Integrative care and bridge building among health care providers in Norway and Denmark.
BACKGROUND
Patients in Norway and Demmark with the medical diagnoses of cancer, multiple sclerosis (MS), and HIV/AIDS use complementary and alternative treatment (CAT) in growing numbers, most often in addition to receiving conventional treatment. At the same time, the interest and demand from patients for more holistic-oriented care is strongly increasing. Following this, there is a desire and need for better communication and cooperation among the conventional medical establishment, CAT practitioners, and patients. This development raises new demands on research designs to incorporate complexity and diversity concerning the intervention, effect mechanisms, and outcomes.


CONCLUSIONS
This article outlines different models used to combine conventional, complementary, and alternative treatment (CCAT), describing various degrees of integration among therapies. The authors are closely involved in three current and planned research projects in Norway and Denmark focusing on cancer, MS, and HIV/AIDS. These research projects are briefly introduced as examples of bridge-building efforts dealing with integrative care. Despite explicit political good will in Norway and Denmark, initiatives to enhance integration face challenges connected to lack of knowledge; resistance toward CCAT; lack of time, space, and economic resources; and patients left without any claim on insurance in the case of treatment failure. These challenges are outlined based on the researchers' experience from being involved in the research projects.


CONCLUSIONS
To optimize treatment outcomes in the future, it is argued that the need for closer cooperation among conventional and alternative therapists across professional boundaries in an interactive partnership with patients is evident. Researchers have to rethink research design and methods in meeting the new trend toward bridge building based on integrative health care.
Gamst
Are
A
National Research Center on Complementary and Alternative Medicine (NAFKAM), University of Tromsø, Tromsø, Norway.
Haahr
Niels
N
Kristoffersen
Agnete Egilsdatter
AE
Launsø
Laila
L
D000529:Complementary Therapies / Q000458:organization & administration*; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D003718:Denmark; D005160:Facility Design and Construction; D015658:HIV Infections / Q000628:therapy; D006282:Health Personnel / Q000458:organization & administration*; D006301:Health Services Needs and Demand / Q000458:organization & administration; D006302:Health Services Research; D006801:Humans; D009103:Multiple Sclerosis / Q000628:therapy; D009369:Neoplasms / Q000628:therapy; D009664:Norway