Addressing Complementary and Alternative Medicine Use Among Individuals With Cancer: An Integrative Review and Clinical Practice Guideline

Abstract

Complementary and alternative medicine (CAM) use is common among individuals with cancer, but many choose not to discuss CAM with healthcare providers (HCPs). Moreover, there is variability in the provision of evidence-informed decision making about CAM use. A clinical practice guideline was developed to standardize how oncology HCPs address CAM use as well as to inform how individuals with cancer can be supported in making evidence-informed decisions about CAM. An integrative review of the literature, from inception to December 31st, 2018, was conducted in MEDLINE, EMBASE, PsychINFO, CINAHL, and AMED databases. Eligible articles included oncology HCPs’ practice related to discussing, assessing, documenting, providing decision support, or offering information about CAM. Two authors independently searched the literature and selected articles were summarised. Recommendations for clinical practice were formulated from the appraised evidence and clinical experiences of the research team. An expert panel reviewed the guideline for usability and appropriateness and recommendations were finalised. The majority of the 30 studies eligible for inclusion were either observational or qualitative, with only three being reviews and three being experimental. From the literature, seven practice recommendations were formulated for oncology HCPs regarding how to address CAM use by individuals with cancer, including communicating, assessing, educating, decision-coaching, documenting, active monitoring, and adverse event reporting. It is imperative for safe and comprehensive care that oncology HCPs address CAM use as part of standard practice. This clinical practice guideline offers directions on how to support evidence-informed decision making about CAM among individuals with cancer.

Terapias complementarias para el control de los síntomas del tracto urinario inferior masculino: revisión sistemática

“…En cuanto a la efectividad de las TC, nueve estudios las consideraron una alternativa eficaz para controlar los STUI en la población masculina (19,(23)(24)(25)(26)(27)(28)(29)(30) . La fitoterapia se destaca como una de las TC más utilizadas por la población general (16,36) . La fitoterapia se basa en el uso de plantas medicinales para tratar ciertos síntomas, y es una práctica ampliamente reconocida y difundida por la Organización Mundial de la Salud (37) .…”

“…La efectividad de la fitoterapia y de la acupuntura ha sido evaluada individualmente por medio de revisiones sistemáticas (12)(13) y comparada con los tratamientos convencionales para el control de los STUI (14)(15) . Sin embargo, se observa que muchas veces las TC se indican de forma empírica (16) . Por lo tanto, se espera que una revisión sistemática sea capaz de resumir la evidencia disponible sobre la efectividad de las diferentes TC para controlar los STUI en la población masculina y así favorecer su implementación en la práctica clínica.…”

Complementary therapies in the control of male lower urinary tract symptoms: A systematic review

“…Phytotherapy and acupuncture have been evaluated individually through systematic reviews regarding their effectiveness (12)(13) and compared to the conventional treatments to control LUTS (14)(15) . Nevertheless, it is observed that CTs indication often occur empirically (16) . Therefore, it is expected that a systematic review will be able to summarize the available evidence on the effectiveness of different CTs to control LUTS in the male population and thus favor its implementation in the clinical practice.…”

“Part of the Conversation”: A Qualitative Study of Oncology Healthcare Professionals’ Experiences of Integrating Standardized Assessment and Documentation of Complementary Medicine

“…To address the lack of standardization of assessment, documentation, and discussion of CM use within cancer care settings we developed a clinical practice guideline that outlined 7 practice recommendations regarding how to address CM use by individuals with cancer. 13 These recommendations focused on communication, assessment, education, decision-coaching, documentation, active monitoring, and adverse event reporting related to CM. We then launched a study that aimed to implement 3 key recommendations drawn from this clinical practice guideline—assessment, documentation, and education—within a provincial cancer agency in Canada.…”