative study. J Altern Complement Med. 2011, 17 (2): 117-125. 10.1089/acm.2010.0171.CrossRefPubMed
19.
Richardson J: What patients expect from complementary therapy: a qualitative study. Am J Public Health. 2004, 94 (6): 1049-1053. 10.2105/AJPH.94.6.1049.CrossRefPubMedPubMedCentral
20.
Grace S, Higgs J: Integrative medicine: enhancing quality in primary health care. J Altern Complement Med. 2010, 16 (9): 945-950. 10.1089/acm.2009.0437.CrossRefPubMed
21.
Shaw A, Thompson EA, Sharp D: Complementary therapy use by patients and parents of children with asthma andthe implications for NHS care: a qualitative study. BMC Health Serv Res. 2006, 6: 76-10.1186/1472-6963-6-76.CrossRefPubMedPubMedCentral
22.
La Cour P: Rheumatic disease and complementary-alternative treatments: a qualitativestudy of patient’s experiences. J Clin Rheumatol. 2008, 14 (6): 332-337. 10.1097/RHU.0b013e31817a7e1f.CrossRefPubMed
23.
Salamonsen A, Launsø L, Kruse TE, Eriksen SH: Understanding unexpected courses of multiple sclerosis among patients usingcomplementary and alternative medicine: A travel from recipient toexplorer. Int J Qual Stud Health Well-being. 2010, 5: 2-CrossRef
24.
Conboy L, Quilty MT, Kerr C, Shaw J, Wayne P: A qualitative analysis of adolescents’ experiences of active and shamJapanese-style acupuncture protocols administered in a clinical trial. J Altern Complement Med. 2008, 14 (6): 699-705. 10.1089/acm.2007.0718.CrossRefPubMed
25.
Adler SR, Wrubel J, Hughes E, Beinfield H: Patients’ Interactions With Physicians and Complementary andAlternative Medicine Practitioners: Older Women With Breast Cancer andSelf-Managed Health Care. Integr Cancer Ther. 2009, 8 (1): 63-70. 10.1177/1534735408329410.CrossRefPubMedPubMedCentral
26.
Ribeiro MA, Harrigan RC: The use of Complementary and Alternative Medicine by Asian women ofHawai’i in the treatment of breast cancer. Hawaii Med J. 2006, 65 (7): 198-205.PubMed
27.
Mulkins AL, Verhoef MJ: Supporting the transformative process: experiences of cancer patientsreceiving integrative care. Integr Cancer Ther. 2004, 3 (3): 230-237. 10.1177/1534735404268054.CrossRefPubMed
28.
Broom A: Intuition, subjectivity, and Le bricoleur: cancer patients’ accounts ofnegotiating a plurality of therapeutic options. Qual Health Res. 2009, 19 (8): 1050-1059. 10.1177/1049732309341190.CrossRefPubMed
29.
McCaffrey AM, Pugh GF, O’Connor BB: Understanding patient preference for integrative medical care: results frompatient focus groups. J Gen Intern Med. 2007, 22 (11): 1500-1505. 10.1007/s11606-007-0302-5.CrossRefPubMedPubMedCentral
30.
Canales MK, Geller BM: Surviving breast cancer: the role of complementary therapies. Fam Community Health. 2003, 26 (1): 11-24. 10.1097/00003727-200301000-00003.CrossRefPubMed
31.
Wanchai A, Armer JM, Stewart BR: Breast cancer survivors’ perspectives of care practices in Western andalternative medicine. Oncol Nurs Forum. 2010, 37 (4): 494-500. 10.1188/10.ONF.494-500.CrossRefPubMed
32.
Smith JM, Sullivan SJ, Baxter GD: The culture of massage therapy: valued elements and the role of comfort,contact, connection and caring. Complement Ther Med. 2009, 17 (4): 181-189. 10.1016/j.ctim.2009.05.003.CrossRefPubMed
33.
Walter FM, Emery JD, Rogers M, Britten N: Women’s views of optimal risk communication and decision making ingeneral practice consultations about the menopause and hormone replacementtherapy. Patient Educ Couns. 2004, 53 (2): 121-128. 10.1016/j.pec.2003.11.001.CrossRefPubMed
34.
Patterson C, Arthur H, Noesgaard C, Caldwell P, Vohra J, Francoeur C, Swinton M: Exploring adolescent complementary/alternative medicine (CAM) use inCanada. J Interprof Care. 2008, 22 (1): 45-55. 10.1080/13561820701795374.CrossRefPubMed
