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Ottenhausen M, Renovanz M, Bartz I, Poplawski A, Kalasauskas D, Krenzlin H, Keric N, Ringel F. Use of complementary therapies and supportive measures of patients with intracranial gliomas-a prospective evaluation in an outpatient clinic. J Neurooncol 2024; 168:507-513. [PMID: 38709354 PMCID: PMC11186898 DOI: 10.1007/s11060-024-04696-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Accepted: 04/23/2024] [Indexed: 05/07/2024]
Abstract
PURPOSE Patients with intracranial gliomas frequently seek for complementary and alternative medicine (CAM), in addition to guideline-directed therapy. In this study, we therefore assessed patients' information needs regarding treatment and support, and evaluated their attitudes toward experimental trials and alternative therapies. METHODS A prospective, cross-sectional, descriptive survey was conducted in our center. We developed an interview focusing on how patients obtain further information about therapy and the use of alternative/complementary therapies. RESULTS A total of 102 patients participated in the survey. 50% (n = 51) of patients reported that they had not attempted any additional therapies. When patients attempted self-therapy, it was most commonly in the areas of nutrition (25%, n = 26) and dietary supplements (17%, n = 17). Alternative or complementary therapies were used by 14% (n = 14) of the patients. Younger age (Odds ratio (OR) 0.96 (95% Confidence interval (CI) 0.92-0.99, p = 0.012) and tumor entity (OR 5.01 (95% CI 1.66-15.11, p = 0.004) for grade 4 vs. 3 tumors and OR 7.22 (95% CI 1.99-26.28) for grade 4 vs. other tumors p = 0.003) were significantly associated with a greater interest in CAM. CONCLUSIONS Interest in complementary and alternative medicine, as well as nutrition and dietary supplements is high (51%) among glioma patients, and significantly higher among younger patients and those with a worse diagnosis (WHO grade 4). A comprehensive approach to information, including paramedical topics, is needed to provide optimal patient counseling and care for glioma patients.
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Affiliation(s)
- Malte Ottenhausen
- Department of Neurosurgery, University Medical Center Mainz, Mainz, Germany.
| | - Mirjam Renovanz
- Department of Neurology & Interdisciplinary Neuro-Oncology, Hertie Institute for Clinical Brain Research, Eberhard-Karls-University of Tübingen, Tübingen, Germany
- Center for Neuro-Oncology, Comprehensive Cancer Center Tübingen-Stuttgart, University Hospital Tübingen, Eberhard Karls University, Tübingen, Germany
- Department of Neurosurgery, University Hospital Tübingen, Tübingen, Germany
| | - Isabell Bartz
- Department of Neurosurgery, University Medical Center Mainz, Mainz, Germany
| | - Alicia Poplawski
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, 55131, Mainz, Germany
| | - Darius Kalasauskas
- Department of Neurosurgery, University Medical Center Mainz, Mainz, Germany
| | - Harald Krenzlin
- Department of Neurosurgery, University Medical Center Mainz, Mainz, Germany
| | - Naureen Keric
- Department of Neurosurgery, University Medical Center Mainz, Mainz, Germany
| | - Florian Ringel
- Department of Neurosurgery, University Medical Center Mainz, Mainz, Germany
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Hush JM, Steffens D, Solomon MJ. A patient-designed integrative oncology intervention for stage IV locally recurrent rectal cancer: A case report. Explore (NY) 2024:S1550-8307(24)00084-3. [PMID: 38777724 DOI: 10.1016/j.explore.2024.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 04/25/2024] [Accepted: 05/03/2024] [Indexed: 05/25/2024]
Abstract
INTRODUCTION Stage IV colorectal cancer is a highly challenging condition to treat, with 5-year survival rates of 13% in Australia, improving to 40% for those patients with locally recurrent rectal cancer who are suitable for total neoadjuvant therapy and pelvic exenterative surgery. This study reports a unique case of a patient with Stage IV locally recurrent rectal cancer (LRRC), who designed and implemented a holistic integrative oncology intervention. CASE PRESENTATION The patient was 59-years-old when diagnosed with Stage IV locally recurrent rectal cancer, and referred to a highly specialised centre for colorectal cancer care at a tertiary teaching hospital in Sydney, Australia. Treatment included chemo/radiotherapy, liver resection and posterior pelvic exenteration surgery. The patient's background as a health researcher and clinician optimised her ability to design and implement an integrative oncology model of care, including yoga, mindfulness, Buddhist meditation and study, social connection, exercise, psychotherapeutic and nutritional support. This paper describes these mind-body practices and lifestyle modifications and outlines her experiences and outcomes at each stage of her extensive and radical treatment. CONCLUSION This case provides a unique perspective into how the integration of mind-body practices and lifestyle modifications with conventional treatment can support those living with colorectal cancer.
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Affiliation(s)
- Julia M Hush
- Faculty of Medicine and Health Sciences, Macquarie University, NSW 2109, Australia.
| | - Daniel Steffens
- Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Camperdown 2050, New South Wales, Australia; Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Camperdown, NSW 2006, Australia
| | - Michael J Solomon
- Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Camperdown, NSW 2006, Australia; Institute of Academic Surgery (IAS), Royal Prince Alfred Hospital, The University of Sydney, Camperdown 2050, New South Wales, Australia
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Coles CE, Earl H, Anderson BO, Barrios CH, Bienz M, Bliss JM, Cameron DA, Cardoso F, Cui W, Francis PA, Jagsi R, Knaul FM, McIntosh SA, Phillips KA, Radbruch L, Thompson MK, André F, Abraham JE, Bhattacharya IS, Franzoi MA, Drewett L, Fulton A, Kazmi F, Inbah Rajah D, Mutebi M, Ng D, Ng S, Olopade OI, Rosa WE, Rubasingham J, Spence D, Stobart H, Vargas Enciso V, Vaz-Luis I, Villarreal-Garza C. The Lancet Breast Cancer Commission. Lancet 2024; 403:1895-1950. [PMID: 38636533 DOI: 10.1016/s0140-6736(24)00747-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 12/18/2023] [Accepted: 04/09/2024] [Indexed: 04/20/2024]
Affiliation(s)
| | - Helena Earl
- Department of Oncology, University of Cambridge, Cambridge, UK
| | - Benjamin O Anderson
- Global Breast Cancer Initiative, World Health Organisation and Departments of Surgery and Global Health Medicine, University of Washington, Seattle, WA, USA
| | - Carlos H Barrios
- Oncology Research Center, Hospital São Lucas, Porto Alegre, Brazil
| | - Maya Bienz
- Mount Vernon Cancer Centre, East and North Hertfordshire NHS Trust, London, UK; Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | | | - David A Cameron
- Institute of Genetics and Cancer and Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Fatima Cardoso
- Breast Unit, Champalimaud Clinical Center/Champalimaud Foundation, Lisbon, Portugal
| | - Wanda Cui
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia
| | - Prudence A Francis
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia
| | - Reshma Jagsi
- Emory University School of Medicine, Atlanta, GA, USA
| | - Felicia Marie Knaul
- Institute for Advanced Study of the Americas, University of Miami, Miami, FL, USA; Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA; Tómatelo a Pecho, Mexico City, Mexico
| | - Stuart A McIntosh
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Kelly-Anne Phillips
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia
| | - Lukas Radbruch
- Department of Palliative Medicine, University Hospital Bonn, Bonn, Germany
| | | | | | - Jean E Abraham
- Department of Oncology, University of Cambridge, Cambridge, UK
| | | | | | - Lynsey Drewett
- Royal Devon University Healthcare NHS Foundation Trust, Exeter, UK
| | | | - Farasat Kazmi
- Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | | | | | - Dianna Ng
- Memorial Sloan Kettering Cancer Center, New York City, NY, USA
| | - Szeyi Ng
- The Institute of Cancer Research, London, UK
| | | | - William E Rosa
- Memorial Sloan Kettering Cancer Center, New York City, NY, USA
| | | | | | | | | | | | - Cynthia Villarreal-Garza
- Breast Cancer Center, Hospital Zambrano Hellion TecSalud, Tecnologico de Monterrey, Monterrey, Mexico
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Hesmert D, Klocke C, Stolz R, Huber R, Samstag Y, Hübner K, Simmet T, Syrovets T, Joos S, Valentini J. Exploring the gap: attitudes, knowledge, and training needs in complementary and integrative medicine among healthcare professionals at German university hospitals. Front Med (Lausanne) 2024; 11:1408653. [PMID: 38784234 PMCID: PMC11111851 DOI: 10.3389/fmed.2024.1408653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 04/23/2024] [Indexed: 05/25/2024] Open
Abstract
Introduction The use of Complementary and Integrative Medicine (CIM) is very popular among the general population in Germany. However, international studies show that nurses, physicians, and other health care professionals (HCPs) at hospitals often do not feel sufficiently informed about different CIM approaches. Moreover, they do not feel trained enough to counsel their patients appropriately. In the German-speaking context, particularly within university hospitals, research on this subject is scarce. Therefore, the aim of this explorative study was to evaluate attitudes, subjective knowledge, and needs regarding CIM among HCPs with direct patient interaction across all four university hospitals in the federal state of Baden-Württemberg, Germany (Tübingen, Ulm, Freiburg, Heidelberg). Methods The multicenter, cross-sectional, anonymous full survey was conducted online using a self-developed, semi-structured, web-based questionnaire. Recruitment took place via all-inclusive e-mail distribution lists of all four university hospitals. Results A total of n = 2,026 participants (response rate varied by location from about 5 to 14%) fully answered the questionnaire. Nurses constituted the largest professional group (n = 1,196; 59%), followed by physicians (n = 567; 28%), physiotherapists (n = 54), psychologists (n = 48), midwives (n = 37), and other professions (n = 124). More than two-thirds (71%, n = 1,437) of the participants were female and 14% (n = 286) reported additional training in CIM. The overall attitude toward CIM (10-point Likert scale, 10 = "very favorable") was clearly positive (M ± SD: 7.43 ± 2.33), with notable differences between professional groups: midwives (9.05 ± 1.18), physiotherapists (8.44 ± 1.74), and nurses (8.08 ± 1.95) expressed the highest support, whereas physicians (5.80 ± 2.39) the lowest. 42% of the participants incorporated CIM in patient care (from 33% of physicians to 86% of midwives). Overall, relaxation therapy (n = 1,951; 96%), external applications (n = 1,911; 94%), massage (n = 1,836; 91%), and meditation/mindfulness (n = 1,812; 89%) were rated as useful or rather useful for patients. The average self-assessed knowledge level about CIM was moderate (M ± SD: 5.83 ± 2.03). Most of the participants found CIM training at university hospitals important and saw research about CIM as one of the tasks of university hospitals. The participants expressed the highest interest in education for acupuncture/acupressure, relaxation therapies, and manual medicine. Discussion This comprehensive survey of health care professionals (HCPs) at university hospitals in Germany reveals a clearly positive disposition toward CIM, aligning with findings from other hospital-based surveys and highlighting differences among professional groups. While most therapies deemed beneficial for patient care are supported by positive evidence, further research is required for others. Given the average self-reported knowledge of CIM, targeted education is essential to meet the needs of both HCPs and patients and to ensure the provision of evidence-based information on the risks and benefits of CIM.
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Affiliation(s)
- Daniela Hesmert
- Institute of General Practice and Interprofessional Care, University Hospital and Faculty of Medicine, Tübingen, Germany
| | - Carina Klocke
- Institute of General Practice and Interprofessional Care, University Hospital and Faculty of Medicine, Tübingen, Germany
| | - Regina Stolz
- Institute of General Practice and Interprofessional Care, University Hospital and Faculty of Medicine, Tübingen, Germany
| | - Roman Huber
- Center for Complementary Medicine, Department of Medicine II, Medical Center, Faculty of Medicine – University of Freiburg, Freiburg im Breisgau, Germany
| | - Yvonne Samstag
- Section of Molecular Immunology, Institute of Immunology, Heidelberg University Hospital, Heidelberg, Germany
| | - Katrin Hübner
- Section of Molecular Immunology, Institute of Immunology, Heidelberg University Hospital, Heidelberg, Germany
| | - Thomas Simmet
- Institute of Experimental and Clinical Pharmacology, Toxicology, and Pharmacology of Natural Products, Ulm University, Ulm, Germany
| | - Tatiana Syrovets
- Institute of Experimental and Clinical Pharmacology, Toxicology, and Pharmacology of Natural Products, Ulm University, Ulm, Germany
| | - Stefanie Joos
- Institute of General Practice and Interprofessional Care, University Hospital and Faculty of Medicine, Tübingen, Germany
| | - Jan Valentini
- Institute of General Practice and Interprofessional Care, University Hospital and Faculty of Medicine, Tübingen, Germany
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Fournier V, Varet F. Conspiracy beliefs and intention to use conventional, complementary and alternative medicines: Two vignette studies. Br J Health Psychol 2024; 29:333-350. [PMID: 37880094 DOI: 10.1111/bjhp.12702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 09/08/2023] [Accepted: 10/05/2023] [Indexed: 10/27/2023]
Abstract
OBJECTIVE Conspiracy beliefs (CBs) can have substantial consequences on health behaviours by influencing both conventional and non-conventional medicine uptake. They can target powerful groups (i.e. upward CBs) or powerless groups (i.e. downward CBs). Considering their repercussions in oncology, it appears useful to understand how CBs are related to the intentions to use conventional, complementary and alternative medicines (CAM). DESIGN AND METHODS This paper includes two pre-registered online correlational studies on a general French population (Study 1 N = 248, recruited on social media Mage = 40.07, SDage = 14.78; 205 women, 41 men and 2 non-binaries; Study 2 N = 313, recruited on social media and Prolific, Mage = 28.91, SDage = 9.60; 154 women, 149 men and 10 non-binaries). We investigated the links between generic and chemotherapy-related CBs and intentions to use conventional, complementary and alternative medicines. Study 2 consisted of a conceptual replication of Study 1, considering the orientation of CBs. RESULTS Generic CBs and chemotherapy-related CBs appear strongly and positively correlated, negatively correlated with intentions to take conventional medicine and positively with intentions to take CAM. The link between generic CBs and medication intention is fully mediated by chemotherapy-related CBs. When distinguished, upward CBs are a stronger predictor of chemotherapy-related CBs than downward CBs. CONCLUSIONS The findings suggest that intentions to use medicine are strongly associated with CBs. This has several important implications for further research and practice, notably on the presence and effects of CBs on medication behaviours in cancer patients.
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Affiliation(s)
- Valentyn Fournier
- CNRS, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, Université de Lille, Lille, France
- ULR 4072 - PSITEC - Psychologie: Interactions, Temps, Emotions, Cognition, Université de Lille, Lille, France
| | - Florent Varet
- Anthropo-Lab, ETHICS EA7446, Lille Catholic University, Lille, France
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6
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Fabi A, Rossi A, Mocini E, Cardinali L, Bonavolontà V, Cenci C, Magno S, Barberi V, Moretti A, Besharat ZM, Iolascon G, Baldari C, Ferretti E, Botticelli A, Paris I, Scambia G, Migliaccio S. An Integrated Care Approach to Improve Well-Being in Breast Cancer Patients. Curr Oncol Rep 2024; 26:346-358. [PMID: 38400984 PMCID: PMC11021235 DOI: 10.1007/s11912-024-01500-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2024] [Indexed: 02/26/2024]
Abstract
BACKGROUND Breast cancer (BC) treatment has recently been revolutionized by the introduction of newer targeted agents, that helped tailoring therapies around the single patient. Along with increased survival rates, a careful evaluation of diet, lifestyle habits, physical activity, emotional and psychological experiences linked to the treatment journey, is now mandatory. However, a true proposal for an omnicomprehensive and "integrative" approach is still lacking in literature. METHODS A scientific board of internationally recognized specialists throughout different disciplines designed a shared proposal of holistic approach for BC patients. RESULTS A narrative review, containing information on BC treatment, endocrinological and diet aspects, physical activity, rehabilitation, integrative medicine, and digital narrative medicine, was developed. CONCLUSIONS In the context of a patient-centered care, BC treatment cannot be separated from a patient's long-term follow-up and care, and an organized interdisciplinary collaboration is the future in this disease's cure, to make sure that our patients will live longer and better. TRIAL REGISTRATION NCT05893368: New Model for Integrating Person-based Care (PbC) in the Treatment of Advanced HER2-negative Breast Cancer (PERGIQUAL). Registration date: 29th May 2023.
