A U.S. Pharmacopeia (USP) overview of Pan American botanicals used in dietary supplements and herbal medicines.

The United States Pharmacopeial Convention (USP) is a nonprofit, scientific, standard-setting organization, and world leader in establishing quality, purity, and testing standards for medicines, foods, and dietary supplements. USP quality standards are used in more than 140 countries and are legally recognized by more than 40 countries. Currently, there is renewed interest in herbal medicines globally, and health policies are being implemented worldwide for the use of complementary and traditional medicine. In response, USP has developed a robust body of monographs that can be used to guide industry and regulators in ensuring the quality and safety of botanical ingredients used in dietary supplements and herbal medicines. Throughout the Pan American regions, there is a strong tradition of using botanicals as herbal medicines and, as in other regions, a growing desire for botanical dietary supplements. This underscores the need for public quality standards to ensure quality, reduce the flow of substandard and adulterated products, and ensure public health and safety. In April 2022, USP launched the Pan America Botanical Dietary Supplements and Herbal Medicines Expert Panel, with experts representing 12 different countries. The Expert Panel's work focuses on developing quality control standards for the most important botanical ingredients used in the respective countries, ingredients that are also of global importance. This article provides an overview of the state of botanical dietary supplements and herbal medicines in different Pan American regions with a focus on the regulatory status of herbal products, the development of national quality and research initiatives, and policies related to agriculture conservation and sustainability, among other topics.

Innovative Statistical Model Uncover Effective Herbal Medicines Among Personalized Treatment Plans in Persian Medicine: A Small-Scale Study in Type 2 Diabetes.

Objectives: In holistic medicine, developing personalized treatment plans is challenging due to the multitude of possible therapy combinations. This study introduces the use of a statistical approach to identify the most effective herbal medicines prescribed in Persian medicine (PM) in a small-scale sample of patients with type 2 diabetes mellitus (T2DM). Methods: This prospective observational cohort study was conducted with 47 patients with T2DM referred to Behesht Clinic in Tehran, Iran. A physician prescribed individualized PM treatment for T2DM and related systemic issues. The fasting blood sugar (FBS) level of each patient was recorded at initial and two follow-up visits, with visit intervals and treatment modifications determined by patient health status. Patients who completed two follow-up visits were included in the final analysis (n = 27). Data were analyzed using R software. A general linear model was assumed for the mean response, along with an exponential covariance pattern model, to manage irregularly timed measurements. Results: Two fitted models showed that, after adjusting for confounders, the use of the "Diabetes Capsule" significantly reduced the average FBS by 17.14 mmol/L (p = 0.046). For each unit increase in the consumption of "Diabetes Capsule" or "Hab-e-Amber Momiai," the average FBS decreased by 15.22 mmol/L (p = 0.015) and 14.14 mmol/L (p = 0.047), respectively. Conclusion: It is possible to observe which medications are most effective, even when treatments are applied in a holistic and personalized fashion. Preliminary studies such as these may identify promising products for testing in clinical trials conducted under standardized conditions, to inform initial choices for future personalized treatments.

A review of the WHO strategy on traditional, complementary, and integrative medicine from the perspective of academic consortia for integrative medicine and health.

Despite important progress in modern medicine, widely regarded as an indispensable foundation of healthcare in all highly advanced nations and regions, not all patients respond well to available treatments in biomedicine alone. Additionally, there are concerns about side effects of many medications and interventions, the unsustainable cost of healthcare and the low resolution of chronic non-communicable diseases and mental disorders whose incidence has risen in the last decades. Besides, the chronic stress and burnout of many healthcare professionals impairs the therapeutic relationship. These circumstances call for a change in the current paradigm and practices of biomedicine healthcare. Most of the world population (80%) uses some form of traditional, complementary, and integrative medicine (T&CM), usually alongside biomedicine. Patients seem equally satisfied with biomedicine and T&CM, but in the field of T&CM there are also many challenges, such as unsupported claims for safety and/or efficacy, contamination of herbal medicines and problems with regulation and quality standards. As biomedicine and T&CM seem to have different strengths and weaknesses, integration of both approaches may be beneficial. Indeed, WHO has repeatedly called upon member states to work on the integration of T&CM into healthcare systems. Integrative medicine (IM) is an approach that offers a paradigm for doing so. It combines the best of both worlds (biomedicine and T&CM), based on evidence for efficacy and safety, adopting a holistic personalized approach, focused on health. In the last decades academic health centers are increasingly supportive of IM, as evidenced by the foundation of national academic consortia for integrative medicine in Brazil (2017), the Netherlands (2018), and Germany (2024) besides the pioneering American consortium (1998). However, the integration process is slow and sometimes met with criticism and even hostility. The WHO T&CM strategies (2002-2005 and 2014-2023) have provided incipient guidance on the integration process, but several challenges are yet to be addressed. This policy review proposes several possible solutions, including the establishment of a global matrix of academic consortia for IM, to update and extend the WHO T&CM strategy, that is currently under review.

