Recognizing and prioritizing the factors that influence the selection of treatment options is essential for effective health service planning and an appropriate health care delivery system. This study aimed to identify and prioritize the barriers and facilitators to the use of Traditional, Complementary, and Integrative Medicine (TCIM) in Iran. A two-phase, mixed-methods study was conducted. First, a two-round Delphi survey was conducted with a panel of 32 experts, including specialists in Persian medicine (PM) and health policymakers, to acheive consensus on a list of barriers and facilitators within the Iranian context. Subsequently, the Analytical Hierarchy Process (AHP) was applied with a 12-expert panel to determine the relative weight and priority of the agreed-upon criteria. The Delphi process yielded consensus on 18 facilitators and nine barriers. The facilitators were categorized into two main dimensions (Cultural and social facilitators, and Systemic facilitators) and six sub-dimensions. In comparison, the barriers formed four main dimensions (service delivery barriers, policy challenges, financial barriers, and knowledge and attitudinal barriers). Quantitative AHP results revealed that among facilitators, "effects of health professionals" (Final Weight: 0.29) was the most critical dimension, with "Recommendation and referral by conventional physicians (CPs)" (Final Weight: 0.18) as its top factor. Conversely, among barriers, "Policy Challenges" (Final Weight: 0.50) was the most significant dimension, substantially outweighing others. The findings highlight that the recommendation of TCIM by CPs are the strongest facilitator; yet, overarching policy challenges critically hamper its implementation. Addressing this disconnect requires integrated policy reforms and interdisciplinary collaboration to leverage TCIM within Iran's health care system effectively.

Acute viral tonsillitis is a common childhood condition, and high-quality randomized evidence on the efficacy of individualized homeopathic medicines (IHMs) remains limited. To evaluate the efficacy and clinical utility of IHMs in children with acute viral tonsillitis. Double-blind, randomized (2:1), placebo-controlled clinical trial. Single-center outpatient pediatric clinical setting. Seventy-eight children with acute viral tonsillitis were enrolled and randomized. Participants received IHMs prescribed according to a classical individualized approach or a matching placebo, in addition to standard supportive care. The primary outcome was longitudinal change in the Tonsillopharyngitis assessment (TPA) score. Secondary outcomes were the Sore Throat Pain Intensity Scale, Difficulty in Swallowing Score, and Swelling of Tonsils Score. Time to sore throat remission and complete clinical recovery (CCR) were also assessed. IHMs produced a significantly greater and faster reduction in objective TPA score than placebo (TPA group × time interaction: F1,76 = 43.19, p < 0.001; partial η2 = 0.362). At day 3, the IHMs group showed a larger improvement in TPA (adjusted mean difference -2.01, 95% confidence interval -2.78 to -1.24; p < 0.001; Cohen's d = 1.35) and a higher rate of meaningful recovery (88.5% vs. 38.5%; number needed to treat = 2.0). Time to sore throat remission and CCR were significantly shorter with IHMs (median 3.0 vs. 4.8 days; both p < 0.001). A Bayesian hierarchical model confirmed a global benefit across outcomes (standardized mean effect -0.71; 99.97% posterior probability of superiority), and findings remained robust across extensive sensitivity and multiplicity-adjusted analyses. Hepar sulphuris was the most frequently prescribed remedy and also showed the most consistent and clinically meaningful improvement across all outcome measures.

Traditional and alternative medicine (TAM) remains a cornerstone of health care in Tanzania, particularly in rural and underserved communities. Despite its cultural significance and widespread use, TAM occupies a largely underregulated space within the national health system. This review critically examines the historical evolution, policy frameworks, and institutional roles shaping TAM's integration in Tanzania. A systematic literature review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement and Joanna Briggs Institute protocols. Searches were undertaken in PubMed, Scopus, and Google Scholar, and supplemented by gray literature from government and international organizations. Studies published between January 2010 and May 2025 were included, alongside selected pre-2010 sources providing essential historical or legislative context. Data were extracted and synthesized thematically to evaluate policy development, regulatory mechanisms, and institutional mandates. The PRISMA flow diagram summarizes the screening process, with 34 studies forming the core evidence base for thematic analysis. Analysis of the 34 included studies indicates progress through instruments such as the Traditional and Alternative Medicine Act (2002), the Traditional Medicine Policy (2009), and the Medicines and Medical Devices Act (2019). Key institutions including the Ministry of Health, the Tanzania Medicines and Medical Devices Authority, and the Tanzania Commission for Science and Technology have advanced regulation, accreditation, and research. However, persistent challenges remain, notably fragmented institutional coordination, limited professional recognition, and inadequate protection of intellectual property. Comparative insights from the World Health Organization and the African Union frameworks highlight opportunities for policy alignment, innovation, and regional collaboration. TAM continues to play a critical role in Tanzania's health care landscape by providing culturally congruent and accessible services. Strengthening regulation, enhancing institutional coordination, embedding monitoring and evaluation mechanisms, and safeguarding indigenous knowledge are essential for sustainable integration. Balancing cultural heritage with scientific validation will support health care equity and consolidate TAM's position within national health policy frameworks.