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Affiliation(s)
- Alessandra Fabi
- Precision Medicine Unit in Senology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy.
| | - Alessandro Rossi
- Precision Medicine Unit in Senology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy
- Department of Movement, Human and Health Sciences, University Foro Italico of Rome, Rome, Italy
| | - Edoardo Mocini
- Department of Experimental Medicine, University Sapienza of Rome, Rome, Italy
| | - Ludovica Cardinali
- Department of Experimental Medicine, University Sapienza of Rome, Rome, Italy
- Bone Metabolic Diseases Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Valerio Bonavolontà
- Department of Biotechnological and Applied Clinical Science, University of L'Aquila, L'Aquila, Italy
| | | | - Stefano Magno
- Center for Integrative Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Vittoria Barberi
- Medical Oncology 1, Regina Elena National Cancer Institute IRCCS, Rome, Italy
| | - Antimo Moretti
- Multidisciplinary Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | | | - Giovanni Iolascon
- Multidisciplinary Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Carlo Baldari
- Department of Theoretical and Applied Sciences, eCampus University, Rome, Italy
| | - Elisabetta Ferretti
- Department of Experimental Medicine, University Sapienza of Rome, Rome, Italy
| | - Andrea Botticelli
- Department of Radiological, Oncological and Pathological Sciences, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Ida Paris
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giovanni Scambia
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Silvia Migliaccio
- Department of Movement, Human and Health Sciences, University Foro Italico of Rome, Rome, Italy
- Department of Experimental Medicine, University Sapienza of Rome, Rome, Italy
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Dürsch H, Boltenhagen U, Mahler C, Joos S, Szecsenyi J, Klafke N. A Qualitative Analysis of Cancer Patients' Perceptions of an Interprofessional Counseling Service on Complementary and Integrative Healthcare. QUALITATIVE HEALTH RESEARCH 2024:10497323241231530. [PMID: 38441438 DOI: 10.1177/10497323241231530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/10/2024]
Abstract
Medical guidelines recommend actively addressing patients' information needs regarding complementary and integrative healthcare (CIH). Within the CCC-Integrativ study, an interprofessional counseling program on CIH was developed and implemented at four comprehensive cancer centers (CCCs) in Germany. As part of the process evaluation, this study examines cancer patients' experiences with interprofessional CIH counseling sessions conducted by a physician and a nurse. Forty problem-centered interviews were conducted using a semi-structured interview guide. All interviews were audio-recorded, transcribed verbatim, and analyzed using deductive-inductive content analysis based on Kuckartz and Rädiker's approach. Findings revealed that most participants had prior experience with CIH approaches and were burdened by physiological and psychological symptoms. Counseling sessions focused on cancer- and treatment-related symptoms and appropriate CIH recommendations (e.g., herbal poultice against anxieties and acupressure against nausea). Participants appreciated the mutual exchange and integration of perspectives from different healthcare professions within the interprofessional approach. They noted that the counseling team comprehensively addressed their healthcare and CIH information needs. Suggestions for improvement included the specificity of the CIH recommendations. As the participants only received counseling and no CIH treatments, information about reputable CIH providers was particularly important to many seeking advice. Patients with cancer receiving tailored CIH counseling from two healthcare professionals experienced benefits in CIH counseling for symptom management. The interprofessional teams offered a comprehensive perspective on patients' needs, proposing personalized recommendations for symptom control. These insights may foster collaboration between healthcare professionals interested in CIH counseling, enabling them to expand and consolidate their counseling services.
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Affiliation(s)
- Helena Dürsch
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Ursula Boltenhagen
- Department of Nursing Science, University Hospital Tuebingen, Tuebingen, Germany
| | - Cornelia Mahler
- Department of Nursing Science, University Hospital Tuebingen, Tuebingen, Germany
| | - Stefanie Joos
- Institute of General Practice and Interprofessional Care, University Hospital Tuebingen, Tuebingen, Germany
| | - Joachim Szecsenyi
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Nadja Klafke
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
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Robison JG, Walter T, Godsey JA, Robinson J. Chairside Yoga Therapy Alleviates Symptoms in Patients Concurrently Receiving Outpatient Cancer Infusions: A Promising Feasibility Study. J Holist Nurs 2024; 42:64-78. [PMID: 37128683 DOI: 10.1177/08980101231170482] [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] [Indexed: 05/03/2023]
Abstract
Purpose: To evaluate effectiveness of chairside yoga therapy on perceptions of fatigue, pain, nausea, anxiety, and distress among oncology patients concurrently receiving outpatient cancer infusion therapy. Design: This prospective pilot study used pre-/post-survey design in convenience sample of cancer patients in outpatient setting. Methods: Researchers developed and administered the Outpatient Cancer Symptom Assessment Scale (OCSAS) comprised of cancer- or treatment-related symptoms commonly reported in the oncology population (nausea, pain, fatigue, anxiety, and distress). Following IRB approval, symptoms were rated using Likert scale of 0 (not present) to 10 (severe) before and after chairside yoga therapy delivered concurrently with outpatient infusions. Qualitative data was collected related to patients' overall infusion experience. Findings: Participants (n = 82) reported positive patient experiences and statistically less pain (p < 0.001), fatigue (p < 0.001), anxiety (p < 0.001), and distress (p < 0.001) following the yoga intervention compared to baseline. Nausea was not significantly impacted by the yoga intervention. Conclusions: Yoga therapy received concurrently during outpatient cancer infusion is consistent with a holistic and integrative approach to care for the oncology population. Yoga therapy offers promise for reducing symptoms which negatively impact quality of life, including pain, fatigue, anxiety, and distress. Qualitative data suggests patients' overall infusion experience was enhanced with yoga therapy.
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9
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Yousefi M, Reihani H, Heydari M, Nasimi Doost Azgomi R, Hashempur MH. Complementary and alternative medicine use among cancer patients in Iran: A systematic review. Prev Med Rep 2024; 39:102644. [PMID: 38384965 PMCID: PMC10879774 DOI: 10.1016/j.pmedr.2024.102644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 12/27/2023] [Accepted: 02/04/2024] [Indexed: 02/23/2024] Open
Abstract
Background Cancer patients frequently turn to complementary and alternative medicine (CAM) to mitigate the adverse effects of conventional cancer treatments, alleviate stress, manage comorbidities, and address the cancer itself. This systematic review aims to investigate descriptive studies conducted in Iran, focusing on the prevalence and methods of CAM use among cancer patients. Methods A thorough search of PubMed, Scopus, Google Scholar, Web of Science, Magiran, and the Scientific Information Database (SID) was conducted in both English and Persian from inception to July 2023. Inclusion criteria targeted studies exploring the frequency and patterns of CAM utilization among Iranian patients across diverse cancer types. Results A total of 604 articles were found in the preliminary search, and 14 were included in this review. Among the 3,990 participants in the included studies, a weighted average of 51.83% (range 4.6%-100%) had used at least one CAM method. The most commonly used CAM methods were prayer (41.8%), medicinal herbs (30.1%), traditional and folk treatments (27.2%), bloodletting (17.3%), and hydrotherapy (13%). Patients reported using CAM for various reasons, including their beliefs, desire to cure the disease, reduce stress, positive past experiences, and improve physical condition. On average, 39% of patients informed their physicians about their CAM use. Conclusion The findings underscore the relatively prevalent adoption of CAM by Iranian cancer patients. Given the low rate of disclosure to physicians, there is a compelling need for healthcare system vigilance and monitoring to ensure comprehensive patient care.
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Affiliation(s)
- Mohammad Yousefi
- Student Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hamid Reihani
- Student Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mojtaba Heydari
- Poostchi Ophthalmology Research Center, Department of Ophthalmology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ramin Nasimi Doost Azgomi
- Traditional Medicine and Hydrotherapy Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Mohammad Hashem Hashempur
- Research Center for Traditional Medicine and History of Medicine, Department of Persian Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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El Toum Y, Costa T, El Toum E, Haddad T, Salameh P, El Karak F, Ghosn M, Nasr F, Chahine G, Kattan J, Kourie HR. Supplement use and its impact on daily life of cancer patients: a cross-sectional study. Support Care Cancer 2024; 32:172. [PMID: 38379082 DOI: 10.1007/s00520-024-08380-y] [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] [Received: 09/02/2023] [Accepted: 02/12/2024] [Indexed: 02/22/2024]
Abstract
PURPOSE This cross-sectional study aimed to investigate the prevalence and characteristics of supplement usage among cancer patients and explore its potential associations with anxiety, excessive daytime sleepiness, and overall quality of life. METHODS Cancer patients receiving specific care at Hôtel Dieu de France University Hospital, Beirut, were enrolled between April and June 2023. In face-to-face interviews, participants were asked to complete a questionnaire consisting of sociodemographic information, supplement usage details, and cancer-related variables. Three validated surveys (Epworth Sleepiness Scale, GAD-7, and EORTC-QLQ-C15-PAL) were employed to assess excessive daytime sleepiness, anxiety, and overall quality of life. Statistical analyses, including chi-square tests, t-tests, and multiple regression models, were conducted to examine associations between supplement use and other variables. RESULTS A total of 202 participants were interviewed. Fifty-two percent reported regular use of supplements following their cancer diagnosis, with vitamin D being the most commonly used supplement. Using multivariate logistic regression, supplement use was associated with being female, having lower educational levels, having a longer duration since cancer diagnosis, and having a poor overall quality of life. The multivariate logistic regression showed no significant correlation between supplement use and excessive daytime sleepiness and anxiety. CONCLUSION This study highlights a high prevalence of supplement usage among cancer patients in Lebanon, indicating a rising interest in alternative therapies aimed at enhancing quality of life. Larger prospective studies are needed to assess the relation between supplement intake and excessive daytime sleepiness and anxiety and establish clear guidelines pertaining to supplement use in cancer patients.
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Affiliation(s)
- Youssef El Toum
- Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon.
| | - Tarek Costa
- Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Elissa El Toum
- Faculty of Medical Sciences, Lebanese University, Hadat, Lebanon
| | - Tina Haddad
- Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Pascale Salameh
- Faculty of Medical Sciences, Lebanese University, Hadat, Lebanon
| | - Fady El Karak
- Hematology-Oncology Department, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Marwan Ghosn
- Hematology-Oncology Department, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Fady Nasr
- Hematology-Oncology Department, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Georges Chahine
- Hematology-Oncology Department, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Joseph Kattan
- Hematology-Oncology Department, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Hampig Raphael Kourie
- Hematology-Oncology Department, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
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11
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Giridharan S, Pandiyan B, Kumar NV, Soumian S. Effects of Pranayama on Cancer Patients: A Narrative Review of Clinical Outcomes. Cureus 2024; 16:e54688. [PMID: 38524027 PMCID: PMC10960562 DOI: 10.7759/cureus.54688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2024] [Indexed: 03/26/2024] Open
Abstract
Pranayama, a set of yogic breathing techniques, is being studied as a potential supportive care option for cancer patients. This review intends to evaluate the effectiveness of Pranayama in enhancing the quality of life and well-being of cancer patients based on evidence from randomized controlled trials. We thoroughly searched databases for studies published between 2013 and 2023. We focused on randomized controlled trials that compared Pranayama interventions with non-yoga control groups. We assessed the primary outcomes, including psychological well-being, quality of life, physiological parameters, and treatment-related side effects. The review indicates that practicing Pranayama can lead to significant improvements in antioxidant levels, stress, anxiety, sleep quality, and overall quality of life for cancer patients. However, the evidence comes from a limited number of studies, which vary in sample sizes and methodologies. Pranayama shows promise as a complementary therapy for cancer patients, potentially enhancing their well-being and quality of life. Nonetheless, the current evidence base is limited, necessitating further research with larger sample sizes and more rigorous study designs to confirm these findings and elucidate the underlying mechanisms.
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Affiliation(s)
| | - Bhuvana Pandiyan
- Psychiatry Department, Worcestershire and Herefordshire Health and Care NHS Trust, Hereford, GBR
| | | | - Soni Soumian
- General Surgery Department, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, GBR
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12
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Raiber L, Raff C, Thiele J, Kramer K. Integrative Nursing Interventions for Cancer-Related Symptoms in Oncology Inpatients: Results of a Descriptive Pilot Study. Integr Cancer Ther 2024; 23:15347354241239930. [PMID: 38680047 PMCID: PMC11057344 DOI: 10.1177/15347354241239930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 02/05/2024] [Accepted: 03/01/2024] [Indexed: 05/01/2024] Open
Abstract
BACKGROUND Integrative nursing (IN) is an essential component of integrative medicine and integrative oncology. IN includes a range of external naturopathic, integrative nursing interventions, such as compresses, embrocation, and foot/hand baths, aimed at alleviating symptoms and side effects of conventional treatment. The project IMPLEMENT-UKU ("Implementation of IN at the University Hospital Ulm") was accompanied by a descriptive pilot study on the use of IN interventions on cancer-related symptoms in oncology inpatients, the characterization of these patients and the evaluation of the impact. METHODS A single-arm study was conducted using a paper-based questionnaire administered before the IN interventions (t0) and 24 hours after the IN interventions (t1). Topics included sociodemographic data, symptoms, quality of life, health status, psychological burden, attitudes, and experience and satisfaction with the IN interventions. Analyses were descriptive using absolute and relative frequencies. RESULTS During the 6-month study period out of 66 patients recommended for IN consultation by medical and nursing staff on 2 wards, 62 (93.9%) accepted the offer. Of those patients who received IN, 21 patients (33.9%) participated in the study. The number of IN interventions received per patient ranged from 1 to 3 during the 24-hour survey period. And a total of 36 IN interventions were performed: The most treated body region was the feet/legs (50.0%), followed by the back (25.0%), using oils such as solum oil (41.7%) and lavender oil (13.9%). Embrocation (77.8%) was the predominant type of IN intervention. For patients, the mean FACIT-F score was 29.2 ± 12.5. The mean PHQ-4 score was 3.0 ± 1.9. Regarding sleep quality in the last 4 weeks, 13 participants (61.9%) described it as rather or very poor. Satisfaction with the IN was high, with a large proportion of participants evaluating the IN interventions very positively. CONCLUSION The study's findings suggest that there is a great need for IN among oncology inpatients. These patients are open to and interested in IN interventions and evaluate them positively. IN provides a promising opportunity to provide non-pharmacological support to inpatients. The integration of IN in conventional oncology care settings may enhance patient-centered care and contribute to improved patient wellbeing.
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Affiliation(s)
- Lea Raiber
- University Hospital Ulm, Ulm, Germany
- Interprofessional Graduate School for Integrative Medicine and Health, Witten/Herdecke University, Germany
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13
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Ortiz M, Schröder ML, Brinkhaus B, Stöckigt B. Implementation of a Mindful Walking Intervention in Breast Cancer Patients After Their Primary Oncologic Treatment: Results of a Qualitative Study Within a Randomized Controlled Trial. Integr Cancer Ther 2024; 23:15347354241237972. [PMID: 38654515 PMCID: PMC11041535 DOI: 10.1177/15347354241237972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 02/06/2024] [Accepted: 02/20/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Breast cancer survivors often suffer from diagnosis- and therapy-related long-term side effects, such as cancer related fatigue, restricted stress resilience and quality of life. Walking as a physical activity and mindfulness practice have been shown to be helpful in studies. The aim of this study was to compare the individual experiences and subjectively perceived effects of walking in combination with mindfulness practice with moderate walking alone in breast cancer patients. This paper focuses on the qualitative results of a mixed-methods pilot study. METHODS Breast cancer patients who had finished their primary oncologic treatment at least 6 months ago were randomized to an 8-week group intervention program of either mindful walking or moderate walking. Within the qualitative study part, semi-structured focus group interviews (2 interviews per study arm) were conducted and analyzed using a qualitative content analysis approach. Audio recorded interviews were transcribed verbatim and pseudonymized. The subsequent data analysis was performed by using MAXQDA®. RESULTS A total of 51 women (mean age 55.8 [SD 10.9] years) were included in the RCT, among these 20 (mean age 56.7 [SD 12.0] years) participated in the focus group interviews (n = 11 patients of the mindful walking group; n = 9 patients of the walking group). Breast cancer patients in both groups described different effects in the complex areas of self-efficacy, coping, body awareness and self-reflection. While mindful walking primarily promoted body awareness and inner strength by mindfulness in breast cancer patients, moderate walking promoted self-efficacy by a confidence of their body and an easily integrated and accepted way of physical activity. CONCLUSIONS Study interventions and the study setting triggered processes and reflections on one's own health and situation. However, mindful walking and moderate walking seem to address different resources. This important knowledge may help oncologists and other therapists to assess what type of interventions can best meet the needs and requirements of individual patients. TRIAL REGISTRATION DKRS00011521; prospectively registered 21.12.2016; https://drks.de/search/de/trial/DRKS00011521.
