USE OF COMPLEMENTARY AND ALTERNATIVE MEDICINE IN GEORGIA.

In Georgia, like in most countries globally, people commonly resort to complementary and alternative medicine (CAM). However, not much is known about CAM practices there. The aim of the study was to document common practices of CAM in Georgia and related patient attitudes. We collected data from peoples who commonly use CAM at 20 service provision centers in Georgia using cluster sampling from 300 patients. We admininstered a cross-sectional survey and conducted descriptive statistical analyses. People in Georgia use CAM either for prevention to improve general health (33%) or to treat chronic conditions (36%), spending about 25 Euros per month out of pocket. Most (77%) get their knowledge about CAM from family or friends , less than half (44%) from books or media, and 11% from medical providers. A close person's advice or experience was the most common rationale given for CAM use (54%). In our sample, 17% either don't trust or are unsatisfied with conventional medicine, 29% found CAM treatment "very effective" and 61% "quite/partially" effective; only 5% not effective. Conventional treatment was stopped in half of the cases. 35% of respondents informed their physicians of their CAM use, while about half did not. Public mistrust towards conventional medicine, CAM user high satisfaction, relatively low cost of such services in Georgia - are the factors letting us to suggest that CAM use will further increase. Frequent self taking decisions made by patients to stop physician prescribed treatment, not informing physicians on CAM use, as well as other factors put patients health at risk. Further research and capacity building in practice, education and other related aspects are needed to establish evidence-based regulation and standards for CAM in Georgia that ensure informed decision making and patient safety.

COMPLEMENTARY AND ALTERNATIVE MEDICINE AND MEDICAL EDUCATION IN GEORGIA: STATE OF THE ART AND FURTHER PERSPECTIVES.

Aim - complementary and alternative medicine (CAM) is popular in Georgia, but providers' training not well understood or regulated. The aim of this mixed-methods study was to inform the process of implementing quality CAM curricula in Georgia and strategies for the inclusion of effective CAM curricula into medical education in Georgia. We analyzed existing medical curricula. We conducted a contextual analysis based of qualitative data collected from relevant medical education experts, qualified physicians, CAM practitioners and other stakeholders; and administered a quantitative MD students' survey to MD students. CAM components are currently not represented in medical curricula in Georgia. Physicians largely lack adequate knowledge of CAM and its practice. All stakeholders supported that it would be beneficial to develop CAM educatory courses, both to future practitioners (medical students, initially as an elective subject) and practicing physicians (through CME). We recommend development/integration of an elective subject and/or a curricular component as a first step of CAM integration into the medical curricula in Georgia for MD students and CME courses for physicians. Interdisciplinary and international collaborations may help achieve best outcome, and safe practice of CAM in Georgia, forming a base for physician - CAM practitioner collaborations for quality care for patients in Georgia.