Chan, WJ, McLachlan, AJ, Hanrahan, JR & Harnett, JE 2020, 'The safety and tolerability of Annona muricata leaf extract: a systematic review', Journal of Pharmacy and Pharmacology, vol. 72, no. 1, pp. 1-16.View/Download from: UTS OPUS or Publisher's site
Harnett, J, Schloss, J, Van De Venter, C, Rickwood, C & McIntyre, E 2019, 'The diagnostic and clinical management of individuals recommended gluten free diets by complementary medicine practitioners', Advances in Integrative Medicine, vol. 6, no. 3, pp. 97-103.View/Download from: Publisher's site
© 2018 Elsevier Ltd Objectives: Excluding gluten containing foods from the diet is medically indicated for the management of coeliac disease, wheat allergy, gluten ataxia, non-coeliac gluten sensitivity, and dermatitis herpetiformis. However, the number of people following a gluten free diet (GF diet) far exceeds the number of people with an indication for such dietary restriction. It has been suggested that 70% of individuals who are recommended GF diets by complementary medicine practitioners have not had coeliac disease adequately excluded. The aim of this study was to describe the diagnostic and clinical management practices of naturopaths, Western herbalists and nutritionists (non-dietetic) associated with recommending GF diets. Design, subjects and outcome measures: A cross-sectional 40-item questionnaire was developed and administered online to 145 Australian naturopaths, nutritionists (non-dietetic) or Western herbal medicine practitioners via professional associations and a practice based network (PRACI) between February and April 2017. Demographic data and practice information related to recommending GF diets was collected. Results: A total of 56.5% (82/145) practitioners reported that in the majority of cases they did not undertake any recommended diagnostic process, and 48% (71/145) of practitioners referred to a general practitioner to exclude medical conditions related to gluten ingestion prior to recommending a GF diet. A total of 10% (15/145) ordered coeliac serology through local laboratories, and 17% (24/145) through functional pathology companies. Non-coeliac gluten sensitivity was diagnosed by 56% (82/145) through an elimination and reintroduction diet, and 61% (88/145) used a diet and symptom diary. IgG antibody tests were used by 23% (33/145) of practitioners, and 5% (7/145) used kinesiology prior to recommending a GF diet. Conclusion: Clinical guidelines for the diagnosis of gluten related disorders are not followed by a substantial number ...
Schloss, J, McIntyre, E, Rickwood, C, Van de Venter, C & Harnett, J 2019, 'Identification of the conditions that complementary medicine practitioners recommend gluten free diets for in Australia', Advances in Integrative Medicine, vol. 6, no. 2, pp. 87-91.View/Download from: UTS OPUS or Publisher's site
© 2018 Introduction: A gluten free diet (GFD) is indicated for the medical management of coeliac disease as well as gluten ataxia, dermatitis herpetiformis, and wheat allergy. Complementary medicine practitioners (CMPs) recommend removing gluten from the diet, but it is not known what symptoms or conditions they recommend gluten free diets for. The aim of this study is to describe for what conditions Australian naturopaths, Western herbalists and nutritionists (non-dietetic) recommend a gluten free diet. Methods: This was a sub-group analysis nested within a cross-sectional survey of practitioners recruited through the PRACI practice-based research network and relevant professional associations. A 40-item survey collected information on sociodemographic characteristics, practice and professional characteristics and specific questions on gluten related disorders between February and August 2017. Data was described using frequencies and percentages along with one-way ANOVA to determine group differences. Results: One hundred and forty-five complementary practitioners responded to the survey. The gastrointestinal conditions most frequently prescribed a GFD for were non-coeliac gluten sensitivity (99%), medically diagnosed coeliac disease (95.2%), inflammatory bowel disease (73.1%) and irritable bowel syndrome (60%). The most frequently prescribed GFDs for extra-intestinal conditions were skin conditions (60%), children with developmental disorders (53.1%), mental health conditions (46.2%) and weight management. Discussion: Results suggest that given the broad application of GFDs by CMPs, there may be therapeutic benefits for conditions other than known gluten related disorders. However, in the absence of appropriate investigations for gluten related disorders, the recommendation and positive response to a GFD may be inadvertently treating an undiagnosed gluten related disorder. In addition, a GFD may also be inadvertently managing other unknown intolerances that req...
