"It's a reality brought to us by the patients": a qualitative study on general practitioners' views on and experience...

A significant proportion of general practitioners (GP) practice, recommend or prescribe complementary medicine (CM) to their patients. However, so far, little is known about their prescribing and referral habits, as well as their needs and expectations regarding CM in everyday practice. This study aimed at exploring how CM is viewed and experienced by GPs in clinical practice in Switzerland.

This descriptive qualitative study was conducted among GPs with no additional training in CM and working in private practices. Data were collected through semi-structured interviews based on an interview guide reflecting the study objectives. The verbatim transcripts of the interviews were coded using a thematic analysis approach.

The analysis generated four main themes: perceptions of CM; recommending CM; discussing CM during the consultation; and needs for the future. Overall, most participants had a positive attitude towards CM, coupled with cautiousness and skepticism when faced with the diversity of therapies. Both perceptions of and recommendations for CM were largely influenced by GPs' personal knowledge, experiences and beliefs. Knowledge about CM, belief in efficacy, availability of scientific evidence, and trust in CM therapists were all facilitators to CM recommendation. Lack of knowledge about CM, lack of insurance coverage, and lack of network were barriers to CM recommendation. During consultations, the subject was more often tackled by patients. However, GPs generally encouraged their patients in their care pathway if they felt that their patients' CM use would not harm them. Needs for the future revolved around training and information sources. GPs advocated introductory courses about CM, in post-graduate or continuous education. In addition, GPs underlined the need for a tool that would centralize information on CM and be easily accessible.

GPs in our study tend to have a pragmatic approach to CM where not only scientific evidence is considered, but also patient's wishes and GPs' own experience and beliefs. Above all, GPs are concerned that patients should be safe and well cared for. Future initiatives to further integrate CM into the healthcare system should thus focus on providing courses and informational tools to GPs to allow them to better support and advise their patients.