35.
Boon H, Brown JB, Gavin A, Kennard MA, Stewart M: Breast cancer survivors’ perceptions of complementary/alternativemedicine (CAM): making the decision to use or not to use. Qual Health Res. 1999, 9 (5): 639-653. 10.1177/104973299129122135.CrossRefPubMed
36.
Jones RA, Taylor AG, Bourguignon C, Steeves R, Fraser G, Lippert M, Theodorescu D, Mathews H, Kilbridge KL: Complementary and alternative medicine modality use and beliefs among AfricanAmerican prostate cancer survivors. Oncol Nurs Forum. 2007, 34 (2): 359-364. 10.1188/07.ONF.359-364.CrossRefPubMedPubMedCentral
37.
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 conventionalbiomedicine. J Altern Complement Med. 2003, 9 (6): 937-947. 10.1089/107555303771952271.CrossRefPubMed
38.
Steinsbekk A, Launsø L: Empowering the cancer patient or controlling the tumor? A qualitative studyof how cancer patients experience consultations with complementary andalternative medicine practitioners and physicians, respectively. Integr Cancer Ther. 2005, 4 (2): 195-200. 10.1177/1534735405276721.CrossRefPubMed
39.
Humpel N, Jones SC: Gaining insight into the what, why and where of complementary and alternativemedicine use by cancer patients and survivors. Eur J Cancer Care (Engl). 2006, 15 (4): 362-368. 10.1111/j.1365-2354.2006.00667.x.CrossRef
40.
McDonald K, Slavin S: My body, my life, my choice: practices and meanings of complementary andalternative medicine among a sample of Australian people living withHIV/AIDS and their practitioners. AIDS Care. 2010, 22 (10): 1229-1235. 10.1080/09540121003668094.CrossRefPubMed
41.
Singh H, Maskarinec G, Shumay DM: Understanding the motivation for conventional and complementary/alternativemedicine use among men with prostate cancer. Integr Cancer Ther. 2005, 4 (2): 187-194. 10.1177/1534735405276358.CrossRefPubMed
42.
Antonovsky A: Salutogenese: zur Entmystifizierung der Gesundheit. 1997, Tübingen: Dgvt-Verl
43.
Correa-Velez I, Clavarino A, Eastwood H: Surviving, relieving, repairing, and boosting up: reasons for usingcomplementary/alternative medicine among patients with advanced cancer: athematic analysis. J Palliat Med. 2005, 8 (5): 953-961. 10.1089/jpm.2005.8.953.CrossRefPubMed
44.
Foote-Ardah CE: The meaning of complementary and alternative medicine practices among peoplewith HIV in the United States: strategies for managing everyday life. Sociol Health Illn. 2003, 25 (5): 481-500. 10.1111/1467-9566.00355.CrossRefPubMed
45.
Richmond JA, Bailey DE, McHutchison JG, Muir AJ: The use of mind-body medicine and prayer among adult patients with chronichepatitis C. Gastroenterol Nurs. 2010, 33 (3): 210-216. 10.1097/SGA.0b013e3181e01a7b.CrossRefPubMed
46.
Chen W-T, Shiu C-S, Simoni J, Fredriksen-Goldsen K, Zhang F, Starks H, Zhao H: Attitudes toward antiretroviral therapy and complementary and alternativemedicine in Chinese patients infected with HIV. J Assoc Nurses AIDS Care. 2009, 20 (3): 203-217. 10.1016/j.jana.2008.12.004.CrossRefPubMedPubMedCentral
47.
Westrom KK, Maiers MJ, Evans RL, Bronfort G: Individualized chiropractic and integrative care for low back pain: thedesign of a randomized clinical trial using a mixed-methods approach. Trials. 2010, 11: 24-10.1186/1745-6215-11-24.CrossRefPubMedPubMedCentral
48.
Garrino L, Curto N, Decorte R, Felisi N, Matta E, Gregorino S, Actis MV, Marchisio C, Carone R: Towards personalized care for persons with spinal cord injury: a study onpatients’ perceptions. J Spinal Cord Med. 2011, 34 (1): 67-75. 10.1179/107902610x12883422813741.CrossRefPubMedPubMedCentral