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Affiliation(s)
- Miriam Ortiz
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin, Germany
| | - Maren Luise Schröder
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin, Germany
| | - Benno Brinkhaus
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin, Germany
| | - Barbara Stöckigt
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin, Germany
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Lee JY, Jin H, Park SB, Kim EH, Yoon JH, Yoon SW. A Prospective Multi-Centered Registry-Based Observational Study for Patients With Cancer: Design and Rationale for Korean Medicine Cancer Registry (KMCARE). Integr Cancer Ther 2024; 23:15347354231223496. [PMID: 38178547 PMCID: PMC10768608 DOI: 10.1177/15347354231223496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 08/11/2023] [Accepted: 12/13/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND Cancer is one of the leading causes of death in most countries with an expected increased burden on healthcare systems. Since integrative medical treatments are not collected within the scope of existing cancer registries, the establishment of the Korean Medicine Cancer Registry (KMCARE), gathering integrative therapies, including conservative care and Korean medicine, is warranted. METHODS A prospective observational study based on the registry will be conducted in 5 Korean medical hospitals. A total of 650 eligible participants undergoing Korean medicine treatments within 1 month of a diagnosis of lung, colorectal, stomach, or breast cancer are anticipated to be enrolled in the registry. Data collected in the KMCARE can be classified into patient information, received treatments, and outcomes. The primary outcome is the Functional Assessment of Cancer Therapy-General Questionnaire score at 3 months. Secondary outcomes include the MD Anderson Symptom Inventory-Core and the Body Constitution Questionnaire at 3 and 6 months. After 6 months of follow-up periods, survival surveillance will be continued for additional 18 months. Descriptive and statistical analysis of primary and secondary outcomes, baseline data, safety, survival, and prognostic factors will be performed. DISCUSSION This is the first prospective, multi-centered, registry-based observational study of cancer patients in Korean medicine hospitals, which could reveal the current status of cancer patients receiving integrative cancer therapies, and provide better insight into the role of Korean medicine in palliative care for patients with cancer. TRIAL REGISTRATION Clinical Research Information Service (CRIS), KCT0007447.
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Affiliation(s)
| | - Hayun Jin
- Department of Clinical Korean Medicine, College of Korean Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Su Bin Park
- Department of Korean Internal Medicine, Kyung Hee University Hospital at Gangdong, Gangdonggu, Seoul, Republic of Korea
| | - Eun Hye Kim
- Department of Clinical Korean Medicine, College of Korean Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Jee-Hyun Yoon
- Department of Korean Internal Medicine, Kyung Hee University Hospital at Gangdong, Gangdonggu, Seoul, Republic of Korea
| | - Seong Woo Yoon
- Department of Korean Internal Medicine, Kyung Hee University Hospital at Gangdong, Gangdonggu, Seoul, Republic of Korea
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Schils A, Lechon AS, Rondeaux S, Souard F, Van Laethem JL, Pochet S, Mathieu V, De Vriese C. Cancer patients' behaviors and attitudes toward natural health products. BMC Complement Med Ther 2023; 23:442. [PMID: 38057795 DOI: 10.1186/s12906-023-04278-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 11/28/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND Natural health products (NHPs), including vitamins, minerals, and herbal supplements, are the most common complementary and alternative medicine (CAM) among cancer patients. Our survey determined the attitudes and behaviors of cancer patients toward natural complementary therapies that should be considered to implement an integrative approach in the future. METHODS Our survey was conducted in four hospitals in Belgium. Questionnaires were posted online from October 2020 to October 2021 for cancer patients. Descriptive statistics were used to analyze the data. A [Formula: see text] test was applied to study the type of NHP consumed according to diagnosis time. Fischer's exact test compared patients who had changed their consumption since diagnosis and those who had not. RESULTS Out of 349 questionnaires collected, only 59 met all inclusion criteria. 83.1 % of the patients agreed that conventional medicine (CM) could benefit from complementary therapies, but they did not estimate (72.3 % of the patients) that those latter are more effective than conventional medicine. More than half of the patients used five or more NHPs. The most frequent NHPs consumed daily were vitamins (64.4 %), followed by other products (i.e., probiotics, gemmotherapy, birch sap and omega 3/6) (42.4 %) and herbs (40.7 %). Almost all patients started taking NHPs before their cancer diagnosis, but 72.7 % have changed their consumption significantly (p = 0.009) since their diagnosis. Boosting the immune system (79.7 %) and limiting conventional treatment side effects (76.9 %) were the most common reasons for NHPs' use. 74.4 % of the patients did not take complementary therapies to delay or avoid conventional treatment. CONCLUSIONS The combination and high diversity of NHPs consumption highlight the importance of educating patients and healthcare providers (HCPs) about the risk of drug interactions associated with these natural products. Most cancer patients are more interested in using this non-mainstream medicine to complement their conventional treatment than as an alternative. Knowing the patients' reasons and understanding patients' attitudes toward NHPs will be essential for HCPs to address NHPs' use.
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Affiliation(s)
- Audrey Schils
- Department of Pharmacotherapy and Pharmaceutics, Faculté de Pharmacie, Université Libre de Bruxelles (ULB), Boulevard du Triomphe 9040, 1050, Brussels, Belgium
| | - Anne-Sophie Lechon
- Department of Pharmacotherapy and Pharmaceutics, Faculté de Pharmacie, Université Libre de Bruxelles (ULB), Boulevard du Triomphe 9040, 1050, Brussels, Belgium
| | - Sarah Rondeaux
- Department of Pharmacotherapy and Pharmaceutics, Faculté de Pharmacie, Université Libre de Bruxelles (ULB), Boulevard du Triomphe 9040, 1050, Brussels, Belgium
| | - Florence Souard
- Department of Pharmacotherapy and Pharmaceutics, Faculté de Pharmacie, Université Libre de Bruxelles (ULB), Boulevard du Triomphe 9040, 1050, Brussels, Belgium
| | - Jean-Luc Van Laethem
- Department of Gastroenterology and Digestive Oncology, Erasme University Hospital, Université Libre de Bruxelles (ULB), Route de Lennik 808, 1070, Brussels, Belgium
| | - Stephanie Pochet
- Department of Pharmacotherapy and Pharmaceutics, Faculté de Pharmacie, Université Libre de Bruxelles (ULB), Boulevard du Triomphe 9040, 1050, Brussels, Belgium
| | - Veronique Mathieu
- Department of Pharmacotherapy and Pharmaceutics, Faculté de Pharmacie, Université Libre de Bruxelles (ULB), Boulevard du Triomphe 9040, 1050, Brussels, Belgium
| | - Carine De Vriese
- Department of Pharmacotherapy and Pharmaceutics, Faculté de Pharmacie, Université Libre de Bruxelles (ULB), Boulevard du Triomphe 9040, 1050, Brussels, Belgium.
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Wang M, Xu Y, Wu Y, Liu C, Chen Y, Hua D, Liu Q. Evaluating the efficacy of auricular acupuncture for chemotherapy-induced taste alterations: A pilot randomized controlled trial. Eur J Oncol Nurs 2023; 67:102458. [PMID: 37951073 DOI: 10.1016/j.ejon.2023.102458] [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] [Received: 08/01/2023] [Revised: 10/06/2023] [Accepted: 10/27/2023] [Indexed: 11/13/2023]
Abstract
PURPOSE Irrespective of the development of acupuncture-based interventions, clinical evidence regarding their efficacy remains controversial owing to issues with the study design and an unclear risk of bias. This study aimed to evaluate the efficacy of auricular acupuncture in managing taste alterations in patients with cancer undergoing platinum-based chemotherapy. METHODS We conducted a pilot randomized controlled trial involving 73 patients randomly assigned to an auricular acupuncture or a control group. The primary outcome was the severity of chemotherapy-induced taste alterations, and the secondary outcomes included quality of life and negative emotions of the patients. RESULTS A total of 49 participants completed the study. Compared to the control group, patients in the auricular acupuncture group showed significant reductions in discomfort, general taste alterations, and total scores on the Chemotherapy-induced Taste Alteration Scale (all p < 0.05). Furthermore, we observed significant improvements in quality of life, including physical function (p = 0.007), role function (p = 0.006), emotional function (p = 0.016), nausea and vomiting (p = 0.021), appetite loss (p = 0.046), and significant improvements in anxiety and depression (p < 0.01). CONCLUSIONS Our findings suggest that auricular acupuncture may be a beneficial intervention for managing chemotherapy-induced taste alterations in patients with cancer receiving platinum-based chemotherapy. It may also contribute to improvements in quality of life and negative emotions. However, these results are preliminary, and further evaluation with larger randomized controlled trials is necessary.
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Affiliation(s)
- Meng Wang
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China.
| | - Yongping Xu
- Department of Oncology, Affiliated Hospital of Jiangnan University, Wuxi, China.
| | - Yaoyao Wu
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China.
| | - Chao Liu
- Department of Epidemiology and Statistics, Bengbu Medical College, Bengbu, China.
| | - Ying Chen
- Department of Oncology, Affiliated Hospital of Jiangnan University, Wuxi, China.
| | - Dong Hua
- Department of Oncology, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, China.
| | - Quan Liu
- Department of Oncology, Affiliated Hospital of Jiangnan University, Wuxi, China.
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Shalgouny M, Bertz-Lepel J, Fischer V Weikersthal L, Herbin J, Meier-Höfig M, Mücke R, Rohe U, Stauch T, Stoll C, Troeltzsch D, Wittmann S, Kurz O, Naumann R, Huebner J. Introducing a standardized assessment of patients' interest in and usage of CAM in routine cancer care: chances and risks from patients' and physicians' point of view. J Cancer Res Clin Oncol 2023; 149:16575-16587. [PMID: 37715831 PMCID: PMC10645655 DOI: 10.1007/s00432-023-05182-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 07/12/2023] [Indexed: 09/18/2023]
Abstract
BACKGROUND Cancer patients often use complementary and alternative medicine (CAM), however, standardized assessment in clinical routine is missing. The aim of this study was to evaluate a screening questionnaire on CAM usage that was published in the S3 Guideline Complementary Medicine in the Treatment of Oncological Patients. METHODS We developed a survey questionnaire to assess the practicability of the guideline questionnaire and communication on CAM between health care providers (HCPs) and patients. We collected 258 guideline questionnaires and 116 survey questionnaires from ten clinics and held twelve semi-structured interviews with HCPs. RESULTS 85% used at least one of the listed CAM methods, 54 participants (N = 77) never disclosed usage to a physician. The most frequently used CAM methods were physical activity (76.4%) and vitamin D (46.4%). 25.2% used at least one method, that was labeled risky by the guideline. 53.4% did not know of CAM's risk of interactions and side effects. Introducing the guideline questionnaire in routine cancer care increased the rate of patients talking to an HCP regarding CAM significantly from 35.5 to 87.3%. The HCPs stated positive effects as an initiation of conversation, increased safety within CAM usage and patients feeling thankful and taken seriously. However, due to the limited amount of time available for discussions on CAM, generalized distribution to all patients was not feasible. CONCLUSION Institutions should focus on implementing standard procedures and resources that help HCPs discuss CAM on a regular basis. HCPs should meet the patient's demands for CAM counseling and make sure they are equipped professionally.
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Affiliation(s)
- M Shalgouny
- Klinik für Innere Medizin II, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Germany.
| | - J Bertz-Lepel
- Klinik für Hämatologie, Helios Klinikum Bad Saarow, Bad Saarow, Germany
| | - L Fischer V Weikersthal
- Praxis für Hämatologie und Internistische Onkologie, Gesundheitszentrum St. Marien GmbH, Amberg, Germany
| | - J Herbin
- Onkologische Schwerpunktpraxis Berlin, Berlin, Germany
| | - M Meier-Höfig
- 3. Medizinische Klinik, Städtisches Krankenhaus Kiel, Kiel, Germany
| | - R Mücke
- MVZ Strahlentherapie RheinMainNahe GmbH, Mainz, Germany
| | - U Rohe
- St. Barbara Klinik Hamm, Hamm, Germany
| | - T Stauch
- Klinik für Onkologie, Median Adelsbergklinik Bad Berka, Bad Berka, Germany
| | - C Stoll
- Rehaklinik für Orthopädie, Klinik Herzoghöhe Bayreuth, Bayreuth, Germany
| | - D Troeltzsch
- Klinik für Mund-, Kiefer- und Gesichtschirurgie, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - S Wittmann
- Klinik für Onkologie, Hämatologie und Palliativmedizin, Helios Dr. Horst Schmidt Kliniken Wiesbaden, Wiesbaden, Germany
| | - O Kurz
- Medizinische Klinik III, Marien Kliniken Siegen, Siegen, Germany
| | - R Naumann
- Medizinische Klinik III, Marien Kliniken Siegen, Siegen, Germany
| | - J Huebner
- Klinik für Innere Medizin II, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Germany
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18
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Hunter J, Harnett JE, Chan WJJ, Pirotta M. What is integrative medicine? Establishing the decision criteria for an operational definition of integrative medicine for general practice health services research in Australia. Integr Med Res 2023; 12:100995. [PMID: 37915439 PMCID: PMC10616154 DOI: 10.1016/j.imr.2023.100995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 09/20/2023] [Accepted: 09/21/2023] [Indexed: 11/03/2023] Open
Abstract
Background Operational definitions outline how a conceptual definition will be measured for consistent, reproducible data collection and analysis. This article reports the decision criteria that will be used for an operational definition of integrative medicine (IM) in a secondary analysis of an Australian national survey of general practitioner activity. Methods A multidisciplinary team applied an iterative approach, informed by expert knowledge and literature reviews to establish decision criteria for categorizing the terms in the Australian clinical interface terminology of the International Classification of Primary Care, second edition (ICPC-2 PLUS) and the Coding Atlas for Pharmaceutical Substances, according to whether they reflected IM, conventional/mainstream medicine (MM), or both IM and MM (IM/MM). Results The final decision criteria categorized all terms for examinations, investigations, advice/counselling, and drugs with synthetic ingredients, and terms for referrals to secondary care services and healthcare practitioners that are not a traditional or complementary medicine practitioner as MM. Terms that could apply to both styles of clinical practice (e.g., preventive health, lifestyle medicine, psychosocial and some drugs with natural ingredients) were categorised as IM/MM. The remaining terms, that mostly reflected the World Health Organization's theoretical definitions of traditional and complementary medicine, were categorized as IM. Conclusion Differentiating between integrative and conventional/mainstream medicine in general practice is context specific and not always possible. The category IM/MM proposes integrative medicine as an extension, rather than an alternative. The rationale for the integrative medicine operational definition has relevance for researchers and health services in Australia, and internationally.
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Affiliation(s)
- Jennifer Hunter
- School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Australia
- Health Research Group Pty. Limited, Sydney, Australia
| | - Joanna E. Harnett
- School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Australia
| | - Wai-Jo Jocelin Chan
- School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Australia
| | - Marie Pirotta
- Department of General Practice, University of Melbourne, Melbourne, Victoria, Australia
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Casini F, Scaltrito F, Grimaldi MT, Pop TL, Calcaterra V, Zuccotti GV, Pettoello-Mantovani M, Ferrara P, Corsello G, Fabiano V. Use of complementary and alternative medicine in children affected by oncologic, neurologic and liver diseases: a narrative review. Ital J Pediatr 2023; 49:152. [PMID: 37968663 PMCID: PMC10647067 DOI: 10.1186/s13052-023-01554-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 10/20/2023] [Indexed: 11/17/2023] Open
Abstract
Complementary and alternative medicine (CAM) consist of a broad group of restorative resources often linked to existing local cultures and established health care systems and are also increasingly used in children with some serious illnesses. In this narrative review, we examine the epidemiology of the use, efficacy, and safety of complementary and alternative medicine in pediatric oncology, neurology, and hepatology. We searched for relevant articles published in Pubmed evaluating CAM use and its efficacy in safety in children affected by oncologic, neurologic and liver diseases. CAM is used to improve the success of conventional therapies, but also to alleviate the pain, discomfort, and suffering resulting from the diseases and their treatment, which are often associated with a significant burden of adverse effects. CAM use must be evaluated in children with neurological, oncological and liver diseases.
