Investigating complementary and alternative medicine in Norwegian hospitals: a cross-sectional study with process evaluation

Hospitals worldwide have expanded their offerings of Complementary and Alternative Medicine (CAM) in recent years. However, there is a lack of updated data about CAM services offered in Norwegian hospitals. This study aimed to investigate the prevalence of CAM in Norwegian hospitals and explore how CAM is practiced within these hospitals. This study employed a mixed-methods approach, including a cross-sectional survey administered to all Norwegian hospitals (response rate, 74%; n = 215) and a process evaluation with healthcare providers (n = 11) practicing CAM at these hospitals. Survey data were analyzed using descriptive statistics, Pearson chi-square test, Fisher exact test, and binary logistic regression. Content analysis was employed to analyze the process evaluation data. More than half of the hospitals (53.5%, n = 115) reported offering CAM to patients, and the highest prevalence was reported at clinics for substance abuse (77%, n = 27) and psychiatric hospitals (74.5% n = 41). Acupuncture (21%, n = 45), expressive art therapy (21%, n = 45), and yoga (21%, n = 45) were the most used modalities. In a process evaluation, four main themes were identified: the incorporation of CAM at hospitals, Reasons for offering CAM at hospitals, Advantages of offering CAM at hospitals, and the Safety of CAM. This study demonstrates that CAM is widely offered in Norwegian hospitals, consistent with previous research. While participants in the process evaluation viewed CAM as a holistic and beneficial approach to care, its adoption remains inconsistent across institutions. This variability, likely due to the lack of defined CAM roles and job descriptions, may pose indirect risks to both healthcare providers and patients. Standardized guidelines are needed to ensure safe and fair implementation.