Tobacco use is a leading cause of morbidity and mortality worldwide. Complementary therapies, such as auriculotherapy, are increasingly being explored for smoking cessation; however, inconsistent administration methods have limited definitive evidence. This study evaluated whether a single auriculotherapy session promotes smoking cessation. In this multicenter, randomized, single-blind, superiority clinical trial conducted at a tertiary care university hospital and two private practices in France, we enrolled cigarette smokers aged ≥18 years who were motivated to quit. Participants were randomized into two groups using centralized computer-generated allocation: auriculotherapy (AUR) and sham auriculotherapy (SHAM). In the AUR group, specific ear points were treated with cryo-auriculotherapy (nitrous oxide gas applied for 2 sec). In the SHAM group, the same points were treated using an empty canister containing only a propellant gas. The participants were blinded to their group assignment. The primary outcome was the percentage of participants who achieved smoking cessation at 1 month, defined as a urinary cotinine level of <50 μg/L. Secondary outcomes included self-reported cessation, exhaled carbon monoxide levels, anxiety, depression, stress, weight gain, and auriculotherapy side effects. Between November 16, 2021, and October 23, 2023, 90 participants were enrolled (45 in each group). The primary analysis included 36 participants in the AUR group and 32 in the SHAM group. Smoking cessation rates based on urinary cotinine <50 μg/L were similar: 18.8% (95% confidence interval [CI]: 0.09-0.35) in SHAM and 33.0% (95% CI: 0.20-0.50) in AUR (p = 0.174). No significant adverse events or unintended effects were observed. A single cryo-auriculotherapy session did not significantly enhance smoking cessation compared with the sham session.

Anecdotal reports and preliminary clinical observations suggest potential benefits of homeopathic medicines in hemorrhoids, but high-quality evidence remains limited. To evaluate whether individualized homeopathic medicinal products (IHMPs) are superior to placebo in reducing anorectal symptom severity and improving quality of life over 3 months in adults with hemorrhoids, and to assess their safety and tolerability. Three-month, double-blind, randomized (1:1), placebo-controlled trial. Surgery, PG3, and research outpatients of a tertiary homeopathic medical college hospital in West Bengal, India. One hundred and thirty-four adults with grade I-III hemorrhoids. IHMPs (verum; n = 67) or identical-looking placebos (control; n = 67) both administered alongside standard concomitant care including sitz baths, pelvic floor exercises, and dietary advice. The primary outcome was the change in the Anorectal Symptom Severity and Quality-of-Life (ARSSQoL) total score over 3 months. Secondary outcomes included ARSSQoL subscales, numeric rating scales (NRSs), and EQ-5D-5L questionnaire and visual analog scale. Outcomes were assessed monthly for up to 3 months. The primary analysis compared model-based estimates of change over time between groups using repeated measures analysis of variance; the secondary analyses comprised multivariate linear mixed models, Bayesian hierarchical modeling, and sensitivity analyses under intention-to-treat and per-protocol frameworks. After 3 months, IHMPs demonstrated significantly greater improvement than placebo in ARSSQoL total (mean group difference -6.5, 95% confidence interval -8.7, -4.2; p < 0.001), with large effect sizes. Most ARSSQoL subscales, NRSs, and EQ-5D-5L scores favored IHMPs. Multivariate and Bayesian analyses confirmed consistent intervention-by-time effects, with a high probability of directional superiority for IHMPs in symptom reduction and self-rated health, while sensitivity analyses showed the findings to be robust to protocol deviations. Kent's repertory was the most frequently used in remedy selection. Nitricum acidum emerged as the most effective remedy. No treatment-related serious adverse events were observed. In this randomized, double-blind trial, IHMPs were associated with greater reductions in the ARSSQoL improvements in quality of life compared with placebo over 3 months. Although the magnitude and consistency of effects across multiple analytic approaches suggest potential clinical relevance, the absence of a validated minimal clinically important difference for the ARSSQoL warrants cautious interpretation. Further independent replications and methodological refinement of outcome thresholds are needed.

Prior qualitative studies have described subjective experiences during Reiki, yet their quantitative relationship to symptom change has not been examined. This study evaluated whether specific subjective Reiki experiences are associated with changes in health-related symptoms using regression and mediation analyses. The study took place at private Reiki practices across the United States. Reiki practitioners (N = 99) invited their clients to complete a survey before and after receiving Reiki. The Reiki sessions were conducted in person, with each session lasting an average of 60 min. Self-report measures based on the Edmonton Symptom Assessment System were used to assess physical and psychological symptoms immediately before (pre) and after (post) the Reiki session. Participants were asked to describe their experience during the Reiki session at post. Linear regression analyses were conducted to explore associations between subjective Reiki experiences and changes in well-being, pain, and anxiety, while controlling for age and gender. Mediation models tested whether pain and anxiety changes mediated the relationship between subjective Reiki experiences and improvements in well-being. A total of N = 1,284 Reiki sessions had both quantitative and qualitative data and were included in the analysis. Experiencing positive emotions was significantly associated with higher well-being and reduced anxiety, and experiencing body sensations was significantly associated with greater pain relief. There was a significant indirect effect of body sensations on well-being via pain relief, a significant indirect effect of positive emotions on well-being via anxiety reduction, and a significant indirect effect of emotional release on well-being via anxiety reduction. The results from this linear regression and mediation analysis suggest that the subjective experience of receiving Reiki is related to changes in different psychological and physical health symptoms. More work is needed to confirm these findings while addressing the limitations of the current study.

Depression remains a major global health burden, and conventional antidepressants, although effective, are limited by side effects and withdrawal symptoms. To map umbrella-level evidence on single-agent nutraceutical and herbal interventions for clinically diagnosed depression in adults. This scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews and Joanna Briggs Institute guidance. PubMed, PsycINFO, Scopus, and Cochrane Library were searched (2015-2025) for umbrella reviews assessing oral nutraceuticals or herbal medicines for depression. Nine umbrella reviews met inclusion criteria, covering omega-3 fatty acids, vitamin D, probiotics, saffron, St John's wort, zinc, and folate. Umbrella reviews generally reported potential antidepressant benefits and acceptable safety profiles for several interventions, although trial overlap and heterogeneity limited certainty. Evidence indicates promising but inconsistent efficacy across several nutraceutical and herbal agents. Standardized reporting, consideration of baseline nutrient status, and economic evaluation are needed to clarify their role in depression care.