Implementation Science in International Practice of Chinese Medicine and Traditional Medicine Volume 5 - Issue 2

Haoyue Li^1,2, Xiaolei Li² and Jing Zhao²*

¹Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing China

²International Cooperation Department, China Academy of Chinese Medical Sciences, Beijing China

Received: September 14, 2023   Published:September 22, 2023

*Corresponding author: Jing Zhao, Professor, Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China

DOI: 10.32474/OAJCAM.2023.05.000206

Abstract PDF

Traditional medicine(TM) is found in almost every country in the world and the demand for its services is increasing. Chinese medicine (CM) has been used to protect human’s health for thousands of years, and has been developed systematic medical theories and varieties of interventions [1-2], which makes it as one of the representatives of TM or Complementary & Alternative Medicine (CAM). For its varieties of interventions of preventing and treating diseases, as well as maintaining wellness, the application of CM/ TM makes it possible to provide more medical services to more people worldwide [3]. Implementation science (IS) research combines comprehensive and scientific study of methods to promote the systematic uptake of research findings and effective evidence-based practices into routine practice, aims to improve the adoption and dissemination of specific proven clinical interventions, drugs, or policies and hence to give more high-quality and effective health services [4-5]. It focuses on the roles of practitioners, policy makers, institutions, etc. in the implementation of health interventions, concerns more about how a health intervention can be executed, and why does it effective or noneffective [6]. Thus, IS research may provide scientific methods for spreading CM and TM, which might help evaluate and analyze the implementation effects and status of CM/TM, impact factors of the implementation of an intervention, and then develop the practical strategy to spread and adjust different the implementation period.

Keywords: Chinese Medicine; Traditional Medicine; Implementation Science; International Practice

To improve the spread and use of TM, the 72nd World Health Assembly reviewed and adopted the Eleventh Revision of the International Classification of Diseases (ICD-11), which for the first time included a chapter on TM and shows more TM interventions could be applied for more health conditions and people in the world [7]. Meanwhile, more global public health disaster like COVID-19, Spain influenza and malaria need implementation of different medicines, among which CM contribute Artemisinin for control of malaria, and there are more researches evidences for influenza and COVID-19 pandemic [8,9]. However, the international application of CM/TM still faces series of challenges. Firstly, the application of CM/ TM is restricted by different kinds of health policies or regulations, as well as insurance systems in different countries and regions. Although many members States of World Health Organization (WHO) have established or developed national or regional policies to promote the safe and effective use of TM [10], CM/TM still couldn’t be used in routine practice and is excluded in the health systems. Secondly, for most of the practitioners of conventional medicine with different culture and medical background, the acceptance of CM/TM even with evidences still needs more time. How to remove the medical bias with more implementation strategy to improve understanding of CM/TM and choose the suitable intervention for patients is another challenge. Thirdly, although the spread of CM/ TM is motivated by the public in some countries, there are still difficulties for people to accept different TM like CM. Therefore, improving the acceptance of people with different social, cultural and customs is also another challenge for CM/TM practice.

The internationalization of CM/TM practice is closely related to medical, social and economic issues, and IS could combine different disciplines to solve a complex problem. There have been many successful cases that proved the effectiveness of IS, and more and more researchers started to use IS methods in solving clinical practice related problems, including reducing medical fees [11], disseminating novel interventions [12], translating knowledge into practice [13], designing experimental studies [14], etc. So it may provide more effective methods in solving the challenges of the internationalization of CM/TM practice. Firstly, IS research theories and frameworks can be used to complete the background investigation, fidelity assessment, impact evaluation of CM/TM practice, which can help to in fully understand the benefits of stakeholders from different sides according to different social and cultural condition, as well as health systems, hence to improve the acceptance to CM/TM [15-17]. Secondly, combining IS research frameworks and models to find feasible and sustainable approaches of CM/TM under different health system and develop a pilot strategy to spread. By fully considering the complex medical system and implementation background of each country, IS can help in finding a suitable CM/TM interventions for practice and promotion [18]. Thirdly, the diseases with high prevalence in different countries should be investigated, especially those with evidence, CM/TM clinical practice guidelines or experts’ consensus, which will increase the acceptance among medical staff and public. Besides, it calls for proper collaboration with local social workers, public managers, medical specialists, and other health related staff, to work together to find an effective way for better spread of CM/ TM.

