Usage and attitudes of physicians in Japan concerning traditional Japanese medicine (kampo medicine): a descriptive evaluation of a representative questionnaire-based survey

Abstract

Kampo medicine has been the primary medical model in Japan until the mid 1800s, regained a prominent role in today's Japanese medical system. Today, 148 herbal Kampo formulas can be prescribed under the national health insurance system, allowing physicians to integrate Kampo in their daily practice. This article aims to provide information about the extent to which Kampo is now used in clinics throughout Japan and about physician's current attitudes toward Kampo. We used the results of a 2008 survey that was administered to physicians throughout Japan (n = 684). The data showed that 83.5% of physicians currently use Kampo in the clinic, although the distribution of physicians who use Kampo differ widely depending on the specialty and provided a breakdown of Kampo usage by specialty. It will be interesting to see how each specialty incorporates Kampo into its respective field as Kampo continues to play a pertinent role in Japanese medical system.

Figure 1

Physicians' experience of Kampo treatment. Total and each specialist's experiences of Kampo treatment. Oblique line bar shows the ratio of physicians who are prescribing Kampo drugs, vertical line bar, the ratio of physicians who have prescribed Kampo drugs before, dotted bar, the ratio of physicians who have never prescribed Kampo drugs.

Figure 2

Treatment Style of usual practice of Kampo. Physicians who use Kampo in daily practice answered to the question whether they prescribe Kampo alone or together with Western medicine. Oblique line bar shows the ratio of physicians who prescribe Kampo drugs alone when physicians think that Kampo drug is necessary for treatment. Vertical line bar shows the ratio of physicians who prescribe Kampo drugs together with Western medicine.

Figure 3

Selection of Kampo drugs. When Kampo using physicians prescribe Kampo drugs, based on what do they choose Kampo? Data is shown by ratio of total number of physicians and each specialist. Oblique line bar shows the ratio of physicians who prescribe Kampo drugs based on Western medicine diagnosis. Vertical line bar shows the ratio of physicians who prescribe Kampo drugs based on SHO (Kampo diagnosis) additionally to Western medicine diagnosis. Dotted bar shows the ratio of physicians who prescribe Kampo drugs based on SHO and Western medicine diagnosis together. Cross line bar shows the ratio of physicians who prescribe Kampo drugs based on Western medicine diagnosis additionally to SHO.

Figure 4

Indications for Kampo treatment. Oblique line bar shows the ratio of physicians who select Kampo for all diseases as a first choice. Vertical line bar shows the ratio of physicians who select Kampo treatment for certain diseases as a first choice. Dotted bar shows the ratio of physicians who select Kampo treatment as a supplement to Western medicine treatment. Cross line bar shows the ratio of physicians who use Kampo to reduce the side effects of Western medicine treatment. Right oblique line bar shows the others.

Figure 5

Satisfaction rate of Kampo treatment by (a) physicians and (b) patients. Satisfaction of Kampo treatment was rated from 1 (low) to 5 (high) by (a) physicians and (b) patients.

Figure 6

Expectation for Kampo in future. (a) Overall physicians' expectation. Cross oblique line pie shows the ratio of physicians who expect clinical evidence of Kampo treatment. Dense pie shows the physicians who expect the understanding of SHO in modern way. Dotted pie shows the ratio of physicians who expect the development of Kampo drug form (easier to take), grid pie shows the physicians who expect more Kampo education. Oblique line pie shows the ratio of physicians who expect better compliance of Kampo drugs (less intake or dose reduction). (b) Expectation for Kampo in each specialty.