Expanding Perspectives on Integrative Medicine: Promoting Global Health in the COVID-19 Era

Joon-Shik Shin

doi:10.56986/pim.2022.09.001

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Editorial Expanding Perspectives on Integrative Medicine: Promoting Global Health in the COVID-19 Era: Joon-Shik Shin^*; Perspectives on Integrative Medicine 2022;1(1):1-2.
DOI: https://doi.org/10.56986/pim.2022.09.001
Published online: September 30, 2022

Jaseng Hospital of Korean Medicine, Seoul, Republic of Korea

*Corresponding author: Joon-Shik Shin, Jaseng Hospital of Korean Medicine, Seoul, Republic of Korea

• Received: August 21, 2022 • Accepted: August 28, 2022

This is an open access article under the CC BY-NC license (http://creativecommons.org/licenses/by-nc/4.0/).

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In this era of coronavirus disease 19 (COVID-19) pandemic, the unprecedented exponential increase in demand for comprehensive medical care may not come as a surprise. Advances in conventional medicine such as the development of vaccines [1–3], and antiviral therapies [4–6] has made it possible to manage the COVID-19 global crisis. However, persistent symptoms following viral clearance known as post-COVID conditions [7], and the paucity of information about the management of these symptoms currently remain unsolved. Furthermore, as social distancing is lifted, and the isolation periods for COVID-19 positive patients are shortened, the previously shared responsibility of individuals supported by public health policy is gradually transforming into individuals’ self-management and a growing demand for unmet healthcare needs.

In conjunction with the spread of COVID-19, the number of cases of chronic diseases have risen. As a result of social isolation due to COVID-19 imposed restrictions and a sedentary lifestyle, mental health has been negatively impacted. The global population has experienced an increase in the number of chronic non-communicable diseases [8], and there has been a deterioration in patients’ existing conditions [9]. In addition, the impaired medical system which has resulted in lower numbers of individuals being screened for cancer, reduced geriatric care, and decreased surveillance for substance abuse has had a substantial impact on the management of chronic diseases [9–11]. This is particularly observed in patients with inadequate social determinants of health, who are unable to provide proper medical care for themselves. Furthermore, the outbreak of COVID-19 has presented medical experts with an unparalleled challenge of addressing both acute and chronic symptoms of COVID-19.

Perspectives on Integrative Medicine was established to address the aforementioned challenges, which necessitate collaboration between medical specialists to provide comprehensive patient care. From the role of complementary and alternative medicine (CAM) therapies in chronic disease management to recent findings on the mechanisms of such therapies, as well as the integration of Korean medicine and osteopathy into standard care, the first issue of this journal was designed to address the demands of the current challenges from the perspective of integrative medicine.

There are two reviews in this issue which discuss the potential of acupuncture as a non-pharmacological intervention for the management of chronic pain. The 1^st article by Birch and his colleagues [12] is a narrative review of clinical guidelines’ acupuncture recommendations for shoulder pain which revealed relatively weak, but increasing levels of evidence. Acupuncture was determined to be safe and may be cost-effective. The findings are suggestive of acupuncture’s potential for pain management and provision of comprehensive care.

Another narrative review by Jang and Park [13] summarizes the mechanisms of acupuncture on neuropathic pain, which frequently coexists with depression, anxiety, and cognitive impairment. While care for chronic pain is challenging due to its multimorbid nature, it is further complicated by consequences from long-term pharmacological interventions. Manual acupuncture and electroacupuncture are some of the non-pharmacological interventions garnering recognition for its effectiveness. The underlying mechanisms of acupuncture include involvement with the dopamine system in the brain, the glutamate system, inflammation, epigenetic modulation, and mitochondrial function.

The current status of Chuna (Tuina) and osteopathic manipulative treatment (OMT) as part of the conventional healthcare listed in the Korean national healthcare insurance system is summarized in the last review by a group of researchers from Korea, the United States of America (USA), and the United Kingdom (UK) [14], summarizing the past two international conferences on manual therapy. In the past, manual therapies such as those listed above were considered to target musculoskeletal disorders. The research presented at the two conferences suggested the potential applications of manual therapy for ophthalmologic conditions/diseases and facial paralysis.

Two original articles [15,16] in this issue reported the use of Korean medicine in the management of post-acute COVID-19 syndrome. In the 1^st article, Kim, Jerng, and Lee [15] conducted a cross-sectional survey of 1,430 patients with post-acute COVID-19 symptoms which had lasted at least four weeks. Although the reported symptoms varied, many patients reported ear, nose, and throat symptoms as well as fatigue, which prompted the majority of patients (85%) to seek medical care. Patients with post-acute COVID-19 conditions had poor quality of life, and following treatment, the highest satisfaction rate was related to Korean medicine which addressed treatment of their overall conditions.

The article by Kim and her colleagues [16] is a cross-sectional survey of 1,064 medical practitioners (Korean Medicine Doctors) with post-acute COVID-19 syndrome treatment experience. Data analysis revealed that fatigue was the most prevalent symptom addressed by KMDs. Herbal prescriptions were indicated as beneficial for postacute COVID-19 treatment, although not covered by the national health insurance system. The findings suggested that KM was applicable for conditions not sufficiently managed by standard care, and that it was necessary to reduce the burden of cost, overcome the lack of publicity, and improve insurance coverage.

Integrative medicine is a term increasingly used to describe comprehensive medical approaches using both conventional medicine and CAM. The term “integrative” indicates the consolidation of both approaches and encompasses preventative measures, treatments, and long-term follow-ups throughout the patient’s disease history, as well as the multimodal interventions available for disease management. However, the best practices for integrated care and the factors that determine the need for integration are yet to be identified. Communication of biomedical research on CAM and integrative medicine approaches is crucial to bridging the gap between scientific research and clinical practice in order to overcome this issue.

This journal promotes expansion of the perspectives on integrative medicine. Despite the recent emphasis on the use of integrative medicine, there are unsolved issues surrounding the identification of individuals requiring integrated treatments, the therapies that are suitable for integration, and the types of diseases requiring integrative medicine as treatment to give the patient comprehensive care. This journal welcomes discussion of pragmatic evidence on CAM therapies, the underlying mechanisms of CAM interventions, and recent advances in scientific methodologies for CAM research, as the first issue illustrates the ongoing effort toward integrative medicine as well as the underlying mechanisms. Active discussions on the aforementioned topics can assist medical practitioners, researchers, and policymakers in assessing the efficacy of such treatments, hence identifying the optimal approach to patient care, and promoting global health.

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Conflicts of Interest

The author have no conflicts of interest to declare.

References

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[14] Lee SMK, Han SB, Buser B, Hensel K, Kim B, Mayo W, et al. Expanding the Scope of Manual Medicine Through Research, Academic Exchange, and Healthcare Coverage: A Summary of Two International Conferences. Perspect Integr Med 2022;1(1):10−16.Article PDF
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[16] Kim D, Park SH, Sung WS, Kim EJ. Current Status of Korean Medicine Treatment for Post-acute COVID-19 Syndrome: A Survey of Korean Medicine Doctors. Perspect Integr Med 2022;1(1):34−44.Article PDF

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