49.
Masi AT, White KP, Pilcher JJ: Person-centered approach to care, teaching, and research in fibromyalgiasyndrome: justification from biopsychosocial perspectives in populations. Semin Arthritis Rheum. 2002, 32 (2): 71-93. 10.1053/sarh.2002.33717.CrossRefPubMed
50.
Gallacher K, Bhautesh J, Deborah M, Sara M, David B, Patricia E, MC R, MV M, T ED, Fiona S, David BG, MF S: Qualitative systematic reviews of treatment burden in stroke, heart failureand diabetes - Methodological challenges and solutions. BMC Med Res Methodol. 2013, 13 (1): 10-10.1186/1471-2288-13-10.CrossRefPubMedPubMedCentral
51.
Greenhalgh T, Robert G, Macfarlane F, Bate P, Kyriakidou O, Peacock R: Storylines of research in diffusion of innovation: a meta-narrative approachto systematic review. Soc Sci Med. 2005, 61 (2): 417-430. 10.1016/j.socscimed.2004.12.001.CrossRefPubMed
52.
Barnett-Page E, Thomas J: Methods for the synthesis of qualitative research: a critical review. BMC Med Res Methodol. 2009, 9: 59-10.1186/1471-2288-9-59.CrossRefPubMedPubMedCentral
53.
Atkins S, Lewin S, Smith H, Engel M, Fretheim A, Volmink J: Conducting a meta-ethnography of qualitative literature: lessons learnt. BMC Med Res Methodol. 2008, 8: 21-10.1186/1471-2288-8-21.CrossRefPubMedPubMedCentral
54.
Wikberg A, Bondas T: A patient perspective in research on intercultural caring in maternity care:A meta-ethnography. Int J Qual Stud Health Well-being. 2010, 5: 10.3402/qhw.v5i1.4648.
55.
McInnes L: To synthesise or not synthesise? That is the question!. Worldviews Evid Based Nurs. 2005, 2 (2): 49-51. 10.1111/j.1741-6787.2005.05007.x.CrossRefPubMed
56.
Mays N, Pope C, Popay J: Systematically reviewing qualitative and quantitative evidence to informmanagement and policy-making in the health field. J Health Serv Res Policy. 2005, 10 (1): 6-20.CrossRefPubMed
57.
Huber M, Knottnerus JA, Green L, Van der Horst H, Jadad AR, Kromhout D, Leonard B, Lorig K, Loureiro MI, Van der Meer JWM, Schnabel P, Smith R, Van Weel C, Smid H: How should we define health?. BMJ. 2011, 343: d4163-10.1136/bmj.d4163.CrossRefPubMed
58.
Musial F, Büssing A, Heusser P, Choi K-E, Ostermann T: Mindfulness-based stress reduction for integrative cancer care: a summary ofevidence. Forsch Komplementmed. 2011, 18 (4): 192-202. 10.1159/000330714.CrossRefPubMed
59.
Kalitzkus V, Matthiessen PF: Personal growth in chronic illness - a biographical case study of living withfibromyalgia. Forsch Komplementmed. 2010, 17 (4): 203-208. 10.1159/000317848.CrossRefPubMed
60.
61.
McClean S: “The illness is part of the person”: discourses of blame,individual responsibility and individuation at a centre for spiritualhealing in the North of England. Sociol Health Illn. 2005, 27 (5): 628-648. 10.1111/j.1467-9566.2005.00459.x.CrossRefPubMed
62.
Kienle GS, Albonico H-U, Fischer L, Frei-Erb M, Hamre HJ, Heusser P, Matthiessen PF, Renfer A, Kiene H: Complementary Therapy Systems and Their Integrative Evaluation. EXPLORE. The Journal of Science and Healing. 2011, 7: 175-187.
63.
Lyng S: Holistic Health and Biomedical Medicine – A Countersystem Analysis.SUNY Series in the Political Economy of Health Care. 1990, Albany: State University of New York Press,
64.
Bischof M: Salutogenese – Unterwegs zur Gesundheit. Neue Gesundheitskonzepte unddie Entfaltung einer Integrativen Medizin. 2010, Drachen Verlag: Klein Jasedow,
65.
Swenson SL, Buell S, Zettler P, White M, Ruston DC, Lo B: Patient-centered communication: do patients really prefer it?. J Gen Intern Med. 2004, 19 (11): 1069-1079. 10.1111/j.1525-1497.2004.30384.x.CrossRefPubMedPubMedCentral