Assessing the safety and use of medicinal herbs during pregnancy: a cross-sectional study in São Paulo, Brazil.

Background: Despite the lack of evidence supporting the safety and clinical efficacy of herbal medicine (HM), its use among pregnant women continues to increase. Given the high prevalence of contraindicated herbs among the pregnant population in Brazil, it is crucial to examine the use of HM and evaluate its safety based on the current scientific literature to ensure that women are using HM appropriately. Methods: A cross-sectional study was conducted from October 2022 to January 2023 at a public teaching hospital in São Paulo, Brazil. A total of 333 postpartum women in the postnatal wards and postnatal clinic were interviewed using a semi-structured questionnaire. The survey instrument consisted of 51 items covering the use of HM during pregnancy, sociodemographic and health-related characteristics, COVID-19 experiences, and pregnancy outcomes. For data analysis, chi-square and multivariate logistic regression were conducted using SPSS ver. 26.0. Results: Approximately 20% of respondents reported using HM during their most recent pregnancy, with a higher use observed among women from ethnic minority groups and those with prior HM experience. Among the 20 medicinal herbs identified, 40% were found to be contraindicated or recommended for use with caution during pregnancy. However, only half of the women discussed their HM use with obstetric care providers. Conclusion: This study emphasizes the continued public health concern regarding the use of contraindicated or potentially harmful HM among pregnant women in Brazil, highlighting the need for sustained efforts to reduce the risk of inappropriate HM use. By updating antenatal care guidelines based on the latest scientific evidence, healthcare providers can make informed clinical decisions and effectively monitor pregnant women's HM use, ultimately promoting safer and more effective healthcare practices.

Mapa de evidências efetividade clínica das Medicinas Tradicionais, Complementares e Integrativas para Câncer do Útero: informe executivo / Map of evidence clinical effectiveness of Traditional, Complementary and Integrative Medicines for Uterine Cancer: executive report

O mapa apresenta uma visão geral das evidências sobre os efeitos clínicos das terapias complementares e integrativas para o câncer do útero e do colo do útero. A partir da caracterização de centenas de estudos na série de mapas de evidências das Medicinas Tradicionais, Complementares e Integrativas (MTCI/PICS), foram selecionados e incluídos 26 estudos de revisão (18 revisões sistemáticas, 7 revisões sistemáticas e metanálises, e 1 metanálise). As revisões avaliaram o efeito de 28 tipos de intervenções distribuídos em 3 grupos ­ Fitoterapia e Plantas Medicinais; Terapias não-Farmacológicas; Suplementos / Produtos Naturais ­ e associadas a 33 desfechos de saúde distribuídos em 5 grupos: Curso da doença; Sintomas relacionados ao Câncer; Indicadores Metabólicos e Fisiológicos; Bem-Estar, Vitalidade e Qualidade de Vida; Saúde Mental.

Mapa de evidências sobre a efetividade clínica da medicina antroposófica: informe executivo / Evidence map on the clinical effectiveness of anthroposophic medicine: executive report

