213268 Use of Complementary and Alternative Medicine among Refugees: A Systematic Review

Monday, November 9, 2009

Sabrina MacDuff, BA , Department of Health Law, Bioethics, and Human Rights, Boston University School of Public Health, Boston, MA
Michael Grodin, MD , Department of Health Law, Bioethics, and Human Rights, Boston University School of Public Health and Global Lawyers and Physicians, Boston, MA
Paula Gardiner, MD, MPH , Department of Family Medicine, Boston University Medical Center, Boston, MA
Background: Little is known about the use of Complementary and Alternative Medicine (CAM) among refugees, despite the common practice of CAM in many non-Western countries.

Methods: We performed a systematic review of peer-reviewed literature using nine electronic databases. We included articles pertaining to refugees and CAM (whole medical systems, mind body medicine, herbal remedies, manipulative therapies, energy medicine). Qualitative and quantitative data were compiled and analyzed through descriptive statistics and chi square distribution tables.

Results: We reviewed 237 abstracts, and 49 publications met our inclusion criteria. 28 papers documented whole medical systems; 11 mind-body medicine; 5 biologically based practices; 4 manipulative and body-based therapies; and 1 study documented the use of energy medicine. There were 20 surveys, 14 qualitative papers, 12 case reports, and 3 clinical trials. Most studies focused on Asian refugee populations (65%; n = 32). Mental problems related to trauma accounted for 33% of CAM use (16).

Discussion: Among included articles, methodological quality was extremely low. Our results show evidence that type of CAM used by refugees may vary based on ethnicity, yet this is most likely due to a bias in the medical literature. Efforts are needed to further explore these results and expand research within this field.

Learning Objectives:
The purpose of this systematic review is to (1) assess the prevalence of CAM use among worldwide refugee populations by searching the published medical literature, (2) analyze the most commonly practiced CAM modalities among refugees, and (3) identify any factors related to the use of CAM, such as ethnicity.

Keywords: Refugees, Alternative Medicine/Therapies

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I received a Boston University Undergraduate Research Opportunities Grant to complete this research during my final summer after college. I was closely monitored by Dr. Paula Gardiner regarding research methodology and data analysis to perform this systematic review. My immediate boss, Dr. Michael Grodin, is trained in a variety of alternative medicine therapies including acupuncture, Tai Chi, Qigong, music therapies, and Reiki.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.