66.
Schattner A, Bronstein A, Jellin N: Information and shared decision-making are top patients’ priorities. BMC Health Serv Res. 2006, 6: 21-10.1186/1472-6963-6-21.CrossRefPubMedPubMedCentral
67.
68.
Berger S, Braehler E, Ernst J: The health professional-patient-relationship in conventional versuscomplementary and alternative medicine. A qualitative study comparing theperceived use of medical shared decision-making between two differentapproaches of medicine. Patient Educ Couns. 2012, 88 (1): 129-137. 10.1016/j.pec.2012.01.003.CrossRefPubMed
69.
Brien SB, Bishop FL, Riggs K, Stevenson D, Freire V, Lewith G: Integrated medicine in the management of chronic illness: a qualitativestudy. Br J Gen Pract. 2011, 61 (583): e89-e96.CrossRefPubMedPubMedCentral
70.
Walach H, Jonas WB: Placebo research: the evidence base for harnessing self-healingcapacities. J Altern Complement Med. 2004, 10 (Suppl 1): S103-S112.CrossRefPubMed
71.
Berger B, Steckelberg A, Meyer G, Kasper J, Mühlhauser I: Training of patient and consumer representatives in the basic competencies ofevidence-based medicine: a feasibility study. BMC Med Educ. 2010, 10: 16-10.1186/1472-6920-10-16.CrossRefPubMedPubMedCentral
72.
Müller V, Schmacke N, Kolip P, Berger B: Desirable, unfamiliar and in need of communication - the evidence-baseddecision aid of the Institute for Quality and Efficiency in Health Care(IQWiG)]. Z Evid Fortbild Qual Gesundhwes. 2012, 106 (4): 290-294. 10.1016/j.zefq.2012.03.001.CrossRef
73.
Humber N, Dickinson P: Rural patients’ experiences accessing surgery in British Columbia. Can J Surg. 2010, 53 (6): 373-378.PubMedPubMedCentral
74.
Joos S, Glassen K, Musselmann B: Herbal Medicine in Primary Healthcare in Germany: The Patient’sPerspective. Evid Based Complement Alternat Med. 2012, 2012: 294638-CrossRefPubMedPubMedCentral
75.
Oguamanam C: Personalized medicine and complementary and alternative medicine: in searchof common grounds. J Altern Complement Med. 2009, 15 (8): 943-949. 10.1089/acm.2009.0056.CrossRefPubMed
76.
77.
George M, Campbell J, Rand C: Self-management of acute asthma among low-income urban adults. J Asthma. 2009, 46 (6): 618-624. 10.1080/02770900903029788.CrossRefPubMedPubMedCentral
Metadata
Title
Individualised medicine from the perspectives of patients using complementarytherapies: a meta-ethnography approach
Authors
Brigitte Franzel
Martina Schwiegershausen
Peter Heusser
Bettina Berger
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Complementary Medicine and Therapies / Issue 1/2013
Electronic ISSN: 2662-7671
DOI
https://doi.org/10.1186/1472-6882-13-124

Other articles of this Issue 1/2013

BMC Complementary Medicine and Therapies 1/2013 Go to the issue

Research article

Red ginseng abrogates oxidative stress via mitochondria protection mediated by LKB1-AMPK pathway

Research article

A practical approach to Sasang constitutional diagnosis using vocal features

Research article

Comparison of the antibacterial activity of essential oils and extracts of medicinal and culinary herbs to investigate potential new treatments for irritable bowel syndrome

Research article

Preliminary antimycobacterial study on selected Turkish plants (Lamiaceae) against Mycobacterium tuberculosis and search for some phenolic constituents

Research article

Urine metabolic profile changes of CCl4-liver fibrosis in rats and intervention effects of Yi Guan Jian Decoction using metabonomic approach

Research article

Instrument-assisted cross fiber massage increases tissue perfusion and alters microvascular morphology in the vicinity of healing knee ligaments