Indirect and non-health risks associated with complementary and alternative medicine use: An integrative review

© 2014 Elsevier GmbH. Introduction: Complementary and alternative medicine (CAM) is being increasingly used across the general population, with much attention drawn to the direct health risks associated with rising CAM use - particularly in respect to efficacy and drug-herb interaction. However, the potential for other forms of risk associated with increased CAM use has received far less attention. This review article provides the first broad overview and appraisal of potential non-health and indirect health risks associated with CAM use. Methods: A comprehensive search of literature from 2000 to 2011 in CINAHL, MEDLINE, AMED, and EMBASE was conducted. The search was confined to peer-reviewed articles published in English reporting non-health and indirect health risks associated with CAM. Results: The review identifies a number of non-health risks associated with CAM use. These can be broadly categorised as risks due to variability; risks due to assumption; risks due to opportunity costs; economic risks, and risks due to unorthodoxy. Indirect and non-health risks may also compound or exacerbate existing direct risks associated with CAM treatment. Conclusion: In order to fully appreciate and appraise the relative merits of CAM practice and provision, researchers need to be mindful that a range of potential risks (beyond direct health risks) may be associated with CAM use. Adequate regulatory and policy frameworks need to be put in place to ensure that these risks are minimised. This article belongs to the Special Issue: "Ensuring and Improving Patients' Safety in Integrative Health Care"