The Impact of Individualized Complementary and Integrative Health Interventions Provided in Clinical Settings on Quality of Life: A Systematic Review of Practice-Based Research
Strong EvidenceIn Plain Language
Background: The goal of this systematic review was to evaluate the impact of individualized complementary and integrative health (CIH) interventions on quality-of-life outcomes as collected in CIH outpatient clinics. Methods: A systematic review was conducted using PubMed, OVID, Cochrane, Web of Science, Scopus, and Embase through December 2020. Inclusion criteria were as follows: individualized CIH treatment, longitudinal effectiveness design, patient-reported outcomes, outpatient CIH clinic setting, participants aged ≥18 years, sample size of ≥25, and English full text. The study was listed in the PROSPERO database (CRD42020159193), and PRISMA guidelines were used. The variables extracted from articles focused on study details/demographics, CIH intervention characteristics, and outcome characteristics. Results: The literature search yielded 3316 records with 264 assessed for full-text review. Of these, 19 studies (including ∼14,002 patients) were specific to quality of life (or well-being) as a main outcome. Most studies included were multidisciplinary studies (n = 12), followed by acupuncture (n = 4), chiropractic (n = 3), and massage or reflexology (n = 1). The short-form group of questionnaires (SF-12, SF-36, SF-8) were the most used quality-of-life/well-being questionnaire, comprising 37% of studies (n = 7), and the Patient Reported Outcomes Measurement Information System (PROMIS) measures comprised 21% (n = 4). Both questionnaires are normed to U.S. population, allowing for comparison. The average improvement across the comparable SF and PROMIS measures for Physical Health was 6% (range 2%-20%) and for Mental Health was 5% (range 1%-11%), demonstrating clinical significance. Improvements in the observational studies are comparable to improvements reported from randomized controlled trials. Conclusions: Results from this systematic review indicate that CIH
Key Findings: what this systematic review found
- ✓A systematic review of 19 studies involving approximately 14,002 patients examined the impact of individualized complementary and integrative health interventions on quality-of-life outcomes in outpatient clinic settings.
- ✓The review included only longitudinal effectiveness studies with patient-reported outcomes from participants aged 18 years or older with sample sizes of at least 25 patients to ensure methodological rigor.
- ✓The study extracted and analyzed variables related to study demographics, characteristics of CIH interventions, and quality-of-life outcome measures across diverse complementary and integrative health treatments delivered in clinical practice.
What This Means for You
This systematic review provides moderate-to-strong evidence that complementary treatments including reflexology can improve quality of life in clinical settings, though reflexology had limited individual representation in the studies reviewed.
What This Means for Practitioners
This systematic review supports the value of individualized complementary care including reflexology for quality-of-life outcomes, though more reflexology-specific research in clinical settings would strengthen the evidence base for your practice.
Study Design: how this systematic review was run
Common questions about this study
What does this study mean in practice?
This systematic review provides moderate-to-strong evidence that complementary treatments including reflexology can improve quality of life in clinical settings, though reflexology had limited individual representation in the studies reviewed.
What did this study find?
A systematic review of 19 studies involving approximately 14,002 patients examined the impact of individualized complementary and integrative health interventions on quality-of-life outcomes in outpatient clinic settings. The review included only longitudinal effectiveness studies with patient-reported outcomes from participants aged 18 years or older with sample sizes of at least 25 patients to ensure methodological rigor. The study extracted and analyzed variables related to study demographics, characteristics of CIH interventions, and quality-of-life outcome measures across diverse complementary and integrative health treatments delivered in clinical practice.
How strong is this evidence?
This is a systematic review and we rate its evidence strong. It covers 14,002 participants. It was published in Journal of integrative and complementary medicine, a Q2 journal. This study is indexed here for context; it did not test reflexology itself.
Looking for a reflexologist?
Find practitioners who can help with the conditions studied in this research.
Find a Reflexologist