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Background: Despite the push for complementary medicine (CM) practitioners to engage in evidence implementation, and arguments in support of evidence-based practice (EBP), uptake of EBP amongst most CM professions remains low. This review aimed to synthesise the evidence examining the barriers and enablers to evidence implementation in CM. Methods: Any primary study examining enablers and barriers to evidence implementation in CM were eligible for inclusion. Eight databases and search engines were searched for eligible studies. Reference lists of included studies were screened, and authors of included studies were contacted to identify current or unpublished studies that met the inclusion criteria. Results: Thirty-nine published and unpublished studies were included in this review. The seven published qualitative studies and 25 published quantitative studies were rated as moderate to high quality. Fifty-two distinct barriers and 62 discrete enablers were identified. Reported barriers were predominantly structural (e.g. limited availability of time and clinical evidence) and cognitive (e.g. skills deficits), with relatively fewer studies reporting cultural (e.g. lack of industry support) or attitudinal barriers (e.g. lack of interest in, or relevance to CM). Enablers of evidence implementation largely focussed on improving access to bibliographic databases and evidence reviews, supporting skills acquisition, and cultivating leadership and interprofessional/interagency collaboration. Conclusions: The findings of this review highlight the diverse barriers and enablers to evidence implementation in CM that span multiple dimensions. The interplay between these various factors highlights the complexity of evidence implementation, and the need for a targeted multistakeholder, multidimensional solution to optimise evidence-based practice in CM. Study registration: The protocol of this review was registered at PROSPERO (CRD42022308527).

Background: Almost one in three women worldwide will be exposed to domestic and family violence some time in their life. This violence can contribute to physical, social, economic and psychological harm. Transcendental Meditation® (TM) may help to lessen the physical and emotional burden of domestic violence. Methods: The objective of this pilot, parallel-group, randomized controlled trial is to compare the effectiveness of TM to support group control, on quality-of-life, perceived stress and mood in women affected by domestic violence. Women living in Adelaide, South Australia, who have experienced domestic violence in their lifetime, will be randomized to eight weeks of standardised TM training or facilitated group support sessions. Health-related quality of life (AQoL-8D), severity of depression, anxiety and perceived stress (DASS-21), and symptoms of post-traumatic stress disorder (PCL-5) will be self-reported by women at baseline, week 8 (post-intervention) and week 16 (follow-up). Data will be analysed by intention-to-treat using linear mixed-effects models. Discussion: TM is an effortless, easily practiced and convenient relaxation technique, with reportedly high rates of adherence. While previous studies have shown TM to be effective in improving a range of psychological and behavioural outcomes across different populations, the effects of TM in survivors of domestic violence is largely unknown. If the study described herein is able to demonstrate the benefits of TM in this population, it might offer survivors an accessible, long-term and potentially cost-effective treatment option for domestic violence-induced distress, anxiety and depression.Trial registration: ACTRN12620000467932.

Background: Clinical guidelines recommend non-pharmacological interventions as the first line of treatment for agitation in dementia. One intervention that shows some promise as a treatment for agitation is essential oils. The objective of this study was to provide preliminary evidence of the effectiveness and feasibility of using topically-administered, individualized essential oil preparations for the alleviation of agitation in persons with dementia. Methods: We conducted a 10-week pragmatic, cluster-randomized, placebo-controlled, pilot feasibility trial to compare the effectiveness of topically-administered, individualized essential oil preparations to control (placebo) preparations. Outcomes included frequency and severity of agitation, quality of life, frequency of antipsychotic medication use and physical restraint, incidence of adverse events, and trial feasibility. Participants with dementia and clinically significant agitation were recruited from five residential aged-care facilities across regional South Australia. Results: Thirty-eight participants were randomized from five sites. Accounting for random effects, we found statistically significant differences between the intervention and control groups in Pittsburgh Agitation Scale (PAS) aberrant vocalization sub score, Cohen Mansfield Agitation Inventory (CMAI) verbally agitated sub score and CMAI total score at week 4, but not at weeks 8 (post-intervention) or 10 (follow-up). No significant time-group interactions were observed for other PAS/CMAI scores or sub scores, quality of life - Alzheimer's disease total score, or frequency of physical restraint or as-needed antipsychotic medication. No adverse events were reported in any group. Conclusions: The study findings highlight some promising effects of topically-administered, individualized essential oil preparations for agitation in dementia, and indicate that a large multi-center, cluster-randomized controlled trial of this treatment is feasible. Trial registration: Australian New Zealand Clinical Trial Registry [ACTRN12617001159347].