O mapa apresenta uma visão geral das evidências sobre os efeitos da Medicina Antroposófica, referida na PNPIC como Antroposofia Aplicada à Saúde, em função de sua natureza multiprofissional. A partir de uma ampla busca bibliográfica foram incluídos no mapa 33 estudos de revisão que analisaram o efeito de intervenções com medicamentos antroposóficos, terapias antroposóficas e terapias multimodais para desfechos clínicos. No mapa estão representadas 63 associações entre 5 tipos de intervenções e 19 desfechos clínicos, com indicação do efeito reportado e nível de confiança da evidência reportada nos estudos. Principais Achados: • As intervenções foram organizadas em três grupos: Medicamentos Antroposóficos (Viscum album ­ 22 revisões e Outros medicamentos ­ 4 revisões), Terapias Antroposóficas (Euritmia ­ 2 revisões e Outras terapias ­ 1 revisão) e Terapias Multimodais (Em Geral ­ 4 revisões). • As intervenções foram associadas a 19 desfechos ordenados em cinco grupos: Bem-estar e Qualidade de Vida, Câncer, Atenção à Saúde, Indicadores Fisiológicos e Metabólicos e Outras Condições Patológicas. • A maioria das associações foi para o grupo de desfecho Câncer, seguido pelo grupo Bem-estar e Qualidade de Vida. Dentre os desfechos, destaque para: Qualidade de Vida (12 revisões), Sobrevida (9 revisões), Segurança do Paciente (8 revisões) e Sintomas de Quimioterapia e Radioterapia (7 revisões). • Dentre as intervenções, a maioria das associações foi para Viscum album (48 associações). • As intervenções multimodais, outros medicamentos, Euritmia e outras terapias foram associadas aos desfechos: Resultado do tratamento (5 associações), Satisfação e Segurança do paciente (2 associações cada), Infecções respiratórias (3 associações), Coordenação cardiorrespiratória, Transtornos gastrointestinais e Edema (1 associação cada). Implicações para a prática e pesquisa: • Considerando os efeitos positivos reportados (em 27 associações), destaque para o uso de medicamento antroposófico Viscum album (19 associações) para os desfechos Qualidade de Vida, Segurança do Paciente e Sintomas de Quimioterapia e Radioterapia. • Quanto aos efeitos potencialmente positivos (em 21 associações), a maioria foi associado ao Viscum album (18 associações) para os desfechos: Sobrevida ao câncer, Sintomas de Quimioterapia e Radioterapia e Qualidade de Vida. • Identificaram-se efeitos inconclusivos em 15 associações para 11 diferentes desfechos, o que sugere uma necessidade de novos estudos primários sobre intervenções com medicamentos e terapias antroposóficas. • Não foram identificados estudos com ausência de efeito ou efeitos negativos.

Evidence map on the clinical effectiveness of anthroposophic medicine: executive report

The map provides an overview of the evidence on the effects of Anthroposophic Medicine, referred to in the National Policy on Integrative and Complementary Practices (PNPIC) as applied Anthroposophy in Health, due to its multiprofessional nature. Based on an extensive literature search, the map includes 33 review studies that analyzed the effects of interventions with anthroposophic medicines, anthroposophic therapies, and multimodal therapies on clinical outcomes. The map represents 63 associations between 5 types of interventions and 19 clinical outcomes, indicating the reported effect and level of confidence in the evidence reported in the studies. Key Findings: • The interventions were organized into three groups: Anthroposophic Medicines (Viscum album - 22 reviews and Other medicines - 4 reviews), Anthroposophic Therapies (Eurythmy - 2 reviews and Other therapies - 1 review), and Multimodal Therapies (Overall - 4 reviews). • The interventions were associated with 19 outcomes grouped into five categories: Well-being and Quality of Life, Cancer, Healthcare, Physiological and Metabolic Indicators, and other Pathological Conditions. • The majority of associations were found in the Cancer outcome group, followed by the Well-being and Quality of Life group. Notable outcomes included Quality of Life (12 reviews), Survival (9 reviews), Patient Safety (8 reviews), and Chemotherapy and Radiotherapy Symptoms (7 reviews). • Among the interventions, the majority of associations were related to Viscum album (48 associations). • Multimodal interventions, other medicines, eurythmy, and other therapies were associated with outcomes such as Treatment Outcome (5 associations), Patient Satisfaction and Safety (2 associations each), Respiratory Infections (3 associations), Cardiorespiratory Coordination, Gastrointestinal Disorders, and Edema (1 association each). Implications for Practice and Research: • Considering the reported positive effects (in 27 associations), the use of anthroposophic medicines Viscum album (19 associations) stands out for Quality of Life, Patient Safety, and Chemotherapy and Radiotherapy Symptoms outcomes. • Regarding potentially positive effects (in 21 associations), the majority were associated with Viscum album (18 associations) for Cancer Survival, Chemotherapy and Radiotherapy Symptoms, and Quality of Life outcomes. • Inconclusive effects were identified in 15 associations for 11 different outcomes, suggesting a need for further primary studies on interventions with anthroposophic medicines and therapies. • No studies were identified with no effect or negative effects.

