Objective: The purpose of this CPG was to describe the state of evidence on CAM interventions for PD reflecting current clinical practice.

Background: Many patients with PD use CAM interventions, but there are currently no guidelines available for PD that address CAM interventions.

Methods: To develop the present CPG for PD, the development group defined clinical questions through analysis of current research. A literature search was conducted using several electronic databases. Results from Pubmed, EMBASE, Cochrane library, CNKI, and Korean databases using OASIS and NDSL. We assessed levels of evidence and recommendation grades according to the Grading of Recommendation Assessment, Development, and Evaluation (GRADE) approach. The GRADE evaluation process is divided into two stages, assessment of evidence level and recommendation grade. Level of evidence is classified as high, moderate, low, or insufficient. Recommendation grades are classified into five levels: A, B, C, D, and GPP. The Delphi technique was adopted as the method of formal expert and clinician consensus. A questionnaire on the initial draft of the recommendation was prepared, and a panel of nine experts in various fields was established under the recommendation of the Review Committee of the CPG Development Group for PD. The expert panel answered questionnaires in two rounds, after which the final recommendation was drafted. The Society of Stroke on Korean Medicine then approved final draft of the CPG.

Results: A total of 23 clinical questions were defined. About herbal medication, it was recommended that patients with idiopathic PD should consider concomitant use of herbal medicines and antiparkinsonian agents (B / low). About acupuncture, patients with idiopathic PD should consider treatment with acupuncture and antiparkinsonian agents (B / low). About moxibustion, Patients with idiopathic PD should consider treatment with moxibustion (C / low). About pharmacoacupuncture, patients with idiopathic PD may consider concomitant treatment with bee venom acupuncture and antiparkinsonian agents (GPP/ insufficient). About Tai Chi, Patients with idiopathic PD should consider practicing Tai chi (B / low).

Conclusions: This EBM CPG for CAM interventions will be helpful for patients and health care providers for decision of usage of CAM interventions for PD. Updated PD CPG for CAM interventions will be published in 2020.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/development-of-evidence-based-clinical-practice-guideline-cpg-of-complementary-and-alternative-medicine-cam-for-parkinsons-disease-pd/