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Lacey J, Huston A, Lopez G, Vozmediano JR, Lam CS, Narayanan S, Lu W, Wolf U, Subbiah IM, Richard P, Lopez AM, Rao S, Frenkel M. Establishing an Integrative Oncology Service: Essential Aspects of Program Development. Curr Oncol Rep 2024; 26:200-211. [PMID: 38358637 DOI: 10.1007/s11912-024-01504-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2024] [Indexed: 02/16/2024]
Abstract
PURPOSE OF REVIEW Over the last 2 decades, integrative oncology (IO) has seen exponential growth within cancer care. It aims to combine evidence-based complementary therapies with conventional treatments to improve the well-being and quality of life for individuals dealing with cancer. The proliferation of integrative medicine programs in major cancer centers globally reflects varying approaches shaped by cultural, demographic, and resource-based factors. RECENT FINDINGS Drawing upon the expertise of leaders in IO from the Society for Integrative Oncology (SIO) Clinical Practice Committee, this manuscript serves as a practical guide for establishing an IO practice. Collating insights from diverse professionals, including oncologists, integrative oncologists, supportive care physicians, researchers, and clinicians, the paper aims to provide a comprehensive roadmap for initiating and advancing IO services. The primary objective is to bridge the gap between conventional cancer care and complementary therapies, fostering a patient-centric approach to address the multifaceted challenges encountered by individuals with cancer. This paper delineates several key sections elucidating different aspects of IO practice. It delves into the core components necessary for an IO service's foundation, outlines the initial medical consultation process, and presents crucial tools essential for successful consultations. By consolidating insights and expertise, this manuscript seeks to facilitate the integration of IO into mainstream cancer care, ultimately enhancing patient outcomes and experiences.
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Affiliation(s)
- Judith Lacey
- Supportive Care and Integrative Oncology, Chris O'Brien Lifehouse, Camperdown, NSW, Australia
| | - Alissa Huston
- Pluta Integrative Oncology & Wellness Center, Wilmot Cancer Institute University of Rochester, Rochester, NY, USA
| | - Gabriel Lopez
- Integrative Medicine Center, Department of Palliative, Rehabilitation and Integrative Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Chun Sing Lam
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, NT, Hong Kong
| | - Santhosshi Narayanan
- Integrative Medicine Center, Department of Palliative, Rehabilitation and Integrative Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Weidong Lu
- Zakim Center, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Ursula Wolf
- Institute of Complementary and Integrative Medicine, University of Bern, Bern, Switzerland
| | - Ishwaria M Subbiah
- Cancer Care Equity and Professional Wellness, Sarah Cannon Research Institute, Nashville, TN, USA
| | - Patrick Richard
- Radiation Oncology, Rocky Mountain Cancer Centers, Boulder, CO, USA
| | - Ana Maria Lopez
- Integrative Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University Cherry Hill, Cherry Hill, NJ, USA
| | - Santosh Rao
- Integrative Oncology, University Hospitals Connor Whole Health. Beachwood, Beachwood, OH, USA
| | - Moshe Frenkel
- Complementary and Integrative Medicine Service, Oncology Division, Rambam Health Care Campus, Haifa, Israel.
- Department of Family Medicine, The University of Texas Medical Branch at Galveston, Galveston, TX, USA.
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Chung VCH, Ho LTF, Leung TH, Wong CHL. Designing delivery models of traditional and complementary medicine services: a review of international experiences. Br Med Bull 2021; 137:70-81. [PMID: 33681965 DOI: 10.1093/bmb/ldaa046] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 11/10/2020] [Accepted: 12/07/2020] [Indexed: 11/13/2022]
Abstract
BACKGROUND The World Health Organization advocates integration of traditional and complementary medicine (T&CM) into the conventional health services delivery system. Integrating quality services in a patient-centred manner faces substantial challenges when T&CM is delivered within a health system dominated by conventional medicine. This review has synthesized international experiences of integration strategies across different contexts. SOURCES OF DATA Publications describing international experiences of delivering T&CM service in conventional healthcare settings were searched. Backward and forward citation chasing was also conducted. AREAS OF AGREEMENT Capable leaders are crucial in seeking endorsement from stakeholders within the conventional medicine hierarchy and regulatory bodies. However, patient demands for integrative care can be successful as demonstrated by cases included in this review, as can the promotion of the use of T&CM for filling effectiveness gaps in conventional medicine. Safeguarding quality and safety of the services is a priority. AREAS OF CONTROVERSY Different referral mechanisms between conventional and T&CM practitioners suit different contexts, but at a minimum, general guideline on responsibilities across the two professionals is required. Evidence-based condition-specific referral protocols with detailed integrative treatment planning are gaining in popularity. GROWING POINTS Interprofessional education is critical to establishing mutual trust and understanding between conventional clinicians and T&CM practitioners. Interprofessional communication is key to a successful collaboration, which can be strengthened by patient chart sharing, instant information exchange, and dedicated time for face-to-face interactions. AREAS TIMELY FOR DEVELOPING RESEARCH Research is needed on the optimal methods for financing integrated care to ensure equitable access, as well as in remuneration of T&CM practitioners working in integrative healthcare.