Mapa de evidências efetividade clínica das Medicinas Tradicionais, Complementares e Integrativas para Doenças Cardiovasculares: informe executivo / Map of evidence clinical effectiveness of Traditional, Complementary and Integrative Medicines for Cardiovascular Diseases: executive report

O mapa apresenta uma visão geral das evidências sobre os efeitos das Práticas Complementares e Integrativas de Saúde (PICS) para Doenças Cardiovasculares. A partir da caracterização de centenas de estudos na série de mapas de evidências das Medicinas Tradicionais, Complementares e Integrativas (MTCI/PICS), foram selecionados e incluídos 208 estudos de revisão. No total foram 424 associações entre intervenções do grupo Plantas Medicinais (149 associações), Práticas Corporais Chinesas (93 associações), Yoga (79 associações), Acupuntura e Auriculoterapia (27 associações) e Outras Terapias (76 associações).

Mapa de evidências sobre a efetividade clínica da ventosaterapia: informe executivo / Evidence map on the clinical effectiveness of cupping therapy: executive report

O mapa apresenta uma visão geral das evidências sobre os efeitos da Ventosaterapia. A partir de uma ampla busca bibliográfica foram incluídos no mapa 25 estudos de revisão. Todos os estudos foram avaliados, caracterizados e categorizados por um grupo de pesquisadores da área de acupuntura e Medicina Tradicional Chinesa. Principais Achados: • As revisões avaliaram o efeito da ventosaterapia em 4 tipos: apenas ventosa, Ventosa multimodal com MTC, Ventosa multimodal com MTC e não-MTC e Ventosa multimodal com não-MTC. • As intervenções foram associadas a 19 desfechos de saúde distribuídos em 5 grupos: Bem-Estar, Vitalidade e Qualidade de Vida, Dor, Doenças Crônicas Não Transmissíveis, Doenças Infectocontagiosas e Doenças Não Transmissíveis. • No total foram 40 associações entre intervenção e desfecho, sendo a maior parte (22) com Ventosa multimodal com MTC e não-MTC e para desfechos do grupo Dor (20). • O grupo dos desfechos Dor recebeu a maioria das associações (20), seguido do grupo Doenças Crônicas Não Transmissíveis (10). Dentre os desfechos, destaque para dor cervical (6), dor lombar (4), alívio da dor (4), dor muscular (3) e herpes zoster (3). Os outros 15 desfechos foram associados 2 ou 1 vez. Implicações para a prática e pesquisa: • Os efeitos positivos de 14 associações foram reportados principalmente para os desfechos: dor cervical (3), dor lombar (3), acne vulgar (2) e herpes zoster (2). • Os efeitos potencialmente positivos foram reportados para 20 associações principalmente para os desfechos: dor cervical (3), alívio da dor (2), Hipertensão Arterial (2), Osteoartrite (2) e Capacidade Funcional (2). • Foram reportados efeitos inconclusivos/misturados para 6 associações, sendo 2 para o desfecho dor muscular e 1 associação para outros 4 desfechos (acne vulgar, acidente vascular cerebral, alívio da dor e mobilidade). • Efeitos negativos não foram reportados.

Mapa de evidências efetividade clínica das Medicinas Tradicionais, Complementares e Integrativas para Dor Crônica: informe executivo / Map of evidence clinical effectiveness of Traditional, Complementary and Integrative Medicines for Chronic Pain: executive report

O mapa apresenta uma visão geral das evidências sobre os efeitos das Práticas Complementares e Integrativas de Saúde (PICS) para Dor. A partir da caracterização de centenas de estudos na série de mapas de evidências das Medicinas Tradicionais, Complementares e Integrativas (MTCI/PICS), foram selecionados e incluídos neste mapa de evidências 142 estudos de revisão (61 revisões sistemáticas com metanálises, 13 revisões sistemáticas de estudos controlados randomizados, 54 revisões sistemáticas e 14 metanálises). Com base na ferramenta AMSTAR2, foi avaliado o nível de confiança para a evidência reportada nestes estudos, resultando em 14 revisões de nível alto, 8 revisões de nível moderado, 62 revisões de nível baixo e 58 revisões de nível criticamente baixo.