After years of development, CM/TM has been accepted and used by more and more countries around the world, and the demand for its services is increasing. For effective delivery of services, and developing appropriate regulations and policies to ensure the safe use of CM/TM, IS and other scientific methods are needed to develop international implementation strategy.

1. CACMS Innovation Fund of Institute of Basic Research in Clinical medicine Innovation Team Project (No. CI2021B003)

2. CACMS Innovation Fund (No. CI2021A00704-4)

1. Luo H, Tang QL, Shang YX, Liang SB, Yang M, et al. (2020) Can Chinese Medicine Be Used for Prevention of Corona Virus Disease 2019 (COVID-19)? A Review of Historical Classics, Research Evidence and Current Prevention Programs. Chin J Integr Med 26(4): 243-250.
2. Joseph N, Lu G (1962) Hygiene and preventive medicine in ancient China. J History Med All Sci 17: 429-478.
3. Wu XQ, Zhang WN, Hao MZ, Liu XP, Xiao J, et al. (2021) How Chinese Herbal Medicine Prevents Epidemics: From Ancient Pestilences to COVID-19 Pandemic. Am J Chin Med 49(5): 1017-1044.
4. Eccles MP, Mittman BS (2006) Welcome to Implementation Science. Implement Sci 22(1): 1.
5. Neuman HB, Kaji AH, Haut ER. (2020) Practical Guide to Implementation Science. JAMA Surg 155(5): 434-435.
6. Waltz TJ, Powell BJ, Fernández ME, Abadie B, Damschroder LJ (2019) Choosing implementation strategies to address contextual barriers: diversity in recommendations and future directions. Implement Sci 14(1): 42.
7. (2023) World Health Organization[Internet]. Geneva: the Organization.
8. (2023) Nobel Prize Outreach AB 2023[Internet]. Stockholm: the Organization.
9. (2023) World Health Organization[Internet]. Geneva: the Organization.
10. (2023) World Health Organization[Internet]. Geneva: the Organization.
11. Malhotra A, Thompson RR, Kagoya F, Masiye F, Mbewe P, et al. (2022) Economic evaluation of implementation science outcomes in low- and middle-income countries: a scoping review. Implement Sci. 17(1): 76.
12. Gilmartin HM, Hessels AJ (2019) Dissemination and implementation science for infection prevention: A primer. Am J Infect Control 47(6): 688-692.
13. Pachana NA (2020) Implementation science in psychogeriatrics. Int Psychogeriatr 32(12): 1383-1385.
14. Miller CJ, Smith SN, Pugatch M (2020) Experimental and quasi-experimental designs in implementation research. Psychiatry Res 283: 112452.
15. Nilsen P, Bernhardsson S (2019) Context matters in implementation science: a scoping review of determinant frameworks that describe contextual determinants for implementation outcomes. BMC Health Serv Res19(1): 189.
16. Birken SA, Ko LK, Wangen M, Wagi CR, Bender M, et al. (2022) Increasing Access to Organization Theories for Implementation Science. Front Health Serv 2: 891507.
17. Damschroder LJ, Reardon CM, Opra Widerquist MA, Lowery J (2022) Conceptualizing outcomes for use with the Consolidated Framework for Implementation Research (CFIR): the CFIR Outcomes Addendum. Implement Sci 17(1): 7.
18. Wensing M, Grol R (2019) Knowledge translation in health: how implementation science could contribute more. BMC Med 17(1): 88.