Atitudes de Estudantes de Medicina sobre Pr&aacute;ticas M&eacute;dicas Heterodoxas no Brasil <span class="so-article-trans-title" dir="auto"> Translated title: Attitudes of Brazilian Medical Students towards Complementary and Alternative Medicines </span>

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Abstract

Resumo: Realizou-se uma enquete com 51 estudantes de medicina presentes ao XXXV Congresso Brasileiro de Educação Médica com o objetivo de identificar as atitudes de estudantes interessados em ensino médico em relação a quatro práticas médicas heterodoxas (PMHs) mais usadas no Brasil. Foram investigados o grau de conhecimento, eficácia, interesse na aprendizagem, utilidade e recomendação para implantação nos currículos das escolas médicas e nos serviços públicos de saúde da acupuntura, fitoterapia, hipnose e homeopatia. Mais da metade dos estudantes manifestaram alto interesse em conhecer melhor as PMHs e consideram que elas deveriam ser ensinadas nas Escolas Médicas Brasileiras, de forma opcional (86%) ou obrigatória (9%). Embora mais de 80% dos entrevistados admitisse estar pouco ou nada informado sobre as PMHs, 60% entendem que elas são bastante ou extremamente eficazes. Para dois terços da amostra, a homeopatia, a fitoterapia e a acupuntura deveriam estar disponíveis na rede pública de saúde, cabendo aos médicos a responsabilidade pela prescrição ou uso das PMHs. Os estudantes de medicina interessados em educação médica admitem conhecer pouco, porém acreditam que as PMHs podem ser bastante eficazes, devem ser oferecidas rotineiramente na rede pública de saúde e querem ser mais bem treinados ou informados sobre elas durante o curso de graduação.

Translated abstract

Abstract: Heterodox or complementary medicines are prescribed by many Braziljan physicians but are not regularly taught m medical schools. We conducted a survey of 51 Brozilian medical students attending a national congress on medical education to determine their attitudes towards four complementary medicines prescribed by physicians in Brazil. Questions were asked of extent of knowledge, efficacy, interest in learning, usefulness, and recommendation for implementation in medical school curricula and public health services in relation to acupuncture, homeopathy, hypnosis and phytotherapy. More than half of the students showed laugh interest in learning complementary medicines and felf that courses should be taught in Brazilian medical schools, whether as optional (86%) or mandatory credits (9%). Although more than 80% of the sample admitted to having little or no information on complementary medicines, 60% claimed they were very or extremely effective. According to two-thirds of the sample, physicians should generally be responsible for prescribing complementary medicines and public health services should routinely offer them to benefit patients. Brazilian medical students interested in medical education are poorly informed about complementary medicines and believe they can be very effective and should be provided routinely in public health services. They also wish to be better trained or informed about them.

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Most cited references 26

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Trends in alternative medicine use in the United States, 1990-1997: results of a follow-up national survey.

D M Eisenberg, R B Davis, S L Ettner … (1998)

A prior national survey documented the high prevalence and costs of alternative medicine use in the United States in 1990. To document trends in alternative medicine use in the United States between 1990 and 1997. Nationally representative random household telephone surveys using comparable key questions were conducted in 1991 and 1997 measuring utilization in 1990 and 1997, respectively. A total of 1539 adults in 1991 and 2055 in 1997. Prevalence, estimated costs, and disclosure of alternative therapies to physicians. Use of at least 1 of 16 alternative therapies during the previous year increased from 33.8% in 1990 to 42.1% in 1997 (P < or = .001). The therapies increasing the most included herbal medicine, massage, megavitamins, self-help groups, folk remedies, energy healing, and homeopathy. The probability of users visiting an alternative medicine practitioner increased from 36.3% to 46.3% (P = .002). In both surveys alternative therapies were used most frequently for chronic conditions, including back problems, anxiety, depression, and headaches. There was no significant change in disclosure rates between the 2 survey years; 39.8% of alternative therapies were disclosed to physicians in 1990 vs 38.5% in 1997. The percentage of users paying entirely out-of-pocket for services provided by alternative medicine practitioners did not change significantly between 1990 (64.0%) and 1997 (58.3%) (P=.36). Extrapolations to the US population suggest a 47.3% increase in total visits to alternative medicine practitioners, from 427 million in 1990 to 629 million in 1997, thereby exceeding total visits to all US primary care physicians. An estimated 15 million adults in 1997 took prescription medications concurrently with herbal remedies and/or high-dose vitamins (18.4% of all prescription users). Estimated expenditures for alternative medicine professional services increased 45.2% between 1990 and 1997 and were conservatively estimated at $21.2 billion in 1997, with at least $12.2 billion paid out-of-pocket. This exceeds the 1997 out-of-pocket expenditures for all US hospitalizations. Total 1997 out-of-pocket expenditures relating to alternative therapies were conservatively estimated at $27.0 billion, which is comparable with the projected 1997 out-of-pocket expenditures for all US physician services. Alternative medicine use and expenditures increased substantially between 1990 and 1997, attributable primarily to an increase in the proportion of the population seeking alternative therapies, rather than increased visits per patient.