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Affiliation(s)
- Vincent C H Chung
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong.,School of Chinese Medicine, The Chinese University of Hong Kong
| | - Leonard T F Ho
- School of Chinese Medicine, The Chinese University of Hong Kong
| | - Ting Hung Leung
- School of Chinese Medicine, The Chinese University of Hong Kong
| | - Charlene H L Wong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong
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Rodondi PY, Lüthi E, Dubois J, Roy E, Burnand B, Grass G. Complementary Medicine Provision in an Academic Hospital: Evaluation and Structuring Project. J Altern Complement Med 2019; 25:606-612. [DOI: 10.1089/acm.2019.0062] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Affiliation(s)
- Pierre-Yves Rodondi
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
- Institute of Family Medicine, University of Fribourg, Fribourg, Switzerland
| | - Emmanuelle Lüthi
- Institute of Family Medicine, University of Fribourg, Fribourg, Switzerland
- Department of Anesthesiology, Center for Integrative and Complementary Medicine, Pain Center, Lausanne University Hospital, Lausanne, Switzerland
| | - Julie Dubois
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
- Institute of Family Medicine, University of Fribourg, Fribourg, Switzerland
| | - Edith Roy
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Bernard Burnand
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Geneviève Grass
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
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Hunter J, Ussher J, Parton C, Kellett A, Smith C, Delaney G, Oyston E. Australian integrative oncology services: a mixed-method study exploring the views of cancer survivors. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2018; 18:153. [PMID: 29743054 PMCID: PMC5944107 DOI: 10.1186/s12906-018-2209-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 04/17/2018] [Indexed: 12/22/2022]
Abstract
Background The significant use of traditional and complementary medicine (T&CM) by cancer survivors is well documented. The aim of this study was to explore cancer survivors’ views on integrating T&CM services with conventional cancer care. Method A mixed-method study design with an emphasis on qualitative methodology was used to conduct and analyse four focus group interviews and an on-line survey. Purposive sampling recruited 33 cancer survivors and caregivers from Arabic, Vietnamese, Chinese and Anglo-European Australian backgrounds who participated in one of four focus group interviews, and 121 cancer survivors who responded to an on-line survey. The inductive thematic analysis was augmented with a descriptive statistical analysis. Results Most participants had used T&CM therapies or consulted T&CM practitioners as an adjuvant during and/or after their initial cancer treatment. Two themes emerged: ‘positive perceptions and experiences’ and ‘barriers and unmet needs’. Participants emphasised that T&CM was not a ‘luxury item’, rather it was considered important for managing side effects and comorbidities, rehabilitation and quality of life. A wide range of complex, interrelated barriers and solutions to IO service provision and access were identified. Structural barriers included inadequate service provision, medical practitioner attitudes, logistical constraints and funding. Personal barriers were influenced by the severity of impairment and disability; attitudes, beliefs and knowledge about T&CM; and available resources (e.g. finances, time, transport). Unmet need and inequitable access was exacerbated by geographical location, ethnicity and ability to pay. There was a mismatch between where participants were accessing T&CM services and their preference for IO service delivery. Participants perceived hospital-based IO services availability to have several benefits, including the T&CM practitioners having more expert knowledge about cancer care, the convenience of co-locating oncology services, and potentially lower out-of-pocket costs. Conclusion Patients’ use, preferences and needs for T&CM services in the oncology setting are important for informing service provision. Inequitable, unmet need reflected the increasing demand and expectation from patients for their oncology teams to be well informed about the benefits, risks and indications for T&CM use, and for the public and private health sectors to formally integrate and fund IO services. Electronic supplementary material The online version of this article (10.1186/s12906-018-2209-6) contains supplementary material, which is available to authorized users.
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