| Fontanella et al. (2007)1616 Fontanella F, Speck FP, Piovezan AP, Kulkamp IC. Conhecimento, acesso e aceitação das práticas integrativas e complementares em saúde por uma comunidade usuária do Sistema Único de Saúde na cidade de Tubarão/SC. ACM 2007; 36(2):69-74.
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Quantitative |
To evaluate the knowledge, access and acceptance related to ICPs of a SUS user community of the South Brazilian region. |
Most ICPs were not known by the population. The use of therapies without expert follow-up was frequent, which, together with the low access of the community, shows the lack of professionals qualified for this care. |
There is evidence of low knowledge and access to ICPs, despite population's interest and acceptance. Also, the use of therapies occurs without the consultation of specialized professionals. |
| Monteiro and Iriart (2007)1212 Monteiro DA, Iriart JAB. Homeopatia no Sistema Único de Saúde: representações dos usuários sobre o tratamento homeopático. Cad Saude Publica 2007 ago; 23(8):1903-1912.
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Case study |
Understand the motivations of users to look for homeopathy, how they portray and explain the action of medications and homeopathic treatments. |
The primary motivation for seeking homeopathy was the failure of allopathic treatment. The holistic perspective, the use of natural medicines, long consultation time and active listening were brought as favorable differential characteristics when compared to allopathic treatment. |
The potential of the contribution of therapeutic alternatives such as homeopathy in the public health service is poorly explored. |
| Tesser and Barros (2008)1717 Tesser CD, Barros NF. Medicalização social e medicina alternativa e complementar: pluralização terapêutica do Sistema Único de Saúde. Rev Saude Publica 2008; 42(5):914-920.
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Reflective analysis |
To analyze potentialities and difficulties of practices and Alternative and Complementary Medicines (ACM) from clinical-institutional experiences and specialized literature |
The SUS provides ACM. There are common favorable manifestations of policies of the civil society and users' representatives regarding the provision of ACM by the SUS. |
ACM has limited "demedicalizing" potential. The political-epistemological hegemony of bioscience and the current health market dispute, whose tendency is to transform any knowledge or practice of the health-disease process into commodities or procedures to be consumed must be observed. |
| Ceolin et al. (2009)88 Ceolin T, Heck RM, Pereira DB, Martins AR, Coimbra VCC, Silveira DSS. A inserção das terapias complementares no sistema único de saúde visando o cuidado integral na assistência. Enferm. glob. 2009; 16:1-10.
|
Reflective analysis |
To discuss the use of complementary therapies in Brazil, aiming at the comprehensive care of the individual and the introduction of the nurse practitioner in these practices. |
The use of medicinal plants has increased to meet the needs of users. Nurses must expand their knowledge and gain space for the use of complementary therapies. |
The biomedical model is flawed in the comprehensive care to the user. Thus, it has sought other treatments. Medicinal plants bridge this gap. |
| Salles and Schraiber (2009)1313 Salles SAC, Schraiber LB. Gestores do SUS: apoio e resistências à Homeopatia. Cad Saude Publica 2009; 25(1):195-202.
|
Reflective analysis |
To investigate the characteristics of the relationship currently established between Homeopathy and Biomedicine, according to the point of view of non-homeopathic physicians. |
The support of managers to the presence of Homeopathy in the SUS is related to the perception of social demand, to the protection of the right of choice of users and to the fact that it is a medical practice that revives the humanist realm of medicine. |
The notion of Homeopathy as a "mild medicine" predominates, which could slowly promote improved symptoms. There is a lack of service structure for acute care cases. The training of homeopaths is flawed since the specialization courses do not provide training to attend severe cases. |
| Andrade and Costa (2010)1818 Andrade JT, Costa LFA. Medicina Complementar no SUS: práticas integrativas sob a luz da Antropologia médica. Saude Soc 2010; 19(3):497-508.
|
Reflective analysis |
To consider the aspects of the institutionalization of ICPs, to reflect on the paradigmatic foundations of their therapeutic action and to analyze the comprehensive and complex character of its application, with specific anthropological views in the dialogue. |
The public health system carries to its core other traditional knowledge and rationalities, which come to live with the conventional logic and services of biomedicine. |
It is necessary to study the concept of integrality further, as well as to face the practical challenges of implementing the ICPs. |
| Marques et al. (2011)1919 Marques LAM, Vale FVVR, Nogueira VAS, Mialhe FL, Silva LC. Atenção farmacêutica e práticas integrativas e complementares no SUS: conhecimento e aceitação por parte da população sãojoanense. Physis. 2011; 21(2):663-674.
