Article type
Year
Abstract
Background: in March 2018, the Brazilian Ministry of Health announced 10 new integrative practices as part of the list of procedures available in the Brazilian public healthcare system, Sistema Único de Saúde (SUS): apitherapy, aromatherapy, bioenergetics, family constellation, chromotherapy, clay therapy, hypnotherapy, hand imposition, ozone therapy and flower therapy. SUS, a free and universal system, has a limited budget, and all interventions should be fairly supported by good quality studies before its implementation. We summarized the evidence from Cochrane Reviews (CRs) about these 10 interventions [1].
Objectives: to review the evidence from CRs that evaluated 10 integrative practices recently incorporated in the Brazilian healthcare system.
Methods: we developed a sensitive search strategy in the Cochrane Library using relevant terms to retrieve any CR that considered 1 of the 10 integrative interventions (Table 1). The selection and extraction processes were performed by two authors independently, and a third author solved disagreements. We discussed the evidence retrieved from the included CR and discussed the implementation of all integrative interventions in the Brazilian healthcare system.
Results: the search was carried out in March 2018 and retrieved 189 reviews. After the selection process, 16 CRs were included. The included CRs evaluated only 4 of the 10 integrative practices (apitherapy, aromatherapy, hypnotherapy and ozone therapy). For six integrative interventions (bioenergetics, family constellation, chromotherapy, geotherapy, flower therapy, and hand imposition), no CR was found. The certainty of evidence ranged from unknown to high. The high-certainty evidence was restricted to honey dressings for partial thickness burns, honey for acute cough in children, and venom immunotherapy for systematic reaction to an insect sting. The main characteristics of the included CRs are presented in Table 2.
Conclusions: our review suggests that almost the totality of the new interventions incorporated by Brazilian Ministry of Health in 2018 are not support by evidence from Cochrane Reviews. The lack of results reflects the uncertainty in the effects of the integrative interventions. Future randomized controlled trials and CRs are imperative to provide evidence for supporting healthcare decisions.
Patient or healthcare consumer involvement: evidence-based knowledge in clinical practice is essential for the adequate application of public policies. Patients should be offered health care supported by the best available evidence. Our results suggest a gap between evidence provided by Cochrane Reviews and the decision of the Brazilian Ministry of Health.
Objectives: to review the evidence from CRs that evaluated 10 integrative practices recently incorporated in the Brazilian healthcare system.
Methods: we developed a sensitive search strategy in the Cochrane Library using relevant terms to retrieve any CR that considered 1 of the 10 integrative interventions (Table 1). The selection and extraction processes were performed by two authors independently, and a third author solved disagreements. We discussed the evidence retrieved from the included CR and discussed the implementation of all integrative interventions in the Brazilian healthcare system.
Results: the search was carried out in March 2018 and retrieved 189 reviews. After the selection process, 16 CRs were included. The included CRs evaluated only 4 of the 10 integrative practices (apitherapy, aromatherapy, hypnotherapy and ozone therapy). For six integrative interventions (bioenergetics, family constellation, chromotherapy, geotherapy, flower therapy, and hand imposition), no CR was found. The certainty of evidence ranged from unknown to high. The high-certainty evidence was restricted to honey dressings for partial thickness burns, honey for acute cough in children, and venom immunotherapy for systematic reaction to an insect sting. The main characteristics of the included CRs are presented in Table 2.
Conclusions: our review suggests that almost the totality of the new interventions incorporated by Brazilian Ministry of Health in 2018 are not support by evidence from Cochrane Reviews. The lack of results reflects the uncertainty in the effects of the integrative interventions. Future randomized controlled trials and CRs are imperative to provide evidence for supporting healthcare decisions.
Patient or healthcare consumer involvement: evidence-based knowledge in clinical practice is essential for the adequate application of public policies. Patients should be offered health care supported by the best available evidence. Our results suggest a gap between evidence provided by Cochrane Reviews and the decision of the Brazilian Ministry of Health.
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