Mapa de evidências sobre a efetividade clínica das plantas medicinais brasileiras: informe executivo / Evidence Map on the clinical effectiveness of Brazilian medicinal plants: executive report

O mapa apresenta uma visão geral das evidências sobre os efeitos das Plantas Medicinais Brasileiras para desfechos em saúde. A partir de uma ampla busca bibliográfica foram incluídos no mapa 214 estudos de revisão sistemática. Todos os estudos foram avaliados, caracterizados e categorizados por um grupo de pesquisadores de Laboratório de Tecnologia de Produtos Naturais (LTPN) da Faculdade de Farmácia da Universidade Federal Fluminense. Principais Achados: ● As revisões avaliaram o efeito de intervenções com 69 tipos de plantas organizadas em 4 categorias: cultivadas, nativas, exóticas e introduzidas no Brasil. ● As intervenções foram associadas a 130 desfechos de saúde organizados em 17 grupos: Bem-Estar, Vitalidade e Qualidade de Vida, Câncer, Condições Patológicas, Dermatopatias, Doenças Cardiovasculares, Doenças Nutricionais e Metabólicas, Doenças Respiratórias, Doenças Reumáticas, Doenças Urogenitais, Dor, Fatores Biológicos, Gastroenteropatias e Hepatopatias, Indicadores Psicológicos e Comportamentais, Indicadores Metabólicos e Fisiológicos, Saúde Mental, Saúde Bucal e Saúde Reprodutiva. ● No total foram 465 associações entre intervenções (as plantas) e desfechos de saúde, com destaque para as plantas cultivadas (251 associações, 54%). ● O grupo dos desfechos "Saúde Mental" foi o que recebeu mais associações (66 associações, 14%), seguido do grupo "Saúde Bucal" (42 associações, 9%). ● Quanto aos desfechos, destaque para: Transtornos de Ansiedade (20 associações), Demência (16 associações), Diabetes Mellitus (17 associações) e Distúrbios Menstruais (15 associações). ● Dentre as plantas, destaque para: Ginkgo biloba (76 associações), Aloe Vera (50), Zingiber officinale (39), Panax ginseng (28) e Curcuma longa (23). Implicações para a prática e pesquisa: ● Considerando o efeito das intervenções para os desfechos, os estudos reportaram efeito positivo ou potencialmente positivo para a maioria (68%) das associações (181 associações com efeito positivo e 137 com efeito potencialmente positivo). ● Destaque para os efeitos positivos ou potencialmente positivos reportados nas intervenções com Ginkgo biloba para os desfechos: Demência, Doença de Alzheimer e Desempenho Cognitivo (8, 7 e 7 associações respectivamente). ● Em 87 associações foi reportado "sem efeito" da intervenção para o desfecho (19,7%). ● Foi reportado efeito inconclusivo para uma pequena parte das associações (9%), que merece mais pesquisas. Nenhum efeito negativo ou potencialmente negativo foi reportado. O efeito não foi informado para 19 associações. ● Note-se que essa lista é dinâmica, podendo mudar com a publicações de novos estudos.

The map provides an overview of the evidence on the effects of Brazilian Medicinal Plants on health outcomes. Based on an extensive literature search, the map includes 214 systematic review studies. All studies were assessed, characterized, and categorized by a group of researchers from the Laboratory of Natural Product Technology (LTPN) at the Faculty of Pharmacy of the Federal Fluminense University. Key Findings: - The reviews evaluated the effects of interventions using 69 types of plants organized into 4 categories: cultivated, native, exotic, and introduced to Brazil. - The interventions were associated with 130 health outcomes organized into 17 groups: Well-being, Vitality and Quality of Life, Cancer, Pathological Conditions, Dermatopathies, Cardiovascular Diseases, Nutritional and Metabolic Diseases, Respiratory Diseases, Rheumatic Diseases, Urogenital Diseases, Pain, Biological Factors, Gastroenteropathies and Hepatopathies, Psychological and Behavioral Indicators, Metabolic and Physiological Indicators, Mental Health, Oral Health, and Reproductive Health. - In total, there were 465 associations between interventions (plants) and health outcomes, with a significant emphasis on cultivated plants (251 associations, 54%). - The "Mental Health" group received the most associations (66 associations, 14%), followed by the "Oral Health" group (42 associations, 9%). - Notable health outcomes included Anxiety Disorders (20 associations), Dementia (16 associations), Diabetes Mellitus (17 associations), and Menstrual Disorders (15 associations). - Among the plants, notable ones included Ginkgo biloba (76 associations), Aloe Vera (50), Zingiber officinale (39), Panax ginseng (28), and Curcuma longa (23). Implications for Practice and Research: - Considering the effects of interventions on health outcomes, the studies reported a positive or potentially positive effect for the majority (68%) of the associations (181 associations with a positive effect and 137 with a potentially positive effect); - Noteworthy are the positive or potentially positive effects reported for interventions with Ginkgo biloba on the outcomes of Dementia, Alzheimer's Disease, and Cognitive Performance (8, 7, and 7 associations, respectively); - In 87 associations, the intervention was reported to have "no effect" on the outcome (19.7%); - An inconclusive effect was reported for a small portion of the associations (9%), indicating a need for further research. No negative or potentially negative effects were reported. The effect was not reported for 19 associations; - It should be noted that this list is dynamic and may change with the publication of new studies.

