Abstract
BACKGROUND: Complementary medicines (CMs), including herbal products, nutritional supplements, vitamins, minerals, probiotics and prebiotics, are increasingly integrated into standard medical treatments. Despite their growing popularity, concerns about safety, efficacy, and potential interactions with conventional medications persist. This systematic review evaluates the effectiveness of various educational interventions (EIs) designed to enhance the knowledge, informed decision-making capabilities, awareness of side effects, and consumer perceptions of safety and efficacy of CMs. This study aims to identify the most effective strategies for improving the awareness of potential risks and benefits, and overall health literacy among CMs users. METHODS: A comprehensive literature search was conducted across multiple databases including PubMed/ MEDLINE, Embase, ISI Web of Science, and the Cochrane Library to identify relevant studies published from inception to May 2024. Medical Subject Headings (MeSH) and non-MeSH terms, along with various logic operators, were used to identify studies evaluating EIs aimed at improving CMs knowledge and decision-making. We included the studies if they evaluated EIs about CMs for consumers, patients, and caregivers, with eligible designs including randomized controlled trials (RCTs) and other types of interventional studies. RESULTS: Fifteen eligible studies were included. Interventions ranged from interactive multimedia programs and online platforms to personalized face-to-face counselling. The interventions demonstrated significant improvements in CMs knowledge, self-efficacy, and informed decision-making among participants. High levels of participant satisfaction were consistently reported, particularly with interactive and engaging tools. CONCLUSION: This systematic review underscores the critical role of education in promoting the safe and informed use of CMs. Effective educational interventions enhance knowledge, informed decision-making abilities, and awareness of side effects. However, challenges such as high attrition rates and variability in study designs indicate the need for further research to optimize these interventions. Future efforts should focus on standardizing educational strategies to improve CMs related health literacy and ensure the safe use of CMs. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12906-025-04931-w.