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Affiliation(s)
- Francesca Casini
- Pediatric Department, University of Milan, "V. Buzzi" Children's Hospital, 20154, Milan, Italy
| | - Francesca Scaltrito
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | | | - Tudor Lucian Pop
- 2Nd Pediatric Discipline, Department of Mother and Child, Center of Expertise in Pediatric Liver Rare Diseases, Iuliu Hatieganu University of Medicine and Pharmacy2Nd Pediatric ClinicEmergency Clinical Hospital for Children Cluj-Napoca, Cluj-Napoca, Romania
- European Pediatric Association-Union of National European Pediatric Societies and Associations, Berlin, Germany
| | - Valeria Calcaterra
- Pediatric Department, University of Milan, "V. Buzzi" Children's Hospital, 20154, Milan, Italy
- Department of Internal Medicine, University of Pavia, 27100, Pavia, Italy
| | - Gian Vincenzo Zuccotti
- Pediatric Department, University of Milan, "V. Buzzi" Children's Hospital, 20154, Milan, Italy
- Department of Biomedical and Clinical Sciences, University of Milan, 20157, Milan, Italy
| | - Massimo Pettoello-Mantovani
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
- European Pediatric Association-Union of National European Pediatric Societies and Associations, Berlin, Germany
| | - Pietro Ferrara
- Department of Medicine and Surgery, University Campus Bio-Medico, Rome, Italy
- Operative Research Unit of Pediatrics, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | | | - Valentina Fabiano
- Pediatric Department, University of Milan, "V. Buzzi" Children's Hospital, 20154, Milan, Italy.
- Department of Biomedical and Clinical Sciences, University of Milan, 20157, Milan, Italy.
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Grange C, Rioufol C, Souquet PJ, Assaad S. Anti-coagulant Treatment of Cancer-Associated Thrombosis in Frail Patients: Impact of Frailties on the Management of Drug-Drug Interactions. Clin Pharmacokinet 2023; 62:1523-1531. [PMID: 37824026 PMCID: PMC10582124 DOI: 10.1007/s40262-023-01298-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2023] [Indexed: 10/13/2023]
Abstract
Low molecular weight heparins (LMWH) and anti-Xa direct oral anti-coagulants (DOACs) are recommended for the long-term treatment of cancer-associated thrombosis (CAT) based on well-documented randomised controlled trials. Anti-Xa DOACs are viewed as a first choice for the treatment of patients with CAT. A large number of drug-drug interactions have been reported between DOACs and chemotherapy drugs, modifying circulating levels of DOAC leading to fears of increased bleeding risks or thrombotic recurrence. Progresses in anti-neoplastic therapies have improved the prognosis and the survival, thus increasing the prevalence of frail patients with cancer. However, since frailties tend to be excluded from large trials due to multiple co-morbidities, current guidelines are not fully applicable to this population. The management of these frail patients with CAT is particularly complex and requires a risk assessment on a case-by-case basis with specific focus on cancer, patient-related risk factors and drug-drug interactions. In this brief review we have identified age, co-morbidities and co-medications as key factors of frailty that require careful attention and we have developed a therapeutic decision algorithm to help clinicians optimising the use of anti-coagulants in patients with cancer with CAT, especially in case of anti-Xa DOACs concomitant medications. With the evaluation of the bleeding risk according to the type of cancer, and anticipating drug-drug interactions intensity, taking into account patient frailties allows the optimisation of the anti-coagulant choice. A systematic collaboration between oncologists, vascular pathology specialists and pharmacists is warranted to ensure an optimal patient management. Clinical studies are needed to determine the real impact of these interactions.
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Affiliation(s)
- Claire Grange
- Service de Médecine Interne-Médecine Vasculaire, Hospices Civils de Lyon, CH Lyon Sud, Lyon, France.
| | - Catherine Rioufol
- Hospices Civils de Lyon, CH Lyon Sud, Service de Pharmacie, UCBL1-EA 3738 CICLY, Lyon, France
| | - Pierre-Jean Souquet
- Service de Pneumologie et Oncologie Thoracique, Hospices Civils de Lyon, CH Lyon Sud, Lyon, France
| | - Souad Assaad
- Département d'Oncologie Médicale, Centre Léon Bérard, Lyon, France
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21
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García-Padilla P, García-Padilla D, Ramírez-Castro MF, Pulido-Rincón P, Murillo R. Patient-doctor interactions around alternative and complementary medicine in the context of oncology care in a Latin American country. Complement Ther Med 2023; 78:102986. [PMID: 37734425 DOI: 10.1016/j.ctim.2023.102986] [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] [Received: 04/28/2023] [Revised: 09/05/2023] [Accepted: 09/18/2023] [Indexed: 09/23/2023] Open
Abstract
OBJECTIVE To characterize doctor-patient communication patterns around the use of complementary and alternative medicines (CAM) in the context of oncology care in Colombia. METHODS A qualitative study was conducted using snowball sampling until data saturation was reached. We included oncology specialists and cancer patients who were in active treatment. Semi-structured interviews were conducted following a guide designed for each group of participants. An analysis based on open coding was performed to identify thematic areas. The coherence of emerging categories was verified by contrasting the data set within the content of the participants' reports and existing literature. RESULTS In total, 10 oncologists and 16 cancer patients were included, representing diverse professional fields and cancer diagnoses, respectively. Communication patterns comprise themes regarding the beginning of the interaction (i.e., patient's anticipations), the patient-doctor relationship (i.e., confidence), the characteristics of the message (i.e., synthetic vs explanatory), the communication styles (i.e., confrontational vs conciliatory), and the closing of the interaction (i.e., continuity vs. end of communication). In addition, extrinsic factors influencing communication were found to be related to participants (i.e., knowledge, cultural background) and context (i.e., institutional procedures). CONCLUSIONS The low frequency of communication contrasts to the increasing use of CAM. Divergent perspectives between doctors and patients could limit shared decision-making on the use of CAM. Enhanced knowledge and education on CAM for both actors is fundamental to improve their interaction and to move away from paternalistic and confrontational communication, particularly in a world region with cultural backgrounds that influence the use of CAM.
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Affiliation(s)
- Pilar García-Padilla
- Centro Javeriano de Oncología - Hospital Universitario San Ignacio, Bogotá, Colombia; Facultad de Psicología, Pontificia Universidad Javeriana, Bogotá, Colombia.
| | | | | | - Paula Pulido-Rincón
- Universidad Isep (Instituto Superior de Estudios Psicológicos), Sinaloa, Mexico
| | - Raúl Murillo
- Centro Javeriano de Oncología - Hospital Universitario San Ignacio, Bogotá, Colombia; Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia
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22
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Raff C, Dörr-Harim C, Otto S, Thiele J, Mihaljevic A, Kramer K. Prehabilitation in an Integrative Medicine Day Clinic for Patients Undergoing Neoadjuvant Treatment: Single-Center Feasibility Pilot Study. JMIR Res Protoc 2023; 12:e46765. [PMID: 37851493 PMCID: PMC10620634 DOI: 10.2196/46765] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 07/31/2023] [Accepted: 08/28/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND Patients with cancer receiving neoadjuvant treatment prior to surgery are in a very stressful situation. Chemotherapy and radiation therapy put a strain on the quality of life and the pending surgery poses a relevant burden for many patients. Preparation of these patients for the intervention in terms of prehabilitation has great potential to reduce the burden of postoperative complications and may improve the clinical outcome. A prehabilitation approach also yields the possibility to address unmet patients' needs and to help them modify their lifestyle in a maintainable way. Therefore, a multimodal approach is mandatory during this critical period. OBJECTIVE The aim of this study is to assess the feasibility of prehabilitation in an integrative medicine day clinic (PRIME-DC) prior to cancer surgery at a major university clinic. PRIME-DC is considered feasible if 80% of enrolled patients are willing and able to complete at least 6 out of the 8 weekly meetings, each lasting 6.5 hours, at such a clinic. Secondary end points aim to evaluate this multimodal program. METHODS The PRIME-DC intervention combines mind-body medicine, exercise therapy, nutrition therapy, naturopathic counseling, and the application of a yarrow liver compress. Adult patients with cancer, with a primary tumor in the abdomen (including intraperitoneal cancer, stomach cancer, and extraperitoneal cancers such as pancreatic, bladder, rectal, esophageal, endometrial, ovarian, and cervical cancer) or the breast requiring a neoadjuvant oncological treatment setting are eligible to participate. The addressed cancer entities imply either an extensive surgical intervention with an expected need for prehabilitation (eg, abdominal surgery) or a neoadjuvant treatment of several months with a high burden of treatment-associated side effects (breast cancer). Adherence to the day clinic program is the primary end point being defined as presence during the day clinic session. Secondary end points are physical assessment and quality of life, together with a structured assessment of neoadjuvant treatment-associated side effects. Furthermore, to collect qualitative data voluntary participants of the day clinic will be interviewed in a semistructured way after completion of the day clinic program on each component of the study (mind-body intervention, exercise, nutrition, naturopathic counseling, and a yarrow liver compress). RESULTS The procedures used in this study adhere to the tenets of the Declaration of Helsinki. As of February 2023, we enrolled 23 patients; the dominant cancer entity is breast cancer (18 enrolled patients). CONCLUSIONS The presented protocol combines prehabilitation, lifestyle modification, naturopathic counseling, dietary assistance, and naturopathic treatment in an innovative and integrative way. TRIAL REGISTRATION Deutsches Register Klinischer Studien German Clinical Trials Register DRKS00028126; https://drks.de/search/de/trial/DRKS00028126. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/46765.
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Affiliation(s)
- Christian Raff
- Department of General and Visceral Surgery, Working Group of Integrative Medicine, University Hospital Ulm, Ulm, Germany
| | - Colette Dörr-Harim
- Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Stephanie Otto
- Comprehensive Cancer Center Ulm, University Hospital Ulm, Ulm, Germany
| | - Johanna Thiele
- Department of General and Visceral Surgery, Working Group of Integrative Medicine, University Hospital Ulm, Ulm, Germany
| | - Andre Mihaljevic
- Department of General, Visceral and Transplantation Surgery, University Hospital Tübingen, Tübingen, Germany
| | - Klaus Kramer
- Department of General and Visceral Surgery, Working Group of Integrative Medicine, University Hospital Ulm, Ulm, Germany
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23
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Carlson LE, Ismaila N, Addington EL, Asher GN, Atreya C, Balneaves LG, Bradt J, Fuller-Shavel N, Goodman J, Hoffman CJ, Huston A, Mehta A, Paller CJ, Richardson K, Seely D, Siwik CJ, Temel JS, Rowland JH. Integrative Oncology Care of Symptoms of Anxiety and Depression in Adults With Cancer: Society for Integrative Oncology-ASCO Guideline. J Clin Oncol 2023; 41:4562-4591. [PMID: 37582238 DOI: 10.1200/jco.23.00857] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 05/13/2023] [Indexed: 08/17/2023] Open
Abstract
PURPOSE To provide evidence-based recommendations to health care providers on integrative approaches to managing anxiety and depression symptoms in adults living with cancer. METHODS The Society for Integrative Oncology and ASCO convened an expert panel of integrative oncology, medical oncology, radiation oncology, surgical oncology, palliative oncology, social sciences, mind-body medicine, nursing, methodology, and patient advocacy representatives. The literature search included systematic reviews, meta-analyses, and randomized controlled trials published from 1990 through 2023. Outcomes of interest included anxiety or depression symptoms as measured by validated psychometric tools, and adverse events. Expert panel members used this evidence and informal consensus with the Guidelines into Decision Support methodology to develop evidence-based guideline recommendations. RESULTS The literature search identified 110 relevant studies (30 systematic reviews and 80 randomized controlled trials) to inform the evidence base for this guideline. RECOMMENDATIONS Recommendations were made for mindfulness-based interventions (MBIs), yoga, relaxation, music therapy, reflexology, and aromatherapy (using inhalation) for treating symptoms of anxiety during active treatment; and MBIs, yoga, acupuncture, tai chi and/or qigong, and reflexology for treating anxiety symptoms after cancer treatment. For depression symptoms, MBIs, yoga, music therapy, relaxation, and reflexology were recommended during treatment, and MBIs, yoga, and tai chi and/or qigong were recommended post-treatment. DISCUSSION Issues of patient-health care provider communication, health disparities, comorbid medical conditions, cost implications, guideline implementation, provider training and credentialing, and quality assurance of natural health products are discussed. While several approaches such as MBIs and yoga appear effective, limitations of the evidence base including assessment of risk of bias, nonstandardization of therapies, lack of diversity in study samples, and lack of active control conditions as well as future research directions are discussed.Additional information is available at www.asco.org/survivorship-guidelines.
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Affiliation(s)
- Linda E Carlson
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | | | | | - Gary N Asher
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC
| | - Chloe Atreya
- University of California San Francisco, San Francisco, CA
| | | | - Joke Bradt
- Department of Creative Arts Therapies, Drexel University, Philadelphia, PA
| | | | | | | | - Alissa Huston
- University of Rochester Medical Center, Rochester, NY
| | | | - Channing J Paller
- Sidney Kimmel Comprehensive Cancer Center, John Hopkins University, Baltimore, MD
| | | | - Dugald Seely
- University of Ottawa, Ottawa, ON, Canada
- Canadian College of Naturopathic Medicine, Toronto, ON, Canada
| | - Chelsea J Siwik
- Osher Center for Integrative Health, University of California, San Francisco, San Francisco, CA
| | - Jennifer S Temel
- Massachusetts General Hospital and Harvard Medical School, Boston, MA
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24
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Ammar A, Soua A, Ezzi O, Chelly S, Ammar N, Ezzairi F, Khenissi N, Chabchoub I, Ben Ahmed S, Mahjoub M, Njah M. Complementary and alternative medicine in oncology: knowledge, attitude and practice among Tunisian healthcare workers. J Cancer Res Clin Oncol 2023; 149:11585-11594. [PMID: 37401941 DOI: 10.1007/s00432-023-05040-2] [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] [Received: 04/15/2023] [Accepted: 06/28/2023] [Indexed: 07/05/2023]
Abstract
PURPOSE Over the past years, there has been a considerable increase in complementary and alternative medicine (CAM) use among cancer patients. However, guidance from health care workers (HCWs) is not always provided. We aimed to determine the knowledge, attitude and practice of Tunisian HCWs regarding the use of CAM in cancer patients. METHODS We conducted a multicenter cross-sectional study over 5 months from February to June 2022 among HCWs caring for cancer patients in the Tunisian center region. Data were collected using a self-administered questionnaire developed by our investigators. RESULTS The level of knowledge about CAM was declared limited by 78.4% of our population. The best known CAM therapies were herbal medicine and homeopathy while chiropractic and hypnosis where the least. HCWs who had sought information on CAM represented 54.3% of our sample and the main source of information was the Internet (37.1%). A positive attitude towards the use of CAM was found in 56% of HCWs. The integration of CAM into supportive care in oncology was approved by 78% of HCWs. Concerning training on CAM, 78% declared its necessity for HCWs and 73.3% expressed a desire to have it. A personal use of CAM was found in 53% of HCWs while 38.8% had previously used CAM in the treatment of their cancer patients. CONCLUSION The majority of HCWs had a positive attitude towards the use of CAM in oncology despite their poor knowledge about it. Our study emphasizes the need to train HCWs dealing with cancer patients on CAM.
