Co-creation of an evidence-based toolkit to facilitate communication on complementary medicine between conventional and complementary healthcare practitioners in the Netherlands

• Communication between complementary and conventional practitioners needs improvement. • Different health care practitioners co-created a communication toolkit. • The toolkit includes tools to improve communication and collaboration. • The toolkit offers a decision aid for 13 complementary therapies and 6 indications. • Uniting care practitioners may boost referrals and broaden complementary care use. The Dutch health care system needs guidance and implementation of complementary care, of which shared decision making, communication and referral between conventional and complementary care practitioners are major components. A Dutch quality register for complementary healthcare practitioners (RBCZ) was interested in adopting and implementing an improved version of a communication toolkit developed in an earlier project. Therefore, the aim was to further develop a communication toolkit to improve the communication and collaboration between member practitioners of RBCZ and conventional healthcare practitioners. Focus group discussions were conducted as part of a co-creation process with conventional and complementary healthcare practitioners to define content and implementation of the toolkit, in three field labs; Utrecht, Amsterdam and the north of the Netherlands. A pragmatic evidence-based decision aid for the respective complementary care modalities was developed based on a literature assessment and Strength Of Recommendation Taxonomy (SORT) criteria. The final toolkit included seven communication tools: (1) getting acquainted; (2) communication; (3) frame letters; (4) decision aid with evidence-based recommendations for 13 complementary therapies and 6 indications: chronic low back pain, depressive symptoms, medically unexplained physical symptoms, irritable bowel syndrome, burnout, and chronic fatigue syndrome; (5) grading evidence; (6) support for communication of the RBCZ members/professional associations and (7) implementation. The evidence-based toolkit will be made available to 23 professional associations covering over 9.500 complementary healthcare practitioners in the Netherlands (RBCZ). The regional collaboration amongst complementary healthcare practitioners was strengthened as well as between complementary and conventional healthcare practitioners.