Cancer-Related Fatigue Outcome Measures in Integrative Oncology: Evidence for Practice and Research Recommendations.

Cancer-related fatigue (CRF) is one of the most common symptoms across the cancer continuum and is often underreported and undertreated. Defined as a distressing, persistent, subjective sense of tiredness or exhaustion related to cancer or its treatment, CRF includes physical, emotional, cognitive, and spiritual dimensions. Patient-reported outcome (PRO) measures are the most widely used tool to screen for and assess fatigue and the associated negative impacts on quality of life. However, selecting subjective CRF measures can be complex. This has resulted in the availability of and inconsistent use of numerous PROs, limiting the ability to cross-compare outcomes clinically and within research. To address this, the PROs that are most widely reported in the literature are recommended to support the standardization of a core set of validated measures. The National Comprehensive Cancer Network single-item tool for clinical significance is recommended for quick use in clinical environments; the Brief Fatigue Inventory allows for fast, easy, helpful cutoffs on severity threshold for triage, and measures both severity and interference with daily functioning; while the MD Anderson Symptom Inventory allows for multisymptomatic assessment. In addition, a fundamental consideration for any PRO use is the administrative burden on the patient and clinician. In this review, we aim to summarize current, validated PROs specific to CRF to aid clinicians and researchers in patient care and in study design and implementation. We conclude with suggestions for future directions in CRF research that can increase the possibility for long-term impact on future guidelines of fatigue management.

Integrative oncology: Addressing the global challenges of cancer prevention and treatment.

The increase in cancer incidence and mortality is challenging current cancer care delivery globally, disproportionally affecting low- and middle-income countries (LMICs) when it comes to receiving evidence-based cancer prevention, treatment, and palliative and survivorship care. Patients in LMICs often rely on traditional, complementary, and integrative medicine (TCIM) that is more familiar, less costly, and widely available. However, spheres of influence and tensions between conventional medicine and TCIM can further disrupt efforts in evidence-based cancer care. Integrative oncology provides a framework to research and integrate safe, effective TCIM alongside conventional cancer treatment and can help bridge health care gaps in delivering evidence-informed, patient-centered care. This growing field uses lifestyle modifications, mind and body therapies (eg, acupuncture, massage, meditation, and yoga), and natural products to improve symptom management and quality of life among patients with cancer. On the basis of this review of the global challenges of cancer control and the current status of integrative oncology, the authors recommend: 1) educating and integrating TCIM providers into the cancer control workforce to promote risk reduction and culturally salient healthy life styles; 2) developing and testing TCIM interventions to address cancer symptoms or treatment-related adverse effects (eg, pain, insomnia, fatigue); and 3) disseminating and implementing evidence-based TCIM interventions as part of comprehensive palliative and survivorship care so patients from all cultures can live with or beyond cancer with respect, dignity, and vitality. With conventional medicine and TCIM united under a cohesive framework, integrative oncology may provide citizens of the world with access to safe, effective, evidence-informed, and culturally sensitive cancer care.

Meditation: Evidence Map of Systematic Reviews.

Study Basis: This evidence map presents a summary of studies that addressed the effects of meditation on various clinical and health conditions. Meditation is a contemplative practice that has been used for the promotion of health, and the treatment of different conditions. Method: The study is based on the search of four electronic databases for the period 1994-November 2019 and includes systematic reviews, meta-analyses, meta-syntheses, and integrative reviews. 3iE evidence gap map was the methodology of choice, and AMSTAR 2 was used for the analyses. Tableau was used to graphically display the confidence level, number of reviews, health outcomes, and intervention effects. Results: This map encompasses 191 studies, with Mindfulness being the key word that retrieved the highest number of results. Several meditation techniques were evaluated in different contexts, and the confidence levels of 22 studies were high, 84 were moderate, and 82 were low. Two 2 meta-syntheses and 1 integrative review were also included. Most of the studies reported positive effects and a beneficial potential of the practice of meditation. Health outcomes were divided into five groups out of which mental health and vitality, and well-being and quality of life stood out with the largest number of studies. Conclusions: Meditation has been applied in different areas. This Evidence Map intends to be an easy visual tool to access valuable evidence-based information on this complementary therapy for patients, health professionals, and managers.