Nationwide survey of Japanese Physicians on Kampo medicine use in frailty care

Frailty is a multidimensional, progressive syndrome that has become a priority for early intervention in aging societies. Kampo medicine, a traditional multi-herbal therapy, may offer an additional treatment option. However, limited evidence exists on how physicians perceive and apply it in frailty care. We conducted a nationwide web-based survey of physicians in Japan (n = 8,351) to evaluate frailty recognition, Kampo prescription patterns, and treatment assessments. Overall, 46.4% reported diagnosing frailty. Clinic-based physicians prescribed Kampo medicine more often than hospital-based physicians (14.1% vs. 10.5%; P < 0.001) and most commonly for appetite loss, malnutrition, and sarcopenia. They also assessed effects earlier (within 2 weeks: 19.5% vs. 13.5%; P = 0.002). In adjusted analyses, Kampo prescribing was more likely among clinic-based physicians and those in internal medicine or surgery, and less likely in larger facilities (≥ 200 beds). Clinic-based physicians were also more likely to rate Kampo as highly effective. In contrast, physicians aged ≥ 60 years prescribed Kampo less often but were more likely to choose it for their own frailty management. This first nationwide study shows that practice setting, specialty, facility size, and physician age shape frailty care and Kampo use in Japan, highlighting the need for further evidence and education to guide integrative care.