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Table 1 Key questions to ask for policymakers, in clinical settings and in risk research that incorporate patients’ use of CAM

From: “Then I went to a hospital abroad”: acknowledging implications of stakeholders’ differing risk understandings related to use of complementary and alternative medicine in European health care contexts



Regulation - the policy-makers perspective

• Which decision factors (like research, efficacy and patient safety elements) is the national regulation of CAM based on?

• How should scientific evidence on direct and indirect risk factors influence regulation of the specific CAM modality?

• Which provider training and treatment requirements will strengthen the safety for CAM users/patients?

• How may a planned regulation of CAM providers and treatments increase patient safety?

• How can more harmonized and integrated regulation of conventional medicine and CAM result in increased patient safety?

• How should we emphasize safety aspects of European regulation on CAM when deciding new CAM regulation on a national level?

• How will the considered regulation of CAM influence public supervision possibilities and patients’ claim and reimbursement rights?

Clinical settings– provider perspective

• How does this CAM user understand risks associated with conventional treatment? Why?

• How does this CAM user understand risks associated with CAM/specific CAM treatments? Why?

• How do I myself as a health-care provider understand risk associated with CAM and conventional treatment?

• Do my risk understandings differ from those of the patient in front of me?

• How can I best communicate important risk information to this patient?

Clinical settings– patient perspective

• How do I as a patient perceive my personal risk associated with the use of the CAM I want to use?

• How do I as a patient perceive my personal risk associated with the use of the recommended conventional treatment?

• How can I best communicate my interest in CAM to medical doctors and nurses in public health care?

• What does this doctor know about CAM?

• What training does this CAM provider have?

• What does this CAM provider know about medicine/conventional treatment?

• Where can I find trustworthy information about CAM treatments and CAM providers?

• Is the CAM treatment I want to use associated with any possible risks?

• Is the conventional treatment I use associated with any possible risks?

• Are there any known risks associated with the combination of the conventional and the CAM treatment I want to use?

• How can I deal with possible risks?

Risk research

• Does the risk study we are planning include an understanding of risk as an objective or a subjective phenomenon?

• Have we actually defined the concept of risk in our study?

• Would another risk understanding/definition influence the study in terms of research questions, methodology, and interpretation of results?