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Affiliation(s)
- Asma Ammar
- Department of Hospital Hygiene, Farhat Hached University Hospital, Sousse, Tunisia
| | - Asma Soua
- Department of Hospital Hygiene, Farhat Hached University Hospital, Sousse, Tunisia.
| | - Olfa Ezzi
- Department of Hospital Hygiene, Farhat Hached University Hospital, Sousse, Tunisia
| | - Souhir Chelly
- Department of Hospital Hygiene, Farhat Hached University Hospital, Sousse, Tunisia
| | - Nouha Ammar
- Department of Medical Oncology, Farhat Hached University Hospital, Sousse, Tunisia
| | - Faten Ezzairi
- Department of Medical Oncology, Farhat Hached University Hospital, Sousse, Tunisia
| | - Nouha Khenissi
- Higher Institute of Nursing Sciences of Sousse, Sousse, Tunisia
| | - Imene Chabchoub
- Department of Medical Oncology, Farhat Hached University Hospital, Sousse, Tunisia
| | - Slim Ben Ahmed
- Department of Medical Oncology, Farhat Hached University Hospital, Sousse, Tunisia
| | - Mohamed Mahjoub
- Department of Hospital Hygiene, Farhat Hached University Hospital, Sousse, Tunisia
| | - Mansour Njah
- Department of Hospital Hygiene, Farhat Hached University Hospital, Sousse, Tunisia
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25
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Murillo R, Pinto-Martínez N, Serrano N, Uribe C, Navarro E, Duque J, Yepes A, Olaya L, Mariño C, Morales OL, Erazo-Muñoz MA, Sánchez-Vega DC, Martínez-Ramos N. Use of complementary and alternative medicine by cancer patients in Colombia. BMC Complement Med Ther 2023; 23:321. [PMID: 37710213 PMCID: PMC10500828 DOI: 10.1186/s12906-023-04144-z] [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] [Received: 06/06/2023] [Accepted: 08/28/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUND The use of complementary and alternative medicines (CAM) among cancer patients varies greatly. The available data suggest an increasing use of CAM over time and a higher prevalence in low- and middle-income countries. However, no reliable data are available from Latin America. Accordingly, we examined the prevalence of CAM use among cancer patients from six Colombian regions. METHODS We conducted a survey on cancer patients attending comprehensive cancer centres in six capital cities from different regions. The survey was designed based on a literature review and information gathered through focus groups on CAM terminology in Colombia. Independent random samples of patients from two comprehensive cancer centres in every city were obtained. Patients 18 years and older with a histopathological diagnosis of cancer undergoing active treatment were eligible. The prevalence of CAM use is reported as a percentage with the corresponding confidence interval. CAM types are reported by region. The sociodemographic and clinical characteristics of CAM users and non-users were compared using Chi square and t tests. RESULTS In total, 3117 patients were recruited. The average age 59.6 years old, and 62.8% were female. The prevalence of CAM use was 51.7%, and compared to non-users, CAM users were younger, more frequently women, affiliated with the health insurance plan for low-income populations and non-Catholic. We found no differences regarding the clinical stage or treatment modality, but CAM users reported more treatment-related side effects. The most frequent types of CAM were herbal products, specific foods and vitamins, and individually, soursop was the most frequently used product. Relevant variability between regions was observed regarding the prevalence and type of CAM used (range: 36.6% to 66.7%). The most frequent reason for using CAM was symptom management (30.5%), followed by curative purposes (19.5%). CONCLUSIONS The prevalence of CAM use among cancer patients in Colombia is high in general, and variations between regions might be related to differences in cultural backgrounds and access to comprehensive cancer care. The most frequently used CAM products and practices have little scientific support, suggesting the need to enhance integrative oncology research in the country.
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Affiliation(s)
- Raúl Murillo
- Hospital Universitario San Ignacio, Diagonal 70B 214 Este Apt 104, Bogotá, Colombia.
- Pontificia Universidad Javeriana, Bogotá, Colombia.
| | | | - Norma Serrano
- Hospital Internacional de Colombia-Fundación Cardiovascular, Bucaramanga, Colombia
| | - Claudia Uribe
- Universidad Autónoma de Bucaramanga, Bucaramanga, Colombia
| | | | - Jorge Duque
- Oncólogos Asociados de Imbanaco, Cali, Colombia
| | - Andrés Yepes
- Clínica de Oncología Astorga, Medellín, Colombia
| | - Laura Olaya
- Unidad Oncológica Surcolombiana, Neiva, Colombia
| | - Carolina Mariño
- Pontificia Universidad Javeriana, Bogotá, Colombia
- Universidad de Valencia, Valencia, Spain
| | - Olga Lucia Morales
- Hospital Universitario San Ignacio, Diagonal 70B 214 Este Apt 104, Bogotá, Colombia
- Pontificia Universidad Javeriana, Bogotá, Colombia
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Guo D, Zhou C, Li H, Su D, Gong G, Chen X, Chen X, Chen Y. Mapping the scientific research on integrated care: a bibliometric and social network analysis. Front Psychol 2023; 14:1095616. [PMID: 37786479 PMCID: PMC10541993 DOI: 10.3389/fpsyg.2023.1095616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 08/25/2023] [Indexed: 10/04/2023] Open
Abstract
Background Integrated care (IC) is the cornerstone of the sustainable development of the medical and health system. A thorough examination of the existing scientific literature on IC is essential for assessing the present state of knowledge on this subject. This review seeks to offer an overview of evidence-based knowledge, pinpoint existing knowledge gaps related to IC, and identify areas requiring further research. Methods Data were retrieved from the Web of Science Core Collection, from 2010 to 2020. Bibliometrics and social network analysis were used to explore and map the knowledge structure, research hotspots, development status, academic groups and future development trends of IC. Results A total of 7,501 articles were obtained. The number of publications on IC was rising in general. Healthcare science services were the most common topics. The United States contributed the highest number of articles. The level of collaboration between countries and between authors was found to be relatively low. The keywords were stratified into four clusters: IC, depression, integrative medicine, and primary health care. In recent years, complementary medicine has become a hotspot and will continue to be a focus. Conclusion The study provides a comprehensive analysis of global research hotspots and trends in IC, and highlights the characteristics, challenges, and potential solutions of IC. To address resource fragmentation, collaboration difficulties, insufficient financial incentives, and poor information sharing, international collaboration needs to be strengthened to promote value co-creation and model innovation in IC. The contribution of this study lies in enhancing people's understanding of the current state of IC research, guiding scholars to discover new research perspectives, and providing valuable references for researchers and policymakers in designing and implementing effective IC strategies.
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Affiliation(s)
- Dandan Guo
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chaofeng Zhou
- Wuhan Library, Chinese Academy of Sciences, Wuhan, China
- Department of Library, Information and Archives Management, School of Economic and Management, UCAS, Beijing, China
| | - Haomiao Li
- School of Political Science and Public Administration, Wuhan University, Wuhan, China
| | - Dai Su
- Department of Health Management and Policy, School of Public Health, Capital Medical University, Beijing, China
| | - Guangwen Gong
- Guangwen Gong, School of Management, Hubei University of Chinese Medicine, Wuhan, China
| | - Xinlin Chen
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xinlan Chen
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yingchun Chen
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Research Centre for Rural Health Service, Key Research Institute of Humanities and Social Sciences of Hubei Provincial Department of Education, Wuhan, China
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27
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Wode K, Sharp L, Fransson P, Nordberg JH. Communication About Complementary and Alternative Medicine When Patients Decline Conventional Cancer Treatment: Patients' and Physicians' Experiences. Oncologist 2023; 28:e774-e783. [PMID: 37071805 PMCID: PMC10485293 DOI: 10.1093/oncolo/oyad084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 02/17/2023] [Indexed: 04/20/2023] Open
Abstract
BACKGROUND Complementary and alternative medicine (CAM) is a broad set of nonconventional practices used alongside or instead of conventional treatment: The latter poses obvious risks related to cancer prognosis. Patient-physician dialogue about CAM is crucial for patient safety and mutual trust. Little is known about communication in the rare situations when patients decline recommended cancer treatment and consider using CAM. The objective of this study was to explore patients' and physicians' experiences from situations when patients decline recommended cancer treatment and consider using CAM. MATERIALS AND METHODS Semi-structured interviews were carried out with 7 CAM-using cancer patients who had declined some or all conventional treatment as well as 10 physicians from oncology and palliative care. Framework analysis was used. RESULTS Regarding treatment choices, there was a dissonance between physicians' focus on medical reasoning and patients' expression of complex values. Physicians' difficulty in understanding patients' treatment decline was exacerbated when patients considered using CAM, impairing communication even further. Inequalities in roles resulting in power struggles risked pushing both parties toward extreme and inflexible standpoints. Despite these challenges regarding treatment choices and hierarchical roles, both parties considered open and respectful communication as crucial. CONCLUSIONS This study highlights the difficulty of shared decision-making in practice when patients' and physicians' views on treatment decisions deviate in clinically challenging situations. Our results point to a need to address the complexity of these situations, pay attention to patients' values, and improve knowledge among physicians about CAM.
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Affiliation(s)
- Kathrin Wode
- Department of Radiation Sciences/Oncology, Umeå University, Umeå, Sweden
- Regional Cancer Centre Stockholm Gotland, Stockholm, Sweden
- Department of Nursing, Umeå University, Sweden
| | - Lena Sharp
- Regional Cancer Centre Stockholm Gotland, Stockholm, Sweden
- Department of Nursing, Umeå University, Sweden
| | | | - Johanna Hök Nordberg
- Regional Cancer Centre Stockholm Gotland, Stockholm, Sweden
- Department of Neurobiology, Caring Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
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Duffy T, Kochanczyk M. Practical cancer cachexia management in palliative care - a review of current evidence. Curr Opin Support Palliat Care 2023; 17:177-185. [PMID: 37384429 DOI: 10.1097/spc.0000000000000655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
PURPOSE OF REVIEW To explore the current evidence relating to the practical management of cancer cachexia in palliative care. RECENT FINDINGS The authors found a growing evidence base including the publication of several expert guidelines since 2020. Guidelines identified the need for individualised nutritional and physical exercise support as the mainstay of cachexia management. Dietician and allied health professional referrals are recommended for the best patient outcomes. Limitations of nutritional support and exercise are acknowledged. Patient outcomes from multimodal anti-cachexia therapy are awaited at this time. Communication about the mechanisms of cachexia and nutritional counselling are identified as ways to reduce distress. Evidence supporting the use of pharmacological agents remains insufficient to make recommendations. Corticosteroids and progestins may be offered for symptom relief in refractory cachexia, taking into consideration well-documented side effects. Emphasis is placed on adequately managing nutritional impact symptoms. A specific role for palliative care clinicians and the use of existing palliative care guidelines in managing cancer cachexia were not identified. SUMMARY Current evidence recognises the inherently palliative nature of cancer cachexia management, and practical guidance correlates with the tenets of palliative care. Individualised approaches to support nutritional intake, physical exercise and alleviate symptoms that accelerate cachexia processes are currently recommended.
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Affiliation(s)
- Tony Duffy
- St Columba's Hospice Care, Edinburgh, UK
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29
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Zhou H, Silverman G, Niu Z, Silverman J, Evans R, Austin R, Zhang R. Extracting Complementary and Integrative Health Approaches in Electronic Health Records. JOURNAL OF HEALTHCARE INFORMATICS RESEARCH 2023; 7:277-290. [PMID: 37637720 PMCID: PMC10449701 DOI: 10.1007/s41666-023-00137-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 04/12/2023] [Accepted: 07/03/2023] [Indexed: 08/29/2023]
Abstract
Complementary and Integrative Health (CIH) has gained increasing popularity in the past decades. While the evidence bases to support them are growing, there is still a gap in understanding their effects and potential adverse events using real-world data. The overall goal of this study is to represent information pertinent to both psychological and physical CIH approaches (specifically, using examples of music therapy, chiropractic, and aquatic exercise in this study) in an electronic health record (EHR) system. We also aim to evaluate the ability of existing natural language processing (NLP) systems to identify CIH approaches. A total of 300 notes were randomly selected and manually annotated. Annotations were made for status, symptom, and frequency of each approach. This set of annotations was used as a gold standard to evaluate the performance of NLP systems used in this study (specifically BioMedICUS, MetaMap, and cTAKES) for extracting CIH concepts. Venn diagram was used to investigate the consistency of medical records searching by Current Procedural Terminology (CPT) codes and CIH approaches keywords in SQL. Since CPT codes usually do not have specific mentions of CIH approaches, the Venn diagram had less overlap with those found in clinical notes for all three CIH therapies. The three NLP systems achieved 0.41 in average lenient match F1-score in all three CIH approaches, respectively. BioMedICUS achieved the best performance in aquatic exercise with an F1-score of 0.66. This study contributes to the overall representation of CIH in clinical note and lays a foundation for using EHR for clinical research for CIH approaches.
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Affiliation(s)
- Huixue Zhou
- Institute for Health Informatics, University of Minnesota, Minneapolis, MN 55414 USA
| | - Greg Silverman
- Department of Surgery, University of Minnesota, Minneapolis, MN 55414 USA
| | - Zhongran Niu
- Institute for Health Informatics, University of Minnesota, Minneapolis, MN 55414 USA
| | - Jenzi Silverman
- Earl E. Bakken Center for Spirituality & Healing, University of Minnesota, Minneapolis, MN 55414 USA
| | - Roni Evans
- Earl E. Bakken Center for Spirituality & Healing, University of Minnesota, Minneapolis, MN 55414 USA
| | - Robin Austin
- School of Nursing, University of Minnesota, Minneapolis, MN 55414 USA
| | - Rui Zhang
- Department of Surgery, University of Minnesota, Minneapolis, MN 55414 USA
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Youn B, Cha J, Cho S, Jeong S, Kim H, Ko S. Perception, attitudes, knowledge of using complementary and alternative medicine for cancer patients among healthcare professionals: A mixed-methods systematic review. Cancer Med 2023; 12:19149-19162. [PMID: 37676102 PMCID: PMC10557909 DOI: 10.1002/cam4.6499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 08/19/2023] [Accepted: 08/25/2023] [Indexed: 09/08/2023] Open
Abstract
BACKGROUND With the rapid increase in the prevalence of cancer worldwide, the utilization of complementary and alternative medicine (CAM) has increased among cancer patients. This review aimed to understand the perception, attitudes, and knowledge of healthcare professionals toward using CAM for cancer patients. METHODS A mixed-methods systematic review was undertaken in four databases. Inclusion criteria were primary studies reporting perception, attitudes, and knowledge of healthcare professionals for using CAM for cancer patients were eligible. A mixed-methods convergent synthesis was carried out, and the findings were subjected to a GRADE-CERQual assessment of confidence. RESULTS Forty-two studies were chosen. The majority of the studies were quantitative and had less than 100 participants. Most publications were from European countries, and oncology was the highest among the specialties. The review found the following themes: feasibility of having negative adverse effects, low expectations of using CAM among HCPs, potential positive effects of using CAM, specific CAM training may be helpful, no concrete regulations to promote CAM practice, and poor physician-patient communication. CONCLUSIONS Nurses had more positive views than other professions; oncologists were concerned regarding herb-drug interactions; integration of CAM into the healthcare system was favorable; HCPs felt the need to participate in specific CAM training; and HCPs agreed that CAM education should be provided more regularly. Future studies should explore the studies views of cancer patients and details of in-depth evidence of CAM in oncology settings.
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Affiliation(s)
- Bo‐Young Youn
- Department of Preventive Medicine, College of Korean MedicineKyung Hee UniversitySeoulSouth Korea
| | - Jie‐Won Cha
- Department of Applied Korean Medicine, Graduate SchoolKyung Hee UniversitySeoulSouth Korea
| | - Sungsu Cho
- Department of Korean Medicine, Graduate SchoolKyung Hee UniversitySeoulSouth Korea
| | - So‐Mi Jeong
- Department of Clinical Korean Medicine, Graduate SchoolKyung Hee UniversitySeoulSouth Korea
| | - Hyo‐Jung Kim
- Department of Clinical Korean Medicine, Graduate SchoolKyung Hee UniversitySeoulSouth Korea
| | - Seong‐Gyu Ko
- Department of Preventive Medicine, College of Korean MedicineKyung Hee UniversitySeoulSouth Korea
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Huebner J, Muecke R, Micke O, Prott FJ, Josfeld L, Büntzel J, Büntzel J. Lay etiology concepts of cancer patients do not correlate with their usage of complementary and/or alternative medicine. J Cancer Res Clin Oncol 2023; 149:6067-6074. [PMID: 36653538 PMCID: PMC10356643 DOI: 10.1007/s00432-022-04528-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 12/08/2022] [Indexed: 01/20/2023]
Abstract
BACKGROUND The usage of complementary and alternative medicine (CAM) is widespread among cancer patients. While reasons for and aims of using CAM have been evaluated in many studies, less is known about whether patients' concepts of how and why cancer develops has an influence on the choice of the CAM method. METHODS We pooled the data from all studies of our working group containing questions on lay etiological concepts and CAM usage and reanalyzed them with respect to the associations between these parameters. RESULTS The pooled dataset from 12 studies included 4792 patients. A third (1645 patients) reported using CAM. Most often used were supplements (55.9%), relaxation techniques (43.6%), and homeopathy (37.9%). Regarding perceived causes, patients most often marked stress (35.4%) followed by genes (31.9%). While all lay etiological beliefs were highly significantly associated with usage of CAM in general, there was no association between single lay etiological concepts and types of CAM used. Yet, in a network analysis, we found two associations: one comprising trauma, mistletoe, genes, and nutritional supplements, the other yoga, vitamin C, nutritional supplements, and TCM herbs. In the correlation heatmap, one cluster comprises etiological concepts of personality, immune system and trauma, and two clusters of CAM methods emerged: one comprising praying, yoga, meditation, and relaxation procedures, the other nutritional supplements, selenium, vitamins A and C. CONCLUSION While physicians are trained to derive treatment strategies from etiological concepts, lay people choosing CAM do not follow these rules, which may point to other needs of patients addressed by CAM.