Bradley, R, Harnett, J, Cooley, K, McIntyre, E, Goldenberg, J & Adams, J 2019, 'Naturopathy as a Model of Prevention-Oriented, Patient-Centered Primary Care: A Disruptive Innovation in Health Care.', Medicina (Kaunas, Lithuania), vol. 55, no. 9.View/Download from: UTS OPUS or Publisher's site
Background and Objective: The concept of a "disruptive innovation," recently extended to health care, refers to an emerging technology that represents a new market force combined with a new value system, that eventually displaces some, or all, of the current leading "stakeholders, products and strategic alliances." Naturopathy is a distinct system of traditional and complementary medicine recognized by the World Health Organization (WHO), emerging as a model of primary care. The objective here is to describe Naturopathy in the context of the criteria for a disruptive innovation. Methods: An evidence synthesis was conducted to evaluate Naturopathy as a potentially disruptive technology according to the defining criteria established by leading economists and health technology experts: (1) The innovation must cure disease; (2) must transform the way medicine is practiced; or (3) have an impact that could be disruptive or sustaining, depending on how it is integrated into the current healthcare marketplace. Results: The fact that Naturopathy de-emphasizes prescription drug and surgical interventions in favor of nonpharmacological health promotion and self-care could disrupt the present economic model that fuels health care costs. The patient-centered orientation of Naturopathy, combined with an emphasis on preventive behaviors and popular complementary and integrative health services like natural products, mind and body therapies, and other therapies not widely represented in current primary care models increase the likelihood for disruption. Conclusions: Because of its patient-centered approach and emphasis on prevention, naturopathy may disrupt or remain a durable presence in healthcare delivery depending on policymaker decisions.
Gan, WC, Smith, L, McIntyre, E, Steel, A & Harnett, JE 2019, 'The prevalence, characteristics, expenditure and predictors of complementary medicine use in Australians living with gastrointestinal disorders: A cross-sectional study.', Complementary therapies in clinical practice, vol. 35, pp. 158-169.View/Download from: UTS OPUS or Publisher's site
AIMS:To determine the prevalence, characteristics, expenditure and predictors of complementary medicine (CM) use in Australian adults living with gastrointestinal disorders (GID). METHODS:A cross-sectional study involving 2,025 Australian adults was conducted. Participants were recruited through purposive convenience sampling. Descriptive statistics were conducted to report the prevalence of people living with GIDs and their CM use, including CM products, mind-body practices and CM practitioner services. Chi-square test and independent-samples t-test were used to determine the associations between sociodemographic or health-related variables with CM use. Binary logistic regression was conducted to determine the significant predictors of CM use in GID participants. Economic data was calculated based on the mean out-of-pocket expenditure on CM. RESULTS:Of the 293 participants reporting a GID, 186 (63.5%) used CM products, 55 (18.8%) used a mind-body practice and 141 (48.1%) visited at least one CM practitioner in the last 12 months. Collectively, the majority of GID participants using any type of CM were female, aged 40-49 years, married and employed. The mean score for health-related quality of life was 49.6 out of 100 in GID participants and 68.2 in participants without a GID (p < 0.001). Average annual out-of-pocket expenditure on CM products was AUD127.29 by CM products users with a GID. The predictors of CM products, mind-body practices and CM practitioner services use differed. Of the 111 CM product users with a GID, 103 (92.8%) disclosed all or some of their CM use to general practitioner, 89 (80.2%) to specialist doctor, 79 (71.2%) to pharmacist and 69 (62.1%) to hospital doctor. CONCLUSIONS:A substantial proportion of Australian adults living with GID use CM products, mind-body practices and CM practitioner services. This study provides important insights to inform and guide the development of a more coordinated health care services for individuals living ...
