CAM in Italy – a brief overview



In Italy, CAM treatments are not reimbursed by the public health service, so CAM therapies and remedies are usually paid for by the citizens. One out of eight have used CAM within the preceding three years: 13.6% of the Italian population. (1) Homeopathy is the most used therapy (7.0% of the population), manual treatments (2) are chosen by 6.4% of the population, while herbal remedies and acupuncture are used by 3.7% and 1.8% of the Italian population respectively.

The typical Italian CAM user is an adult between 35 and 44 years, with post-high-school qualifications, and women use CAM more than men: 4.7 millions (15.8%) against 3.16 millions (11.2%).

The highest prevalence is among people living in the North-Eastern regions (21.9%), followed by the North-Western regions (17.9%), the Central regions (13.6%), the Islands (7.0%) and the Southern regions (5.4%).

In Italy today there are almost 3,000 MDs who practise acupuncture, more than 8,000 homeopaths, about 20,000 MDs with homeopathic training and approximately 160 MDs who have completed the three-year residential course in anthroposophic medicine.

There are more than 20,000 Italian practitioners (physicians, dentists, veterinarians) who prescribe homeopathic and anthroposophic medicines. Many are doctors and veterinarians who have completed years of post-graduate training to acquire specific skills in homeopathy, anthroposophic medicine and homotoxicology, which are the three sectors that use homeopathic medication.

There is no official list of medical doctors practising CAM, and Italian universities do not have professionalising courses in the CAM field. Research activities are mostly focused on observational and clinical studies, and they are carried out at a few university departments (such as University of Florence, University of Verona) and in some instances outside the universities.

In 2002, the Italian National Federation of Medical Doctors and Dentists (FNOMCeO) approved the “Guideline for Non-Conventional Medicines” in order to grant safety for citizens and appropriateness of treatments (FNOMCeO, 2002). The document recognised nine CAM disciplines: Acupuncture, Phytotherapy, Ayurvedic Medicine, Anthroposophic Medicine, Homeopathy, Traditional Chinese Medicine, Homotoxicology, Osteopathy, Chiropractic. FNOMCeO considers these disciplines as a “medical act”, and for this reason only medical doctors and dentists may practise them.

There is no national law regulating CAM status and practice - but The Supreme Court has stated that it is an abuse of the medical profession to practise CAM without a degree in medicine.

According to the Italian Constitution, the central government shares the responsibility for public health care with the twenty regional governments. There are many differences between the Italian regions with respect to demographic aspects, economic development, healthcare infrastructures and expenditure; the main differences are between North and South. This has a great influence on the CAM situation in Italy.

Several regions try to overcome the lack of legislation through different initiatives. Tuscany approved a regional law on CAM, introducing acupuncture, homeopathy and phytotherapy treatments into the regional services available for all citizens. This policy usually is the responsibility of the national government.

In 2004, the Emilia-Romagna Region established the Regional Observatory for non conventional medicines (OMNCER), which has the task of planning and promoting research in this field through specific regional experimental programmes investigating the efficacy and safety of several non-conventional treatments and the possibility of their integration in the Regional Health Service. The 2nd Experimental Programme for Unconventional Medicines 2008-2009, recently approved and supported by the government of Emilia Romagna Region, includes 14 studies, whose 3 on homeopathic treatments, 3 on herbal treatments, 5 on acupuncture, and 3 on different non conventional treatments. Ten out of 14 studies are randomised controlled clinical trials.

In 2003, the first Consensus Conference of CAM in Italy was promoted, and a related first Consensus Document on CAM in Italy was signed by the most important associations of CAM. “The Permanent Committee of Consensus and Coordination for CAM in Italy” (participating in CAMbrella) represents about 12 000 medical doctors and veterinarians and is Italy’s most representative nonprofit, independent and multidisciplinary CAM organisation. The coordinator is Paolo Roberti di Sarsina.

The Italian participants in CAMbrella are

Agenzia Sanitaria e sociale regionale Regione Emilia-Romagna

Comitato Permanente di Consenso e Coordinamento per le Medicine Non-Convenzionali in Italia


Text: Jesper Odde Madsen


Footnotes

1) In 2007, the Italian National Institute for Statistics (ISTAT) published its latest multipurpose survey, “Condizioni di salute e ricorso ai servizi sanitari” (Health conditions and the use of health care services), with a brief chapter dedicated to “Le terapie non convenzionali in Italia” (Non conventional therapies in Italy).

2) Manual treatments include osteopathy and chiropractic.


Sources

Stefania Florindi, Agenzia Sanitaria e sociale regionale Regione Emilia-Romagna. http://www.regione.emilia-romagna.it/age...

Paolo Roberti di Sarsina, M.D., The Permanent Committee of Consensus and Coordination for CAM in Italy. http://www.fondazionericci.it/comitato


Further references

Cardini F., Lesi G., Lombardo F., Van der Sluijs C., The Use of Complementary and Alternative Medicine by women experiencing menopausal symptoms in Bologna, BMC Women’s Health. 10: 7.

FNOMCeO, Linee guida della FNOMCeO su Medicine e Pratiche Non Convenzionali. Consiglio Nazionale, Terni, 2002.

France G., Taroni F., Donatini A., The Italian health-care system. Health Econ 2005; 14: 187-202.

ISTAT, Le terapie non convenzionali in Italia. Anno 2005. Indagine multiscopo, 2007.

Roberti di Sarsina P., Iseppato I., Non-conventional Medicine in Italy: The present situation. European Journal of Integrative Medicine, 1 (2009): 65-71.
http://www.europeanintegrativemedicinejr...

Roberti di Sarsina P., Iseppato I., Looking for a Person-centred Medicine: Non Conventional Medicine in the Conventional European and Italian Setting. eCAM, 2009.
http://ecam.oxfordjournals.org/cgi/repr...