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Affiliation(s)
- J Huebner
- Klinik Für Innere Medizin II, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Germany.
| | - R Muecke
- Strahlentherapie RheinMain, Rüsselsheim, Germany
| | - O Micke
- Klinik für Strahlentherapie und Radioonkologie, Franziskus Hospital, Bielefeld, Germany
| | - F-J Prott
- RNS Praxisgemeinschaft, Radiologie und Strahlentherapie, Wiesbaden, Germany
| | - L Josfeld
- Klinik Für Innere Medizin II, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Germany
| | - J Büntzel
- Klinik für HNO-Erkrankungen, Kopf-Hals-ChirurgieInterdisziplinäre Palliativstation, Südharz Klinikum Nordhausen, Nordhausen, Germany
| | - J Büntzel
- Klinik für Hämatologie und Onkologie, Universitätsklinikum Göttingen, Göttingen, Germany
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Lattard C, Baudouin A, Larbre V, Herledan C, Cerutti A, Cerfon MA, Kimbidima R, Caffin AG, Vantard N, Schwiertz V, Ranchon F, Rioufol C. Clinical and economic impact of clinical oncology pharmacy in cancer patients receiving injectable anticancer treatments: a systematic review. J Cancer Res Clin Oncol 2023; 149:7905-7924. [PMID: 36853384 DOI: 10.1007/s00432-023-04630-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 02/01/2023] [Indexed: 03/01/2023]
Abstract
PURPOSE Clinical pharmacy can reduce drug-related iatrogenesis by improving the management of adverse effects of drugs, limiting drug-drug interactions, and improving patient adherence. Given the vulnerability of cancer patients and the toxicity of injectable anticancer drugs, clinical pharmacy service (CPS) could provide a significant clinical benefit in cancer care. This review aims to synthesize existing evidence on clinical pharmacy's impact on patients treated with intravenous anticancer drugs. METHODS A comprehensive search was performed in the PubMed/Medline database from January 2000 to December 2021, associating the keywords: clinical pharmacy, pharmaceutical care, pharmacist, oncology, and chemotherapy. To be eligible for inclusion, studies have to report clinical pharmaceutical services for patients treated with intravenous chemotherapy with a clinical and/or economic impact. RESULTS Forty-one studies met the selection criteria. Various CPS were reported: medication reconciliation, medication review, and pharmaceutical interview with patient. There was a lack of randomized study (n = 3; 7.3%). In one randomized controlled trial, pharmaceutical intervention significantly improved quality of life of patients receiving pharmaceutical care during injectable anticancer drugs courses. Economical results appear to show positive impact of clinical pharmacy with cost savings reported from 3112.87$ to 249 844€. Although most studies were non-comparative, they highlighted that clinical pharmacy tend to limit chemotherapy side effects and drug-related problems, improve quality of life and satisfaction of patients and healthcare professional, and a positive economic impact. CONCLUSION Clinical pharmacy can reduce adverse drug events in cancer patients. More robust and economic evaluations are still required to support its development in everyday practice.
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Affiliation(s)
- Claire Lattard
- Hospices Civils de Lyon, Groupement Hospitalier Sud, Unité de Pharmacie Clinique Oncologique, Pierre-Bénite, France
| | - Amandine Baudouin
- Hospices Civils de Lyon, Groupement Hospitalier Sud, Unité de Pharmacie Clinique Oncologique, Pierre-Bénite, France
| | - Virginie Larbre
- Hospices Civils de Lyon, Groupement Hospitalier Sud, Unité de Pharmacie Clinique Oncologique, Pierre-Bénite, France
- Université Lyon 1- EA 3738, CICLY Centre Pour l'Innovation en Cancérologie de Lyon, 69921, Lyon, Oullins Cedex, France
| | - Chloé Herledan
- Hospices Civils de Lyon, Groupement Hospitalier Sud, Unité de Pharmacie Clinique Oncologique, Pierre-Bénite, France
- Université Lyon 1- EA 3738, CICLY Centre Pour l'Innovation en Cancérologie de Lyon, 69921, Lyon, Oullins Cedex, France
| | - Ariane Cerutti
- Hospices Civils de Lyon, Groupement Hospitalier Sud, Unité de Pharmacie Clinique Oncologique, Pierre-Bénite, France
| | - Marie-Anne Cerfon
- Hospices Civils de Lyon, Groupement Hospitalier Sud, Unité de Pharmacie Clinique Oncologique, Pierre-Bénite, France
| | - Reine Kimbidima
- Hospices Civils de Lyon, Groupement Hospitalier Sud, Unité de Pharmacie Clinique Oncologique, Pierre-Bénite, France
| | - Anne-Gaelle Caffin
- Hospices Civils de Lyon, Groupement Hospitalier Sud, Unité de Pharmacie Clinique Oncologique, Pierre-Bénite, France
| | - Nicolas Vantard
- Hospices Civils de Lyon, Groupement Hospitalier Sud, Unité de Pharmacie Clinique Oncologique, Pierre-Bénite, France
| | - Vérane Schwiertz
- Hospices Civils de Lyon, Groupement Hospitalier Sud, Unité de Pharmacie Clinique Oncologique, Pierre-Bénite, France
| | - Florence Ranchon
- Hospices Civils de Lyon, Groupement Hospitalier Sud, Unité de Pharmacie Clinique Oncologique, Pierre-Bénite, France
- Université Lyon 1- EA 3738, CICLY Centre Pour l'Innovation en Cancérologie de Lyon, 69921, Lyon, Oullins Cedex, France
| | - Catherine Rioufol
- Hospices Civils de Lyon, Groupement Hospitalier Sud, Unité de Pharmacie Clinique Oncologique, Pierre-Bénite, France.
- Université Lyon 1- EA 3738, CICLY Centre Pour l'Innovation en Cancérologie de Lyon, 69921, Lyon, Oullins Cedex, France.
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Miller EA, Beaumont S, Zhou ZN, Brewer JT, Thomas C, Chapman-Davis E, Cantillo E, Holcomb K, Pua T, Frey MK. Attitudes and beliefs regarding complementary and alternative medicine in a diverse gynecologic oncology patient population. Gynecol Oncol Rep 2023; 48:101232. [PMID: 37415958 PMCID: PMC10320404 DOI: 10.1016/j.gore.2023.101232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/20/2023] [Accepted: 06/22/2023] [Indexed: 07/08/2023] Open
Abstract
Objectives To measure prevalence of complementary and alternative medicine (CAM) use in a diverse gynecologic oncology patient population and evaluate how attitudes and beliefs regarding CAM relate to demographic factors. Methods A validated Attitudes and Beliefs about Complementary and Alternative Medicine (ABCAM) survey was distributed to patients with gynecologic malignancy. Results were evaluated using Pearson's Chi-squared and Fisher's exact tests for categorical variables and Wilcoxon ranks sum and Kruskal-Wallace tests for non-normally distributed variables. Results One-hundred thirty patients completed the ABCAM survey. Self-reported race and ethnicity included Asian or Pacific Islander (n = 54; 42%), Hispanic/Latino (n = 23; 18%), White (n = 21; 16%), Black or African American (n = 20; 15%), American Indian/Alaska Native (n = 8; 6.2%) and Other (n = 4; 3.1%). Twenty-four respondents (18%) reported use of CAM. There was a significant difference in expected benefits to CAM between respondents of different races/ethnicities (p < 0.001). Black and Asian respondents reported greater expected benefit to CAM. Hispanic/Latino, American Indian/Alaskan Native, and White respondents reported fewer expected benefits. A significant association was found between perceived barriers to CAM and race/ethnicity (p 0.043), with Asian, Hispanic/Latino and White respondents perceiving more barriers while Black and American Indian/Alaskan Natives reported perceiving fewer barriers to CAM. Respondents with incomes greater than $100,000 reported fewer barriers to CAM. Conclusions Use of CAM among gynecologic oncology patients is lower than previously thought. Income, race, and ethnicity inform patient engagement with CAM and can be used to better tailor the provision of evidence-based CAM interventions to benefit a greater number of gynecologic cancer patients.
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Affiliation(s)
- Emily A. Miller
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, New York Presbyterian Hospital Weill Cornell Medicine, 525 E 68th St, New York, NY 10065, USA
| | - Shanice Beaumont
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, New York Presbyterian Hospital Weill Cornell Medicine, 525 E 68th St, New York, NY 10065, USA
| | - Zhen Ni Zhou
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Michigan Medicine, 1500 E. Medical Center Dr., Ann Arbor, MI 48109, USA
| | - Jesse T. Brewer
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, New York Presbyterian Hospital Weill Cornell Medicine, 525 E 68th St, New York, NY 10065, USA
| | - Charlene Thomas
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, New York Presbyterian Hospital Weill Cornell Medicine, 525 E 68th St, New York, NY 10065, USA
| | - Eloise Chapman-Davis
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, New York Presbyterian Hospital Weill Cornell Medicine, 525 E 68th St, New York, NY 10065, USA
| | - Evelyn Cantillo
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, New York Presbyterian Hospital Weill Cornell Medicine, 525 E 68th St, New York, NY 10065, USA
| | - Kevin Holcomb
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, New York Presbyterian Hospital Weill Cornell Medicine, 525 E 68th St, New York, NY 10065, USA
| | - Tara Pua
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, New York Presbyterian Hospital Weill Cornell Medicine, 525 E 68th St, New York, NY 10065, USA
| | - Melissa K. Frey
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, New York Presbyterian Hospital Weill Cornell Medicine, 525 E 68th St, New York, NY 10065, USA
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Chen KW, Chung KP, Hsu CH. The intention of utilization and experience toward traditional Chinese medicine among breast cancer patients in the early and late stages: a qualitative study. BMC Complement Med Ther 2023; 23:226. [PMID: 37420247 DOI: 10.1186/s12906-023-04054-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 06/24/2023] [Indexed: 07/09/2023] Open
Abstract
BACKGROUND In Taiwan, breast cancer patients usually take conventional medicine and traditional Chinese medicine simultaneously. The utilization of traditional Chinese medicine among breast cancer patients at various stages has not been examined. This study aims to compare the intention of utilization and experience toward traditional Chinese medicine among early- and late-stage breast cancer patients. METHOD This qualitative research collected data from breast cancer patients through focus groups interview by convenience sampling. Conducted in 2 branches of Taipei City Hospital, a public hospital managed by the Taipei City government. Breast cancer patients > 20 years old and had used TCM for breast cancer therapy for at least 3 months were included in the interview. A semi-structured interview guide was adopted in each focus group interview. In the following data analysis, stages I and II were considered early-stage, and stages III and IV were late-stage. For analyzing the data and reporting the results, we used qualitative content analysis as the approach for data analysis, assisted by NVivo 12. Categories and subcategories were identified through content analysis. RESULTS Twelve and seven early- and late-stage breast cancer patients were included in this study, respectively. The side effects were the main intention of utilizing traditional Chinese medicine. Improving side effects and constitution was the main benefit for patients in both stages. Additionally, early-stage breast cancer patients used traditional Chinese medicine to prevent recurrence or metastasis. Late-stage breast cancer patients responded more frequently to the use of traditional Chinese medicine due to the side effects of western medicine. However, some of their symptoms were not fully relieved. CONCLUSIONS Breast cancer staging may influence the intention and utilization of traditional Chinese medicine. Health policymakers should consider the results of this research and the evidence-based illustrations to establish guidelines for integrating traditional Chinese medicine among various stages of breast cancer to improve the outcome and quality of care for cancer patients.
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Affiliation(s)
- Kai-Wei Chen
- Institute of Health Policy and Management, National Taiwan University, 17 Xuzhou Road, Zhongzheng District, Taipei City, 100, Taiwan
- Linsen, Chinese Medicine and Kunming Branch, Taipei City Hospital, 100 Kunming Street, Wanhua District, Taipei City, 108, Taiwan
| | - Kuo-Piao Chung
- Institute of Health Policy and Management, National Taiwan University, 17 Xuzhou Road, Zhongzheng District, Taipei City, 100, Taiwan.
| | - Chung-Hua Hsu
- Linsen, Chinese Medicine and Kunming Branch, Taipei City Hospital, 100 Kunming Street, Wanhua District, Taipei City, 108, Taiwan
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Ayesh W, Ibrahim Hassan AA, Jaafar H, Khorshid O, Laviano A, Lovey J, Mahrous M, Mogawer E, Molla H, Morsy A, Ouaijan K. Unmet needs in cancer patients: Creating recommendations to overcome geographical disparities in economic growth. Clin Nutr ESPEN 2023; 55:267-276. [PMID: 37202056 DOI: 10.1016/j.clnesp.2023.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 03/14/2023] [Indexed: 05/20/2023]
Abstract
Cancer is a major clinical, economic and societal challenge across different world regions. Effective anticancer therapies are now available, yet the impact of these treatments on the needs of patients with cancer remains questionable, since improved survival is not frequently associated with improved quality of life. In an effort to raise patients' needs at the core of anticancer therapies, the importance of nutritional support has become recognized by international scientific societies. It is recognized that the needs of patients with cancer are universal, yet the economic and societal status of any country influence the availability and implementation of nutritional care. The Middle East is a geographic area in which major differences in economic growth coexist. Consequently, it appears reasonable that international guidelines on nutritional care in oncology are reviewed to highlight those recommendations which could be universally adopted and those which may need a progressive implementation. To this end, a group of Middle East healthcare professionals working in cancer centers across the region gathered to develop a list of recommendations to be implemented in daily practice. This would translate in a likely better acceptance and delivery of nutritional care, aligning all Middle East cancer centers to the quality standards now available only in selected hospital across the region.
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Kwong MH, Ho L, Li ASC, Nilsen P, Ho FF, Zhong CCW, Chung VCH. Integrative oncology in cancer care - implementation factors: mixed-methods systematic review. BMJ Support Palliat Care 2023:spcare-2022-004150. [PMID: 37173126 DOI: 10.1136/spcare-2022-004150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 05/02/2023] [Indexed: 05/15/2023]
Abstract
BACKGROUND Integrative oncology (IO) appears to be beneficial to patients with cancer, but its implementation remains a challenge. Guided by the Theoretical Domains Framework (TDF) and the Capability-Opportunity-Motivation-Behaviour (COM-B) model, this systematic review identified the barriers to and facilitators of IO implementation in conventional cancer care settings. METHODS We searched eight electronic databases from their inception until February 2022 for qualitative, quantitative or mixed-methods empirical studies reporting the implementation outcomes for IO services. Critical appraisal approach was tailored according to study types. The identified implementation barriers and facilitators were mapped onto TDF domains and the COM-B model, and subsequently onto the behavioural change wheel (BCW) for formulating behavioural change interventions. RESULTS We included 28 studies (11 qualitative, 6 quantitative, 9 mixed-methods and 2 Delphi studies) of satisfied methodological quality. The main implementation barriers were the lack of IO knowledge, the absence of funding and healthcare professionals' low level of IO receptiveness. The key implementation facilitators were the dissemination of evidence on IO clinical benefits, the equipping of professionals with IO service delivery skills and the provision of a supportive organisational climate. CONCLUSION Multifaceted implementation strategies are needed to address the determinants influencing IO service delivery. Based on our BCW-based analysis of the included studies, the key behavioural change techniques are: (1) educating healthcare professionals about the value and application of traditional and complementary medicine; (2) ensuring access to actionable clinical evidence on IO effectiveness and safety and (3) designing guidelines on communicating traditional and complementary medicine interventions with patients and caregivers for biomedically trained doctors and nurses.
