Exploring the prospect of a complementary and integrative medicine database for use in the Australian primary care setting

BackgroundA minimum dataset (MDS) has the potential for many uses in the complementary and integrative medicine (CIM) setting. Methods such as comparative effectiveness (CER) are conducted in real-life clinical settings using data sourced from clinical records and patient reported outcomes (PROs), which is then collated into a MDS of high quality to provide information both immediately and over time. Other uses of a CIM-MDS include surveillance and monitoring CIM use.MethodStrategies for establishing a CIM-MDS in Australia were explored. The focus was data sources, especially the role of PROs. The findings drew on a body of research that included a case study of an IM primary care clinic; interviews with patients, practitioners, and staff from the clinic and a systematic literature review of patient questionnaires for use in the IM setting.ResultsAside from basic information, automated data extraction of clinical data from Australian CIM clinics is very limited. A small battery of patient (and possibly practitioner) questionnaires may the best way to begin obtaining data. Patient and practitioners may well seek benefits other than contributing to research from the exercise of data collection, such as accessing individual patient results to track outcomes and inform clinical care. The format of the questionnaires matters as well. Although electronic formats are acceptable to many patients, paper questionnaires are still preferable to some.DiscussionA bottom-up approach that involves all stakeholders and builds on other national and international initiatives is recommended for developing a CIM-MDS. The final choice of data for a CIM-MDS will be informed by its intended uses. The lack of any standardised nomenclature for CIM coding is an important obstacle to building a robust dataset; however, in establishing a CIM-MDS there is the opportunity to collect data that could help inform a CIM coding system.