What is the evidence for Naturopathy? ........ Continuing on from the above artice regarding Private Health Insurance Reforms:
There are a number of health conditions which have been identified as national health priority areas by the Australian Government based on their contribution to the burden of disease in Australia – dementia, obesity, arthritis and musculoskeletal conditions, asthma, diabetes, mental health, injuries, cardiovascular disease, and cancer.8 A comprehensive review which looked at the nature of complementary medicine usage within Australia, found it to be commonly utilised by patients with these diseases,9 a trend that is supported by a wealth of evidence on the effectiveness of natural medicines for these conditions. For example, in the priority area of mental health, Professor Jerome Sarris’s January 2018 systematic review highlights high quality (scientifically rigorous) evidence for several herbs in the treatment of anxiety (including passionflower) and depressive disorders (including saffron). For arthritis, the British Medical Journal published a positive meta-analysis in 2017, for both omega-3 fatty acids and turmeric in the reduction of pain and disease activity.10 For cardiovascular disease and diabetes, magnesium supplementation has consistently demonstrated significant improvements in numerous markers including insulin, glucose, lipids, blood pressure, as well as improved heart function and survival in heart disease patients – all in placebo-controlled trials and meta-analyses.11
A 2014 Frost and Sullivan report predicted the potential healthcare savings if at-risk Australians utilised just a handful of natural medicines for the prevention or treatment of key conditions – B vitamins and omega-3 for cardiovascular health; magnesium, calcium and vitamin D for bone health; lutein and zeaxanthin for eye health; and St John’s wort for depression. Utilisation of these therapies by affected segments of the population was projected to result in a $3 billion net economic benefit annually.12
Beyond the prescribing of natural medicines, Naturopaths are key proponents of the comprehensive lifestyle interventions needed to mitigate chronic conditions. Dietary change, stress reduction and exercise are key therapies recommended by Naturopaths, all backed by a large body of evidence, and essential for the prevention and treatment of lifestyle-related conditions such as cardiovascular disease, obesity, diabetes and dementia.13,14,15,16
Unfortunately in Australia, where approximately 63% of the population are overweight or obese, It has been shown that, only one third or less of these and/or hypertensive patients receive lifestyle advice from their General Practitioner.17
The medical system needs complementary healthcare Practitioners who are experts in the implementation of lifestyle medicine, and who have the capacity and time to engage with and counsel their patients.
In order to understand the patient’s perception of care provided by complementary medicine Practitioners, Hope Foley and Dr Amie Steel of the Endeavour Office of Research, published a systematic review last year. They found that patients felt higher levels of empathy and empowerment from complementary medicine consultations than from conventional medicine. Further, this empowerment is associated with a shift towards behavioural change and a more positive way of thinking.18
Chronic diseases require a significant amount of self ‐ management on the patients behalf, therefore empowering them can be key to effective management.19,20 In doing so, patients develop a greater understanding of the impact of their behaviours on their health, make informed choices and decisions to achieve their health goals, and stay committed when challenges arise.21
Higher levels of empowerment in diabetes management have been associated with better patient knowledge, improved medication adherence, and positive lifestyle behaviours.22 While some studies reported that all complementary medicine consultations created empowerment, this has been more consistently reported with Naturopaths and Herbalists than with acupuncture, massage and homeopathy.23 This may be due to typical Naturopathic and Herbalist consultations involving a large advice component, compared to the focus in other modalities being on the selection and administration of the treatment by the Practitioner.
Australians are Voting With Their Feet
The high utilisation of complementary medicine in Australia demonstrates that it is considered by many to be a legitimate and important component of healthcare.24 Complementary medicine is extensively utilised by people with chronic conditions and low quality of life.25,26
In the CAMELOT study of 2915 Australians with cardiovascular disease or diabetes, 43% had used complementary medicine in the last 12 months.27 Naturopaths are one of the top four most commonly consulted healthcare Practitioners in Australia, alongside massage therapists, chiropractors and acupuncturists.28
For those seeking out complementary medicine, key reasons provided include unsatisfactory results as well as side effects from conventional therapy. Patients also report choosing natural medicine due to its ability to be used as preventative medicine, providing a sense of self-control and self-determination over their own health, and the comprehensive approach to their individual health considerations.29,30
In a time when most countries of the world are heading towards a chronic disease healthcare crisis (a crisis from both a budgetary and morbidity perspective), individuals who are proactively seeking and engaging with preventative healthcare Practitioners need to be supported in their choices and efforts. Far from marginalising an established and highly frequented network of healthcare Practitioners, the government should respond to any perceived lack of evidence by supporting continued research into complementary medicine.31 Such an approach would continue to have both the individual’s and the nation’s physical and financial health in mind.
Author: Marla Cunningham, Metagenics Head of Clinical Innovation