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Affiliation(s)
- Ming Hong Kwong
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - Leonard Ho
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - Angus S C Li
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - Per Nilsen
- Division of Society and Health, Department of Health, Medicine and Caring Sciences, Linköping University, Linkoping, Östergötland, Sweden
| | - Fai Fai Ho
- School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - Claire C W Zhong
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - Vincent C H Chung
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
- School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
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Niederreiter M, Klein J, Arndt K, Werner J, Mayer B. Anti-Cancer Effects of Artesunate in Human 3D Tumor Models of Different Complexity. Int J Mol Sci 2023; 24:ijms24097844. [PMID: 37175551 PMCID: PMC10178545 DOI: 10.3390/ijms24097844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 04/22/2023] [Accepted: 04/24/2023] [Indexed: 05/15/2023] Open
Abstract
The anti-malaria drug Artesunate (ART) shows strong anti-cancer effects in vitro; however, it shows only marginal treatment results in clinical cancer studies. In this study, ART was tested in preclinical 3D cancer models of increasing complexity using clinically relevant peak plasma concentrations to obtain further information for translation into clinical use. ART reduced cell viability in HCT-116 and HT-29 derived cancer spheroids (p < 0.001). HCT-116 spheroids responded dose-dependently, while HT-29 spheroids were affected more strongly by ART than by cytostatics (p < 0.001). HCT-116 spheroids were chemo-sensitized by ART (p < 0.001). In patient-derived cancer spheroids (PDCS), ART led to inhibition of cell viability in 84.62% of the 39 samples tested, with a mean inhibitory effect of 13.87%. Viability reduction of ART was 2-fold weaker than cytostatic monotherapies (p = 0.028). Meanwhile, tumor-stimulation of up to 16.30% was observed in six (15.38%) PDCS-models. In 15 PDCS samples, ART modulated chemotherapies in combined testing, eight of which showed chemo-stimulation (maximum of 36.90%) and seven chemo-inhibition (up to 16.95%). These results demonstrate that ART's anti-cancer efficacy depends on the complexity of the tumor model used. This emphasizes that cancer treatment with ART should be evaluated before treatment of the individual patient to ensure its benefits and prevent unwanted effects.
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Affiliation(s)
- Marlene Niederreiter
- Department of General, Visceral, and Transplant Surgery, Ludwig-Maximilians-University Munich, Marchioninistraße 15, 81377 Munich, Germany
| | - Julia Klein
- Department of General, Visceral, and Transplant Surgery, Ludwig-Maximilians-University Munich, Marchioninistraße 15, 81377 Munich, Germany
| | - Kerstin Arndt
- Department of General, Visceral, and Transplant Surgery, Ludwig-Maximilians-University Munich, Marchioninistraße 15, 81377 Munich, Germany
| | - Jens Werner
- Department of General, Visceral, and Transplant Surgery, Ludwig-Maximilians-University Munich, Marchioninistraße 15, 81377 Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, Pettenkoferstraße 8a, 80336 Munich, Germany
| | - Barbara Mayer
- Department of General, Visceral, and Transplant Surgery, Ludwig-Maximilians-University Munich, Marchioninistraße 15, 81377 Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, Pettenkoferstraße 8a, 80336 Munich, Germany
- SpheroTec GmbH, Am Klopferspitz 19, 82152 Martinsried, Germany
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Huber C, Zhang L, Schlaeppi M, Müller T, Roll S, Voiss P, Barth J, Driessen C, Witt CM. Acupuncture in chemotherapy-induced dysgeusia (AcuDysg): study protocol of a randomised controlled trial. BMJ Open 2023; 13:e066137. [PMID: 36898749 PMCID: PMC10008328 DOI: 10.1136/bmjopen-2022-066137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/12/2023] Open
Abstract
INTRODUCTION Dysgeusia is a common side effect of chemotherapy in patients with cancer, but to date, there is no effective treatment. Many patients with cancer request complementary medicine treatment in addition to their cancer treatments, and acupuncture is highly accepted for patients with cancer; however, evidence regarding the effectiveness of acupuncture for dysgeusia is scarce.The study investigates the effectiveness of an additional dysgeusia-specific acupuncture plus self-acupressure intervention compared with supportive acupuncture plus self-acupressure intervention alone for chemotherapy-induced dysgeusia in patients with cancer. METHODS AND ANALYSIS This is a multicentre, randomised, controlled and two-armed parallel-group, single-blind trial involving 130 patients. Both groups will receive eight sessions of acupuncture treatment over a period of 8 weeks and will be trained to perform self-acupressure (eLearning combined with therapist instruction) at predefined acupressure points once a day during the whole treatment period. Patients in the control group will receive supportive routine care acupuncture and self-acupressure treatment only; in addition to this treatment, the intervention group will receive the dysgeusia-specific acupuncture and acupressure within the same treatment session. The primary outcome is the perceived dysgeusia over 8 weeks, measured weekly after the acupuncture treatment. Secondary outcomes include the indices from the objective taste and smell test, weight loss, perceived dysgeusia, fatigue, distress, nausea and vomiting, odynophagia, xerostomia and polyneuropathy, as well as quality of life at the different time points. ETHICS AND DISSEMINATION The study has been approved by the Cantonal Ethics Committee (CEC) (Kanton Zürich Kantonale Ethikkommission) (approval no. KEK-ZH-Nr. 2020-01900). The results will be submitted to a peer-reviewed journal for publication. TRIAL REGISTRATION NUMBERS DRKS00023348, SNCTP000004128.
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Affiliation(s)
- Christine Huber
- Institute for Complementary and Integrative Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Linxin Zhang
- Institute for Complementary and Integrative Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Marc Schlaeppi
- Center for Integrative Medicine, Kantonsspital St Gallen, Cantonal Hospital St. Gallen, Sankt Gallen, Switzerland
| | - Twyla Müller
- Institute for Complementary and Integrative Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Stephanie Roll
- Institute of Social Medicine, Epidemiology and Health Economics, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Petra Voiss
- Department of Internal and Integrative Medicine, Evang. Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Jürgen Barth
- Institute for Complementary and Integrative Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Christoph Driessen
- Department of Oncology and Hematology, Kantonsspital St Gallen, Cantonal Hospital St. Gallen, Sankt Gallen, Switzerland
| | - Claudia M Witt
- Institute for Complementary and Integrative Medicine, University Hospital Zurich, Zurich, Switzerland
- Institute of Social Medicine, Epidemiology and Health Economics, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité Universitätsmedizin Berlin, Berlin, Germany
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Carrillo-Mora P, Rodríguez-Barragán MA, Quinzaños-Fresnedo J, Del Refugio Pacheco-Gallegos M, Soto-Lara M, Velázquez-Ortega M, Villarreal-Azamar MF, Aguirre-Medina IJ, Rubalcava-Gracia-Medrano M. Alternative and complementary medicine in neurological disorders and neurological disability patients: Prevalence, factors, opinions and reasons. Complement Ther Med 2023; 72:102920. [PMID: 36646394 DOI: 10.1016/j.ctim.2023.102920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 01/11/2023] [Accepted: 01/12/2023] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVES This cross-sectional study is aimed to investigate the prevalence of the use of complementary and alternative medicine (CAM), types of CAMs used, as well as reasons and factors found in patients with neurological diseases or neurological disability. METHODS An anonymous, self-administered survey was designed to collect information about demographics, personal medical history, CAM usage habits, and different opinions about CAM vs. conventional medicine (CM). The survey was applied by non-medical personnel in a rehabilitation hospital to patients older than 18 years, with a confirmed diagnosis of neurological disorder or neurological disability. RESULTS 453 patients were included, 59.7 % were female. Mean age: 49 years (SD: 18.2). 200 patients (44.2 %) had a history of chronic diseases. Depression was found in 139 patients (30.7 %). Neurological disorders were: peripheral neuropathy: 97 (21.4 %), headache or migraine: 78 (17.2 %), neurodegenerative diseases: 69 (15.2 %) and stroke: 58 (12.8 %). 60.2 % (n = 273) had some degree of disability. Prevalence of CAM use was 36 % (n = 163). Most common CAMs were: Biological therapies: 133 (71.1 %), energy-based therapies: 63 (33.7 %) and body manipulation therapies: 51 (27.3 %). Reasons to use CAM were: "to complement the pharmacological treatment" (45 = 27.6 %), and "treatment failure with CM" (43 = 26.4 %). Finally, older age (p = 0.0280) and having a chronic disease (p = 0.0229) or depression (p < 0.001) were the factors associated with the current use of CAM. CONCLUSION One third of patients with neurological pathologies use CAM, the most popular type of CAM is biologic therapies. As in other pathologies, CAM use was associated with older age, history of depression, and chronic diseases. Therefore, it is suggested that physicians routinely ask patients about the use of CAM, if they need more information about CAM, and even verify the possibility of drug interactions or adverse effects.
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Affiliation(s)
- Paul Carrillo-Mora
- División de Neurociencias Clínicas, Instituto Nacional de Rehabilitación "Luis Guillermo Ibarra Ibarra", Mexico.
| | - Marlene A Rodríguez-Barragán
- División de Rehabilitación Neurológica, Instituto Nacional de Rehabilitación "Luis Guillermo Ibarra Ibarra", Mexico
| | - Jimena Quinzaños-Fresnedo
- División de Rehabilitación Neurológica, Instituto Nacional de Rehabilitación "Luis Guillermo Ibarra Ibarra", Mexico
| | | | - María Soto-Lara
- Facultad de Medicina, Universidad Nacional Autónoma de México, México City, Mexico
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Kollikowski A, Schiffmann L, Gabriel K, Gágyor I, Heuschmann P, Langhorst J, Keil T, Löffler C. [How Common are Complementary Medicine Procedures in Bavarian Acute Care Hospitals? Results of A Bavarian-wide Website Screening]. DAS GESUNDHEITSWESEN 2023; 85:165-174. [PMID: 36543259 PMCID: PMC10075256 DOI: 10.1055/a-1961-1064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND In Germany, complementary medicine is used by up to 62% of patients, but type and extent of in-patient complementary care are not known. The objective of this study was, therefore, to conduct a survey on complementary medicine procedures in Bavarian acute care hospitals by screening the websites of all respective facilities in order to cover a broad range of complementary procedures. METHODS In 2020, an independent and comprehensive website screening of all 389 Bavarian acute hospitals, including all departments, was conducted by two independent raters. Complementary medicine procedures offered were analysed in total as well as separately by specialty. RESULTS Among all 389 Bavarian acute care hospitals, 82% offered at least one and 66% at least three different complementary procedures on their website. Relaxation techniques (52%), acupuncture (44%), massage (41%), movement-, art-, and music therapy (33%, 30%, and 28%), meditative movement therapies like yoga (30%), and aromatherapy (29%) were offered most frequently. Separated by specialty, complementary procedures were most common in psychiatry/psychosomatics (relaxation techniques 69%, movement and art therapy 60% each) at 87%, and in gynaecology/obstetrics (most common acupuncture 64%, homeopathy 60%, and aromatherapy 41%) at 72%. CONCLUSION The vast majority of Bavarian acute care hospitals also seem to conduct complementary medicine procedures in therapy, especially for psychological indications and in obstetrics and gynaecology, according to the hospital websites. How often these procedures are used in inpatient or outpatient settings as well as evidence on effectiveness of the applied procedures should be investigated in further studies.
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Affiliation(s)
- Anne Kollikowski
- CCC WERA, Komplementäre Onkologie Integrativ, Universitätsklinikum Würzburg, Würzburg, Germany.,Institut für Klinische Epidemiologie und Biometrie, Julius-Maximilians-Universität Würzburg, Würzburg, Germany
| | - Lisa Schiffmann
- CCC WERA, Komplementäre Onkologie Integrativ, Universitätsklinikum Würzburg, Würzburg, Germany.,Institut für Klinische Epidemiologie und Biometrie, Julius-Maximilians-Universität Würzburg, Würzburg, Germany
| | - Katharina Gabriel
- Institut für Klinische Epidemiologie und Biometrie, Julius-Maximilians-Universität Würzburg, Würzburg, Germany
| | - Ildikó Gágyor
- Institut für Allgemeinmedizin, Universitätsklinikum Würzburg, Würzburg, Germany
| | - Peter Heuschmann
- Institut für Klinische Epidemiologie und Biometrie, Julius-Maximilians-Universität Würzburg, Würzburg, Germany.,Zentrale für Klinische Studien Würzburg, Universitätsklinikum Würzburg, Würzburg, Germany
| | - Jost Langhorst
- Klinik für Integrative Medizin und Naturheilkunde, Sozialstiftung Bamberg, Bamberg, Germany.,Stiftungslehrstuhl für Integrative Medizin, Universität Duisburg-Essen, Duisburg, Bamberg, Germany
| | - Thomas Keil
- Institut für Klinische Epidemiologie und Biometrie, Julius-Maximilians-Universität Würzburg, Würzburg, Germany.,Landesinstitut Gesundheit I, Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit, Erlangen, Germany
| | - Claudia Löffler
- Medizinische Klinik und Poliklinik II, Universitätsklinikum Würzburg , Würzburg, Germany.,CCC WERA, Komplementäre Onkologie Integrativ, Universitätsklinikum Würzburg, Würzburg, Germany
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Arbuckle C. Exploring the use of alternative diets in people living with cancer. Nurs Stand 2023; 38:63-68. [PMID: 36710635 DOI: 10.7748/ns.2023.e11963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2022] [Indexed: 01/31/2023]
Abstract
There is significant use of alternative diets by people living with cancer, with data suggesting this has continued to increase since the 1980s. Commonly used alternative diets include the ketogenic diet, Gerson therapy, alkaline diets and fasting diets. This article explains the latest trends in relation to alternative diets, discusses the reasons why people may want to use these and examines their hypothesised mechanisms of action. The author outlines and critically reviews the evidence underpinning the use of such diets in those living with cancer, and suggests that this remains weak. The article also explores the challenges that nurses may experience when a person living with cancer wishes to adopt an alternative diet, and provides practical advice and recommendations on nutrition.
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Affiliation(s)
- Cameron Arbuckle
- University College London Hospitals NHS Foundation Trust, London, England
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42
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Källman M, Bergström S, Carlsson T, Järås J, Holgersson G, Nordberg JH, Nilsson J, Wode K, Bergqvist M. Use of CAM among cancer patients : Results of a regional survey in Sweden. BMC Complement Med Ther 2023; 23:51. [PMID: 36797715 PMCID: PMC9933304 DOI: 10.1186/s12906-023-03876-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Accepted: 02/07/2023] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND The use of complementary and alternative medicine (CAM) by patients is widespread. However, there is a lack of knowledge regarding the extent and details of patient CAM use in Sweden, especially in rural Sweden. The aim of this study was to estimate the extent and characteristics of CAM use among cancer patients in Region Gävleborg. METHODS A total of 631 questionnaires were distributed to which 376 responses were registered, yielding a response rate of 59.6%. Questionnaires were distributed to oncology patients at their first visit for curative treatment at the Department of Oncology, Gävle Hospital. Palliative patients were recruited at their first visit and during enrollment in palliative outpatient care in their own homes. The characteristics of the respondents were presented with standard descriptive statistics. A multivariable logistic model was fitted to calculate odds ratios (ORs) and identify potential predictors (Age, Gender, Education, Diagnosis) of CAM use post-cancer diagnosis. RESULTS 54% of all participants reported lifetime CAM use, 34% reported CAM use post-diagnosis. The most common CAM methods used after diagnosis are vitamins, health food preparations, herbal teas, prayer and dietary methods. The most common source of information reported is family and friends. Almost 70% of those who used CAM after their diagnosis stated that they did not discuss their use with healthcare professionals. Most patients reported that they would like some CAM modalities to be offered within conventional care regardless of their own CAM use. CONCLUSIONS The use of CAM is common among patients with cancer in the region of Gävleborg, and previous studies show a similar use in Sweden in general. Based on the widespread use of CAM and patient interest in discussing CAM use with healthcare professionals, greater attention and focus should be placed on creating a basis for this dialogue. If we, as healthcare professionals, are to emphasise our commitment to providing patient-centred care, we must acknowledge that patients use CAM and are seeking a dialogue about CAM use in their care.