Harnett, JE, McIntyre, E, Steel, A, Foley, H, Sibbritt, D & Adams, J 2019, 'Use of complementary medicine products: a nationally representative cross-sectional survey of 2019 Australian adults.', BMJ open, vol. 9, no. 7.View/Download from: UTS OPUS or Publisher's site
OBJECTIVES:To provide a contemporary description of complementary medicine (CM) product use in Australia. DESIGN:Cross-sectional survey. SETTING:Online. PARTICIPANTS:A nationally representative sample (n=2019) of the Australian adult population. PRIMARY AND SECONDARY OUTCOME MEASURES:Primary outcomes measures included the use and type of CM products used, and source of recommendation. Secondary measures included disclosure of CM product use to health practitioners, concomitant use of pharmaceuticals and predictors of use. RESULTS:Prevalence of CM product use was 50.3%, with the most frequently used being vitamin and mineral supplements (VMSs; 47.8%) and homoeopathic medicines the least used (6.8%). A majority of respondents using CM products were also using pharmaceutical products, and small but significant associations were found between the use of CM products and pharmaceuticals (p<0.05). Small statistically significant associations were found between use of vitamin products and disclosure of use to general practitioners (GPs; Cramer's V=0.13, p=0.004) and hospital doctors (Cramer's V=0.11, p=0.04), and between use of herbal medicines and disclosure to both GPs (Cramer's V=0.11, p=0.02) and hospital doctors (Cramer's V=0.12, p=0.03). Women, those with higher education and those with no private health insurance were more likely to use CM products (p<0.05), while those without chronic conditions were less likely to use CM products (p<0.05) (χ2(29)=174.70, p<0.001). CONCLUSIONS:The number of Australians using CM products has remained relatively stable and substantial for nearly two decades. The majority of CM use relates to VMSs. Given the number of Australians using both CM products and pharmaceutical medicines, it is important to evaluate the potential clinical implications of such practices to ensure safe, effective and coordinated health policy and patient care.
McIntyre, E, Adams, J, Foley, H, Harnett, J, Leach, MJ, Reid, R, Schloss, J & Steel, A 2019, 'Consultations with Naturopaths and Western Herbalists: Prevalence of Use and Characteristics of Users in Australia.', Journal of Alternative and Complementary Medicine, vol. 25, no. 2, pp. 181-188.View/Download from: UTS OPUS or Publisher's site
OBJECTIVES:To report the prevalence of naturopathic and Western herbal medicine service utilization in Australia, and describe the characteristics of individuals who use these services. DESIGN:This is a national cross-sectional study. SETTINGS:Online survey platform. SUBJECTS:Purposive convenience sampling was used to recruit 2025 adults who were matched to Australian population demographics by gender, age, and state of residence. INTERVENTIONS:A survey instrument consisting of 50 items covering demographics, health service utilization, health status, health literacy, and medicine disclosure to complementary healthcare providers. OUTCOME MEASURES:The prevalence, frequency, and cost of naturopathy and Western herbal medicine consultations and sociodemographic characteristics of users of naturopathic and Western herbalist services and associations between these factors. RESULTS:The final data set included 2019 participants: 6.2% (n = 126) consulted a naturopath and 3.8% (n = 76) a Western herbalist. These health services were most commonly used to improve well-being. An average of AUD$102.67 and AUD$49.64 was spent per user on consultations with naturopaths and Western herbalists, respectively, in the previous year. The most prevalent users were those between 18 and 29 years of age (39.3%), in a relationship (51%), employed (70%), and held a bachelor degree or higher (40.5%). Some degree of financial difficulty was reported by 65.4% of users. Having a chronic illness (p < 0.01) and using both conventional and complementary medicines (p = 0.05) were both associated with using naturopathic or Western herbal medicine services. Less than 40% of participants disclosed their use of conventional medicines to Western herbalists. CONCLUSIONS:Naturopathy and Western herbal medicine services are used by a substantial number of Australian adults who also use conventional health services. Accordingly, research is needed to determine how these health professions can be better in...
Reid, R, Steel, A, Wardle, J, McIntyre, E, Harnett, J, Foley, H & Adams, J 2019, 'The prevalence of self-reported diagnosed endometriosis in the Australian population: results from a nationally-representative survey.', BMC research notes, vol. 12, no. 1.View/Download from: UTS OPUS or Publisher's site
OBJECTIVE:Currently, it is estimated that one in 10 women of reproductive age are affected by the reproductive condition known as endometriosis. However, there has been limited research and policy attention on the prevalence of endometriosis in Australia. Utilising a nationally-representative Australian sample (N = 2025), this study aimed to report on the prevalence of endometriosis in the general population and to examine the sociodemographic factors associated with the condition. RESULTS:The results identified a prevalence rate for endometriosis of 3.4%, which aligns with previous Australian research on this topic. However, the prevalence rate from this data set is lower than the estimate prevalence from the Global Burden of Disease Study. In addition, this study reported that women self-reporting diagnosis of endometriosis, were between 40-49 years of age, with a higher proportion living in South Australia (18.2%) compared to women within the general population (8.4%). The findings highlight endometriosis as a significant health care issue warranting further research and policy attention. While acknowledging some limitations, the study provides an important foundation for further large-scale research to be conducted on this important women's health topic.