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Unconventional medicine in the United States. Prevalence, costs, and patterns of use.

D M Eisenberg, R C Kessler, C Foster … (1993)

Many people use unconventional therapies for health problems, but the extent of this use and the costs are not known. We conducted a national survey to determine the prevalence, costs, and patterns of use of unconventional therapies, such as acupuncture and chiropractic. We limited the therapies studied to 16 commonly used interventions neither taught widely in U.S. medical schools nor generally available in U.S. hospitals. We completed telephone interviews with 1539 adults (response rate, 67 percent) in a national sample of adults 18 years of age or older in 1990. We asked respondents to report any serious or bothersome medical conditions and details of their use of conventional medical services; we then inquired about their use of unconventional therapy. One in three respondents (34 percent) reported using at least one unconventional therapy in the past year, and a third of these saw providers for unconventional therapy. The latter group had made an average of 19 visits to such providers during the preceding year, with an average charge per visit of $27.60. The frequency of use of unconventional therapy varied somewhat among socio-demographic groups, with the highest use reported by nonblack persons from 25 to 49 years of age who had relatively more education and higher incomes. The majority used unconventional therapy for chronic, as opposed to life-threatening, medical conditions. Among those who used unconventional therapy for serious medical conditions, the vast majority (83 percent) also sought treatment for the same condition from a medical doctor; however, 72 percent of the respondents who used unconventional therapy did not inform their medical doctor that they had done so. Extrapolation to the U.S. population suggests that in 1990 Americans made an estimated 425 million visits to providers of unconventional therapy. This number exceeds the number of visits to all U.S. primary care physicians (388 million). Expenditures associated with use of unconventional therapy in 1990 amounted to approximately $13.7 billion, three quarters of which ($10.3 billion) was paid out of pocket. This figure is comparable to the $12.8 billion spent out of pocket annually for all hospitalizations in the United States. The frequency of use of unconventional therapy in the United States is far higher than previously reported. Medical doctors should ask about their patients' use of unconventional therapy whenever they obtain a medical history.

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Acupuncture

NIN Consensus Development Panel on Acupuncture (1998)

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Author and article information

Journal

Journal ID (publisher-id): rbem

Title: Revista Brasileira de Educação Médica

Abbreviated Title: Rev. bras. educ. med.

Publisher: Associação Brasileira de Educação Médica (Brasília, DF, Brazil )

ISSN (Print): 0100-5502

ISSN (Electronic): 1981-5271

Publication date (Print and electronic): May 2002

Volume: 26

Issue: 2

Pages: 99-104

Affiliations

[1] Minas Gerais orgnameUniversidade Federal de Uberlândia orgdiv1Departamento de Clínica Médica Brazil

[2] orgnameUFU Brazil

Article

Publisher ID: S0100-55022002000200099 Publisher ID: S0100-5502(02)02600200099

DOI: 10.1590/1981-5271v26.2-005

SO-VID: b61abdd3-1fbc-43d9-b466-afbd6e96c219

License:

This work is licensed under a Creative Commons Attribution 4.0 International License.

History

Date received : 27 July 2000

Date accepted : 30 April 2002

Page count

Figures: 0, Tables: 0, Equations: 0, References: 26, Pages: 6

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SciELO Brazil

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Atitudes de Estudantes de Medicina sobre Práticas Médicas Heterodoxas no Brasil Translated title: Attitudes of Brazilian Medical Students towards Complementary and Alternative Medicines

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