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Affiliation(s)
- Mikael Källman
- Department of Radiation Sciences, Umeå University, Umeå, Sweden. .,Centre for Research and Development, Uppsala University/Region Gävleborg, Gävle, Sweden. .,Department of Oncology, Gävle Hospital, Gävle, Sweden.
| | - Stefan Bergström
- grid.12650.300000 0001 1034 3451Department of Radiation Sciences, Umeå University, Umeå, Sweden ,grid.8993.b0000 0004 1936 9457Centre for Research and Development, Uppsala University/Region Gävleborg, Gävle, Sweden ,grid.413607.70000 0004 0624 062XDepartment of Oncology, Gävle Hospital, Gävle, Sweden
| | - Tobias Carlsson
- grid.413607.70000 0004 0624 062XDepartment of Oncology, Gävle Hospital, Gävle, Sweden
| | | | - Georg Holgersson
- grid.412354.50000 0001 2351 3333Department of Oncology, Uppsala University Hospital, Uppsala, Sweden
| | - Johanna Hök Nordberg
- Regional Cancer Centre Stockholm–Gotland, Stockholm, Sweden ,Department of NVS, Karolinska Institution, Stockholm, Sweden ,Department of Physiology & Pharmacology, Karolinska Institution, Stockholm, Sweden
| | - Jonas Nilsson
- grid.12650.300000 0001 1034 3451Department of Radiation Sciences, Umeå University, Umeå, Sweden ,grid.8993.b0000 0004 1936 9457Centre for Research and Development, Uppsala University/Region Gävleborg, Gävle, Sweden
| | - Kathrin Wode
- grid.12650.300000 0001 1034 3451Department of Radiation Sciences, Umeå University, Umeå, Sweden ,Regional Cancer Centre Stockholm–Gotland, Stockholm, Sweden ,grid.12650.300000 0001 1034 3451Department of Nursing, Umeå University, Umeå, Sweden
| | - Michael Bergqvist
- grid.12650.300000 0001 1034 3451Department of Radiation Sciences, Umeå University, Umeå, Sweden
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Mohamed A, Karima S, Nadia O. Contextualization and validation of the questionnaire ABCAM (Attitudes and Beliefs about Complementary and Alternative Medicine) in cancer patients in Morocco. Eur J Integr Med 2023. [DOI: 10.1016/j.eujim.2023.102237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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Tian EJ, Veziari Y, Leach MJ, Kumar S. The effectiveness of reflexology on mental health in cancer patients: A systematic review and meta-analysis of randomised controlled trials. Complement Ther Clin Pract 2023; 50:101708. [PMID: 36434907 DOI: 10.1016/j.ctcp.2022.101708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 10/19/2022] [Accepted: 11/13/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND PURPOSE The current body of research examining the effectiveness of reflexology in patients with cancer have predominantly focused on managing physical symptoms and treatment side effects. This review aimed to synthesise evidence from randomised controlled trials (RCTs) examining the effectiveness of reflexology on mental health outcomes in people with cancer. METHODS RCTs published in English and measuring stress, anxiety, depression or quality of life (QoL) were included. Eligible RCTs were identified through search of MEDLINE, Embase, Emcare, PsycINFO, Scopus, the Cochrane Library, OTseeker, PEDro (18 June 2021) and Google and Google Scholar (21 June 2021). The Critical Appraisal Skills Programme Randomised Controlled Trials Checklist was used to assess risk of bias. Meta-analysis and narrative synthesis were undertaken. The certainty of evidence was assessed by using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) framework. RESULTS Fifteen RCTs (1356 adult participants) were included. Evidence for stress and anxiety (primary outcomes), as well as depression and QoL (secondary outcomes), were mixed and conflicting. The certainty of the evidence was low to very low. CONCLUSION An unequivocal recommendation supporting reflexology cannot be made. Greater utilisation of well-established reporting guidelines, together with increased investment in well-designed, high-quality clinical research are required.
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Affiliation(s)
- Esther Jie Tian
- UniSA Allied Health and Human Performance, University of South Australia, GPO Box 2471, Adelaide, South Australia, 5001, Australia.
| | - Yasamin Veziari
- UniSA Allied Health and Human Performance, University of South Australia, GPO Box 2471, Adelaide, South Australia, 5001, Australia.
| | - Matthew J Leach
- Southern Cross University, Lismore Campus, Military Road, East Lismore, New South Wales, 2480, Australia.
| | - Saravana Kumar
- UniSA Allied Health and Human Performance, University of South Australia, GPO Box 2471, Adelaide, South Australia, 5001, Australia.
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Wiese F, Kutschan S, Doerfler J, Mathies V, Buentzel J, Buentzel J, Huebner J. Green tea and green tea extract in oncological treatment: A systematic review. INT J VITAM NUTR RES 2023; 93:72-84. [PMID: 33593083 DOI: 10.1024/0300-9831/a000698] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Purpose: Teas are an essential part of traditional phytotherapy. The aim of this systematic review is to assess the clinical evidence using green tea catechins in cancer care. Methods: A systematic search was conducted searching five electronic databases concerning the effectiveness and risks of epigallocatechin gallate (EGCG) on cancer patients. Results: Seven studies with 371 patients were included. Patients were mainly suffering from breast and prostate cancer. Dosing ranged from 28 mg to 1600 mg EGCG, intervention time from 7 days to 6 months with different applications (topical 2 studies; oral 5 studies). The studies showed heterogeneous methodological quality and results leading not to conduct a meta-analysis. There was a small decrease in prostate-specific-antigen levels in one study (N=60; T0:(mean±SD) 9.6±5.2 ng/ml, T1: 8.4±4.3 ng/ml vs. T0: 9.9±8.5 ng/ml, T1: 10.0±9.0 ng/ml; p=0.04), whereas in a second study only a trend was seen. Topical green tea was as effective as metronidazole powder in reducing the odor of fungating malignant wounds (1 study; N=30) with a consequent increase in quality of life (QoL) (p<0.001), improvement of appetite (p<0.001), malodorous control (p<0.001), social activities (p<0.001). Radiotherapy-induced diarrhea was lower in the green tea intervention group compared to placebo (1 study; N=42; week 4+5: without diarrhea p=0.002). Conclusions: The studies suggest that EGCG is as effective as a local antibiotic in malodorous control and improvement of QoL of fungating malignant wounds. Green tea could be a possible complementary method for treating acute radiation-induced diarrhea. Due to limitations, further studies with higher methodological quality and larger sample sizes are needed.
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Affiliation(s)
- Fanny Wiese
- Klinik für Innere Medizin II, Hämatologie und Internistische Onkologie, Universitätsklinikum Jena, Germany
| | - Sabine Kutschan
- Klinik für Innere Medizin II, Hämatologie und Internistische Onkologie, Universitätsklinikum Jena, Germany
| | - Jennifer Doerfler
- Klinik für Innere Medizin II, Hämatologie und Internistische Onkologie, Universitätsklinikum Jena, Germany
| | | | - Jens Buentzel
- Klinik für HNO-Erkrankungen, Kopf-Hals-Chirurgie, Südharz-Klinikum Nordhausen, Germany
| | - Judith Buentzel
- Klinik für Hämatologie und Medizinische Onkologie, Universitätsmedizin Göttingen, Germany
| | - Jutta Huebner
- Klinik für Innere Medizin II, Hämatologie und Internistische Onkologie, Universitätsklinikum Jena, Germany
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Medioni J, Scimeca D, Marquez YL, Leray E, Dalichampt M, Hoertel N, Bennani M, Trempat P, Boujedaini N. Benefits of Homeopathic Complementary Treatment in Patients With Breast Cancer: A Retrospective Cohort Study Based on the French Nationwide Healthcare Database. Clin Breast Cancer 2023; 23:60-70. [PMID: 36376237 DOI: 10.1016/j.clbc.2022.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 09/21/2022] [Accepted: 10/01/2022] [Indexed: 12/27/2022]
Abstract
BACKGROUND Complementary therapy in oncology aims to help patients better cope with the illness and side effects (SEs) of cancer treatments that affect their quality of life (QOL). This study aimed to assess the benefits of homeopathic treatment on the health-related QOL (HRQOL) of patients with non-metastatic breast cancer (BC) prescribed in postsurgical complementary therapy. PATIENTS AND METHODS An extraction from the French nationwide healthcare database targeted all patients who underwent mastectomy for newly diagnosed BC between 2012 and 2013. HRQOL was proxied by the quantity of medication used to palliate the SEs of cancer treatments. RESULTS A total of 98,009 patients were included (mean age: 61 ± 13 years). Homeopathy was used in 11%, 26%, and 22% of patients respectively during the 7 to 12 months before surgery, the 6 months before, and 6 months after. Thereafter, the use remained stable at 15% for 4 years. Six months after surgery, there was a significant overall decrease (RR = 0.88, confidence interval (CI)95 = 0.87-0.89) in the dispensing of medication associated with SEs in patients treated with ≥ 3 dispensing of homeopathy compared to none. The decrease appeared to be greater for immunostimulants (RR = 0.79, (CI)95 = 0.74-0.84), corticosteroids (RR = 0.82, (CI)95 = 0.79-0.85), and antidiarrheals (RR = 0.83, (CI)95 = 0.77-0.88). CONCLUSION The study showed an increasing use of homeopathy in patients with BC following diagnosis. This use was maintained after surgery and seemed to play a role in helping patients to better tolerate the SEs of cancer treatments.
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Affiliation(s)
- Jacques Medioni
- APHP Hôpital Européen Georges Pompidou, Paris, France; Université Paris Cité, Paris, France
| | | | | | - Emmanuelle Leray
- Univ Rennes, EHESP, CNRS, Inserm, ARENES UMR 6051, RSMS U 1309, F-35000 Rennes, France
| | | | - Nicolas Hoertel
- Université Paris Cité, Paris, France; APHP Corentin Celton, Paris, France
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Mascher A, Pelzer F, Duncan LJ, Martin DD, Baumgartner S, Berger B. The Introspective Patient Experience of Mistletoe Therapy in Cancer: A Qualitative Study. Integr Cancer Ther 2023; 22:15347354231198474. [PMID: 37731253 PMCID: PMC10515602 DOI: 10.1177/15347354231198474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 08/02/2023] [Accepted: 08/15/2023] [Indexed: 09/22/2023] Open
Abstract
INTRODUCTION The introspective experience of cancer patients using mistletoe therapy has received little scientific interest, although it is crucial for a holistic understanding of this therapy. This study contributes to patient-centered research and treatment by documenting the subjective experiences of individuals undergoing mistletoe therapy. METHODS In this qualitative, explorative study, 20 outpatients with a history of various cancer types were recruited from Arlesheim Hospital (Arlesheim, Switzerland). All patients received subcutaneous mistletoe therapy for at least 2 years (median 7.5 years). Data was collected through 2 semi-structured, in-depth interviews per patient. Qualitative content analysis was applied to examine the data. The individual experience of mistletoe therapy was analyzed in relation to 6 predefined levels of human experience: physical, vital, emotional, mental, spiritual and social. In addition, 3 further aspects, considered as cross-dimensional perspectives, emerged out of the material: warmth, immune strengthening, and general wellbeing. RESULTS Data analysis revealed considerable heterogeneity among patients' experiences with mistletoe therapy. The importance of specific aspects became apparent, such as increased vitality to manage daily life, greater emotional and mental stability, warmth as a multidimensional phenomenon, feelings of safety and protection through mistletoe therapy, heightened self-awareness and improved self-care, as well as sensations of spiritual connectedness. CONCLUSIONS Prior to this study it had not been shown that cancer patients using mistletoe therapy do have observations on different levels of experience. These results may lead to a deeper understanding of patients receiving mistletoe therapy, enabling them to be supported in a more holistic way both during mistletoe treatment and on their life path. Further investigations into the effects of mistletoe therapy on the emotional, mental, and spiritual level are warranted.
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Affiliation(s)
- Annika Mascher
- Witten/Herdecke University, Witten, Germany
- Society for Cancer Research, Arlesheim, Switzerland
- Klinik Arlesheim, Arlesheim, Switzerland
| | - Florian Pelzer
- Witten/Herdecke University, Witten, Germany
- Society for Cancer Research, Arlesheim, Switzerland
| | | | | | - Stephan Baumgartner
- Witten/Herdecke University, Witten, Germany
- Society for Cancer Research, Arlesheim, Switzerland
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Open dialogue about complementary and alternative medicine early in the oncology treatment trajectory. A qualitative study of patients’ lived experiences. Eur J Integr Med 2023. [DOI: 10.1016/j.eujim.2023.102228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Yussof I, Ab Muin NF, Mohd M, Hatah E, Mohd Tahir NA, Mohamed Shah N. Breast cancer prevention and treatment misinformation on Twitter: An analysis of two languages. Digit Health 2023; 9:20552076231205742. [PMID: 37808244 PMCID: PMC10559708 DOI: 10.1177/20552076231205742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2023] [Indexed: 10/10/2023] Open
Abstract
Objective To determine the prevalence and types of misinformation on Twitter related to breast cancer prevention and treatment; and compare the differences between the misinformation in English and Malay tweets. Methods A total of 6221 tweets related to breast cancer posted between 2018 and 2022 were collected. An oncologist and two pharmacists coded the tweets to differentiate between true information and misinformation, and to analyse the misinformation content. Binary logistic regression was conducted to identify determinants of misinformation. Results There were 780 tweets related to breast cancer prevention and treatment, and 456 (58.5%) contain misinformation, with significantly more misinformation in Malay compared to English tweets (OR = 6.18, 95% CI: 3.45-11.07, p < 0.001). Other determinants of misinformation were tweets posted by product sellers and posted before the COVID-19 pandemic. Less misinformation was associated with tweets utilising official/peer-reviewed sources of information compared to tweets without external sources and those that utilised less reliable information sources. The top three most common content of misinformation were food and lifestyle, alternative medicine and supplements, comprising exaggerated claims of anti-cancer properties of traditional and natural-based products. Conclusion Misinformation on breast cancer prevention and treatment is prevalent on social media, with significantly more misinformation in Malay compared to English tweets. Our results highlighted that patients need to be educated on digital health literacy, with emphasis on utilising reliable sources of information and being cautious of any promotional materials that may contain misleading information. More studies need to be conducted in other languages to address the disparity in misinformation.
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Affiliation(s)
- Izzati Yussof
- Centre for Quality Management of Medicines, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nur Fa’izah Ab Muin
- Oncology and Radiotherapy Department, Hospital Canselor Tuanku Muhriz, Cheras, Malaysia
| | - Masnizah Mohd
- Faculty of Information Science and Technology, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Ernieda Hatah
- Centre for Quality Management of Medicines, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nor Asyikin Mohd Tahir
- Centre for Quality Management of Medicines, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Noraida Mohamed Shah
- Centre for Quality Management of Medicines, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Li P, Wang Q, Liu L, Zhang Q, Zhou R, Wang Y, Liu T, Feng L. The Role of Complementary and Alternative Medicine on Cancer-Related Fatigue in Adults: An Overview of Systematic Reviews. Integr Cancer Ther 2023; 22:15347354231188947. [PMID: 37515495 PMCID: PMC10387784 DOI: 10.1177/15347354231188947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 05/15/2023] [Accepted: 07/04/2023] [Indexed: 07/31/2023] Open
Abstract
BACKGROUND Cancer-related fatigue (CRF) has an enormous adverse impact on quality of life and subsequent therapy of cancer patients. Complementary and alternative medicine (CAM) is reported to improve CRF in many systematic reviews (SRs), but the effects are controversial because of variations in the quality and outcomes. METHODS Thirteen databases were searched from inception to September 2022. Only SRs of randomized controlled trials (RCTs) were included. We assessed the quality of included SRs with the AMSTAR-2 tool, the strength of evidence with the GRADE system, the risk of bias with the ROBIS tool, and the integrity of SRs with the PRISMA checklist. RESULTS We included 30 eligible SRs (27 meta-analyses). Based on the AMSTAR-2 tool, 29 SRs were rated as "critically low" quality, and only one was rated as "low" quality. With the ROBIS tool, 19 SRs demonstrated a low risk of bias. According to the PRISMA checklist, no SRs reported all the items, and 10 SRs sufficiently reported over 70%. Based on the GRADE system, 7 outcomes were assessed as high-quality evidence. CONCLUSION This overview demonstrates promising evidence for the effectiveness of CAM interventions in the treatment of CRF in adults. The roles of qigong, music, auricular point therapy, and dietary supplements in CRF need further evaluation. Although findings are mixed, it is recommend to select appropriate CAM to manage cancer-related fatigue under the guidance of physicians. More studies with rigorous methodological designs and sufficient sample sizes are needed.
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Affiliation(s)
- Peijin Li
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy for Medical Sciences and Peking Union Medical College, Beijing, China
- Beijing University of Chinese Medicine, Beijing, China
| | - Qian Wang
- Beijing University of Chinese Medicine, Beijing, China
| | - Lixing Liu
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy for Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qinglin Zhang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy for Medical Sciences and Peking Union Medical College, Beijing, China
- Beijing University of Chinese Medicine, Beijing, China
| | - Rui Zhou
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy for Medical Sciences and Peking Union Medical College, Beijing, China
- Beijing University of Chinese Medicine, Beijing, China
| | - Yue Wang
- Beijing Hospital of Traditional Chinese Medicine, Beijing, China
| | - Tingting Liu
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy for Medical Sciences and Peking Union Medical College, Beijing, China
- Beijing University of Chinese Medicine, Beijing, China
| | - Li Feng
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy for Medical Sciences and Peking Union Medical College, Beijing, China
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