Schloss, J, McIntyre, E, Steel, A, Bradley, R, Harnett, J, Reid, R, Hawrelak, J, Goldenberg, J, Van De Venter, C & Cooley, K 2019, 'Lessons from outside and within: Exploring advancements in methodology for naturopathic medicine clinical research', Journal of Alternative and Complementary Medicine, vol. 25, no. 2, pp. 135-140.View/Download from: UTS OPUS or Publisher's site
Chan, W-JJ, McLachlan, AJ, Wheate, NJ & Harnett, JE 2018, 'An evaluation of garlic products available in Australian pharmacies–From the label to the laboratory', Journal of Herbal Medicine, vol. 14, pp. 61-67.View/Download from: UTS OPUS or Publisher's site
Garlic is one of the most commonly used herbal medicines worldwide. There is medium quality evidence to support that specific garlic formulations at specific doses have an antihypertensive effect in a cohort of individuals with hypertension. There is lower quality evidence for garlic’s hypolipidaemic effects. While there are many garlic products available in Australian pharmacies, it is unclear if these products are formulated based on the current evidence for use in such populations. The aim of this study was to evaluate garlic product formulations available in Australian pharmacies for quality indicators including: supporting evidence, labelling, product, safety and manufacturing information and the presence of key constituents previously identified as having hypotensive or hypolipidaemic properties. A qualitative evaluation of commercially available garlic products was conducted in accordance with the study aims. Thin-layer chromatography (TLC) was included in the evaluation to investigate the presence of alliin and s-allyl cysteine in both garlic products and raw garlic. The quality indicators evaluated in this study including evidence for the formulation used, labelling, product, safety and manufacturing information and key constituents varied significantly between the garlic products available in Australian pharmacies. These findings have a number of implications that relate to the formulations and doses chosen by herbalists, pharmacists and consumers who may consider using garlic products in the management of hypertension and/or dyslipidaemia.
Gan, WC, Smith, L, Luca, EJ & Harnett, JE 2018, 'The prevalence and characteristics of complementary medicine use by Australian and American adults living with gastrointestinal disorders: A systematic review', Complementary Therapies in Medicine, vol. 41, pp. 52-60.View/Download from: Publisher's site
Steel, A, McIntyre, E, Harnett, J, Foley, H, Adams, J, Sibbritt, D, Wardle, J & Frawley, J 2018, 'Complementary medicine use in the Australian population: Results of a nationally-representative cross-sectional survey', Scientific Reports, vol. 8, no. 1, pp. 1-7.View/Download from: UTS OPUS or Publisher's site
In order to describe the prevalence and characteristics of complementary medicine (CM) practice and product use by Australians, we conducted a cross-sectional online survey with Australian adults aged 18 and over. Rates of consultation with CM practitioners, and use of CM products and practices were assessed. The sample (n = 2,019) was broadly representative of the Australian population. Prevalence of any CM use was 63.1%, with 36% consulting a CM practitioner and 52.8% using any CM product or practice. Bodywork therapists were the most commonly consulted CM practitioners (massage therapists 20.7%, chiropractors 12.6%, yoga teachers 8.9%) and homeopaths were the least commonly consulted (3.4%). Almost half of respondents (47.8%) used vitamin/mineral supplements, while relaxation techniques/meditation were the most common practice (15.8%). CM users were more likely to be female, have a chronic disease diagnosis, no private health insurance, a higher education level, and not be looking for work. Prevalence of CM use in Australia has remained consistently high, demonstrating that CM is an established part of contemporary health management practices within the general population. It is critical that health policy makers and health care providers acknowledge CM in their attempts to ensure optimal public health and patient outcomes.