Open Access Highly Accessed Correspondence

High prevalence but limited evidence in complementary and alternative medicine: guidelines for future research

Felix H Fischer1*, George Lewith2, Claudia M Witt13, Klaus Linde4, Klaus von Ammon5, Francesco Cardini6, Torkel Falkenberg78, Vinjar Fønnebø9, Helle Johannessen10, Bettina Reiter11, Bernhard Uehleke12, Wolfgang Weidenhammer13 and Benno Brinkhaus1

Author Affiliations

1 Institute for Social Medicine, Epidemiology, and Health Economics, Charité Universitätsmedizin, Luisenstr. 57, 10098 Berlin, Germany

2 Complementary and Integrated Medicine Research Unit, University of Southampton, Southampton, UK

3 Center for Integrative Medicine, School of Medicine, University of Maryland, Baltimore, USA

4 Institute of General Practice, Klinikum rechts der Isar, Technische Universität München, Munich, Germany

5 Institute of Complementary Medicine (KIKOM), University of Bern, Bern, Switzerland

6 Healthcare and Social Agency of Emilia Romagna Region, Bologna, Italy

7 Research Unit for Integrative Healthcare Research, Karolinska Institute, Stockholm, Sweden

8 I C – The Integrative Care Science Center, Järna, Sweden

9 National Research Center on Complementary and Alternative Medicine (NAFKAM), University of Tromsø, Tromsø, Norway

10 Institute of Public Health, Research Unit Health, Man and Society, University of Southern Denmark, Odense, Denmark

11 International Academy for Holistic Medicine, Vienna, Austria

12 Institute of Complementary Medicine, Department of Internal Medicine, University Hospital Zurich, Zurich, Switzerland

13 Competence Centre for Complementary Medicine and Naturopathy, Klinikum rechts der Isar, Technische Universität, Munich, Germany

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BMC Complementary and Alternative Medicine 2014, 14:46  doi:10.1186/1472-6882-14-46

Published: 6 February 2014


The use of complementary and alternative Medicine (CAM) has increased over the past two decades in Europe. Nonetheless, research investigating the evidence to support its use remains limited. The CAMbrella project funded by the European Commission aimed to develop a strategic research agenda starting by systematically evaluating the state of CAM in the EU. CAMbrella involved 9 work packages covering issues such as the definition of CAM; its legal status, provision and use in the EU; and a synthesis of international research perspectives. Based on the work package reports, we developed a strategic and methodologically robust research roadmap based on expert workshops, a systematic Delphi-based process and a final consensus conference. The CAMbrella project suggests six core areas for research to examine the potential contribution of CAM to the health care challenges faced by the EU. These areas include evaluating the prevalence of CAM use in Europe; the EU cititzens’ needs and attitudes regarding CAM; the safety of CAM; the comparative effectiveness of CAM; the effects of meaning and context on CAM outcomes; and different models for integrating CAM into existing health care systems. CAM research should use methods generally accepted in the evaluation of health services, including comparative effectiveness studies and mixed-methods designs. A research strategy is urgently needed, ideally led by a European CAM coordinating research office dedicated to fostering systematic communication between EU governments, the public, charitable and industry funders, researchers and other stakeholders. A European Centre for CAM should also be established to monitor and further a coordinated research strategy with sufficient funds to commission and promote high quality, independent research focusing on the public’s health needs and pan-European collaboration. There is a disparity between highly prevalent use of CAM in Europe and solid knowledge about it. A strategic approach on CAM research should be established to investigate the identified gaps of knowledge and to address upcoming health care challenges.

Complementary and alternative medicine; Research strategy; Randomized clinical trials; Safety; Qualitative studies; Comparative effectiveness research