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Qualitative |
To investigate the knowledge and acceptance of integrative and complementary therapies and pharmaceutical care by users of SUS PHC facilities |
100% of participants did not know what integrative and complementary therapies were all about. Doctors' knowledge about acupuncture and homeopathy is almost non-existent. |
Most of the respondents would accept the use of the therapies if they were offered by the health facility, in addition to finding the pharmacist's attention more critical. There is little dissemination, and few social programs seek to show the benefits of such therapies. |
| Nagai and Queiroz (2011)2020 Nagai SC, Queiroz MS. Medicina complementar e alternativa na rede básica de serviços de saúde: uma aproximação qualitativa. Cien Saude Colet 2011; 16(3):1793-1800.
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Qualitative |
To focus the implementation of complementary and alternative practices with the purpose of evaluating the conditions of their occurrence from the social representations of the professionals who participate in this process. |
Four reasons were found for the success of the inclusion of ICPs: the willingness of the clientele; the health vision of hygienist doctors; extensive support from non-medical health professionals; and the perspective of alternative and complementary medicines that are in line with the SUS proposal. |
Despite the success in implementing these practices in the primary network, the planning of these actions is insufficient and the vision is simplified, which turns alternative rationalities into mere techniques that follow the same mechanistic principles of allopathic medicine and the same reified understanding of the disease. |
| Santos et al. (2011)99 Santos RL, Guimaraes GP, Nobre MSC, Portela AS. Análise sobre a fitoterapia como prática integrativa no Sistema Único de Saúde. Rev. Bras. Pl. Med. 2011; 13(4):486-491.
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Qualitative |
To do a bibliographical survey, on the subjects like the importance of the herbal medicine; how it is being used; its benefits to the Public Health System; training of professionals in this area and programs and laws for implementation in the SUS. |
The government has shown interest in the development of policies for health care procedures that are effective, comprehensive, humanized and less dependent on the pharmaceutical industry. Brazilian municipalities have carried out the implementation of Herbal medicine Programs in primary care. |
Studies on herbal medicine are still scarce in Brazil, and research is needed in this area to expand the knowledge of health professionals and students, helping and strengthening the safety and efficacy bases for the implementation of herbal medicine practices in the SUS. |
| Thiago and Tesser (2011)2121 Thiago SCS, Tesser CD. Percepção de médicos e enfermeiros da Estratégia de Saúde da Família sobre terapias complementares. Rev Saude Publica 2011; 45(2):249-257.
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Quantitative |
To analyze the perception of professionals of the Family Health Strategy (ESF) about integrative and complementary practices. |
17 health centers provided integrative and complementary practices; 12.4% of professionals were homeopathy or acupuncture experts. In total, 88.7% of the participants did not know the national guidelines on this subject, although 81.4% agreed with their inclusion in the SUS. |
Professionals accept ICPS, and this is due to with their prior contact and possibly related to in family medicine and community / family health residency / specialization. |
| Ischkanian and Pelicioni (2012)2222 Ischkanian PC, Pelicioni MCF. Desafios das práticas integrativas e complementares no SUS visando a promoção da saúde. Rev Brasileira de Crescimento Desenvolvimento Humano. 2012; 22(2):233-238.
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Qualitative |
To investigate the knowledge, opinions and social representations of the managers and health professionals about the ICPs in the SUS and to identify the difficulties and challenges in their implementation, use and disclosure in the Health Services. |
The managers were not prepared for the implementation of the NICPP in the SUS. The biomedical model is prevalent and the provision of supplies used for the application of ICPs has been a problem. The dissemination of ICPs has not been sufficient among professionals and users. |
The municipality must encourage and create conditions for the provision of ICPs, improving their dissemination and supporting the integration of non-medical professionals with appropriate training. ICPs integration in the SUS can undoubtedly contribute to health promotion. |
| Oliveira et al. (2012)1010 Oliveira SGD, Moura FRR, Demarco FF, Nascente PS, Del Pino FAB, Lund RG. An ethnomedicinal survey on phytotherapy with professionals and patients from Basic Care Units in the Brazilian Unified Health System. J Ethnopharmacol 2012; 140(2):428-437.
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Quantitative |
Interviewing professionals working in the SUS, as well as patients who use PHC, concerning their experience with ethnomedicine. |
91.6% of the participants made use of medicinal plants at least once to treat specific diseases. Of the professionals, 65% used medicinal plants and 10% prescribed herbal medicines to patients. Patients and professionals reported knowing the medicinal plants due to their parents or grandparents. |
A high proportion of users and professionals made use of medicinal plants and plants. Mallow was the most commonly used. The primary source of knowledge about herbal medicine was from parents or grandparents. |
| Fontenele et al. (2013)1111 Fontenele RP, Sousa DMP, Carvalho ALM, Oliveira FA. Fitoterapia na Atenção Básica: olhares dos gestores e profissionais da Estratégia Saúde da Família de Teresina (PI), Brasil. Cien Saude Colet 2013; 18(8):2385-2394.
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Quali-quantitative |
To understand how managers and professionals at tertiary level in Teresina (PI) see the introduction of herbal medicine in Primary Care in the city, relating these data with knowledge of these professionals about this therapeutic practice, its use and the public policies involved. |
The strengthening of the herbal medicine in PHC and its incorporation in the routine of the professional practice of the ESF are necessary for the discussion about herbal medicine in the PHC between the actors and the bodies involved, and the qualification of the health professionals. |
The professionals' knowledge about health practices is relevant for the recognition of the situation, planning and streamlining of the application of health actions, especially those involving herbal medicine and other ICPs because they have specific policies. |
| Galhardi et al. (2013)1414 Galhardi WMP, Barros NF, Leite-Mor ACMB. O conhecimento de gestores municipais de saúde sobre a Política Nacional de Prática Integrativa e Complementar e sua influência para a oferta de homeopatia no Sistema Único de Saúde local. Cien Saude Colet 2013; 18(1):213-220.
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Quanti-qualitative |
To analyze the knowledge of the health managers of the municipalities of São Paulo on the Policy and its importance for the implementation of homeopathy in the local health services. |
Of the 645 municipalities analyzed, 47 provided homeopathy. 42 municipalities were interviewed. 26% knew the NICPP, 31% knew little and 41% were unaware of it. |
NICPP is unknown to health managers and those who know it use it to divulge the homeopathic medical rationality and justify its indication in the SUS. |
| Silva and Tesser (2013)1515 Silva EDC, Tesser CD. Experiência de pacientes com acupuntura no Sistema Único de Saúde em diferentes ambientes de cuidado e (des)medicalização social. Cad Saude Publica 2013; 29(11):2186-2196.
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Qualitative |
To investigate the experience of SUS acupuncture users in Florianópolis, Santa Catarina, Brazil about their treatment, including their perception of efficacy, reduced medication use, guidelines received, changes in self-care and explanatory models of users, from the viewpoint of medicalization in the mentioned focus. To investigate this experience in different care settings by testing the hypothesis that primary health care may assumingly be an environment more favorable to the rationality of Traditional Chinese Medicine and acupuncture. |
Acupuncture has poorly contributed to autonomy and demedicalization, except for its effectiveness. The attitude of professionals is essential to stimulate a more active and integral posture. |
Most patients came to acupuncture in secondary care when other treatments failed. The practice was perceived effectively and favored the reduction of medications. Despite the difficulty of access, it was observed that PHC professionals have greater autonomy to care for patients, and can treat more severe cases for a more extended period. |
| Lima et al. (2014)2323 Lima KMSV, Silva KL, Tesser CD. Práticas integrativas e complementares e relação com promoção da saúde: experiência de um serviço municipal de saúde. Interface (Botucatu) 2014; 18(49):261-272.
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Qualitative |
To show and discuss results of a research that analyzed the organization of ICPs developed in a CIP referral service, in the metropolitan region of Belo Horizonte, focusing its relationship with the promotion of health and its insertion in the SUS. |
Practices can be a useful resource in health promotion, notably by establishing a new understanding of the health-disease process. |
It is necessary to overcome the challenges of its organization and its expansion to strengthen ICPs in the field of promotion and care in the SUS, such as drawing professionals closer to CIP referral and support services of PHC. |
| Sousa and Tesser (2017)2424 Sousa IMC, Tesser CD. Medicina Tradicional e Complementar no Brasil: inserção no Sistema Único de Saúde e integração com a atenção primária. Cad Saude Publica 2017; 33(1):e00150215.
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Qualitative |
To analyze the insertion of traditional and complementary medicine (TCM) in the SUS, with the aim of supporting the discussion about its integration in PHC via ESF. |
Types of TCM insertion and integration: Type 1 - Integrated; Type 2 - Overlapped; Type 3 - Integrated; Type 4 - No integration. The combination of types 1 and 3 is considered a potential for the expansion of TCM in the SUS, influencing growth and its integration into PHC. |
The growing presence of the TCM in SUS requires thinking strategies for its expansion, beyond NICPP, considering the previous experiences. |
Source: Authors.