Addressing Unmet Information Needs: Results of a Clinician-Led Consultation Service About Complementary and Alternative Medicine for Cancer Patients and Their Relatives

Abstract

Purpose. To report on a telephone consultation service with cancer patients and their relatives about complementary and alternative medicine (CAM) between 1999 and 2011. Methods. We offered a Germany-wide, free-of-charge telephone consultation service about CAM led by oncology clinicians from a comprehensive cancer center. The consultations followed a patient-centered approach with the aim to provide guidance and evidence-based information. Sociodemographic, disease-related data as well as information about the consultations’ content were collected in a standardized manner, and feedback questionnaires were sent out immediately after the consultations. Results. Overall, 5269 callers from all over Germany used the service (57% patients, 43% relatives). The “big 4” cancer types (breast, gastrointestinal, prostate, and lung) accounted for 55% of all calls. In 67% of calls, patients had just received the diagnosis or commenced anticancer therapy; 69% of patients had advanced or metastatic diseases. More than half of the callers (55%) had vague concerns like “what else can I do?” rather than specific questions related to CAM. The consultations covered a broad spectrum of issues from CAM therapies to cancer treatment and measures supportive of health, nutrition, and psychosocial support. Callers highly valued the service. Conclusions. Consulting about CAM addresses important unmet needs from cancer patients and their relatives. It provides clinicians with the opportunity to engage in open and supportive dialogues about evidence-based CAM to help with symptom management, psychological support, and individual self-care. Consulting about CAM cannot be separated from consulting about conventional care and should be provided from the beginning of the cancer journey.

A national survey of oncology survivors examining nutrition attitudes, problems and behaviours, and access to dietetic care throughout the cancer journey

“…This difference may be explained by higher CAM use amongst women and higher information seeking activity amongst breast cancer survivors [45e47]. It is important that HCPs communicate openly with cancer survivors about CAM in order to identify potentially harmful practices while supporting survivors' holistic goals [48,49]. This may increase self-efficacy, internalise locus of control and improve the sense of wellbeing associated with feeling like a participant in one's own recovery [26,48,50,51].…”

Impact of integrative open dialogue about complementary alternative medicine. A phase II randomized controlled trial

“…In this study, 53 of 57 allocated to IOD-CAM completed the intervention and we consider it feasible to integrate in standard oncology care. The high completion rate could be an expression of patients' substantial need for reliable information and counselling about CAM as an integrated part of oncology care [35][36][37].…”

KOKON: A Germany-Wide Collaborative Research Project to Identify Needs, Provide Information, Foster Communication and Support Decision-Making about Complementary and Alternative Medicine in Oncology

“…We advanced the findings of a previous project [10] into a communication manual for a multicenter physician-led consultation service and implemented and evaluated the service at 7 cancer centres. Based on the manual, we developed a training programme for gynaecologists consulting cancer patients about CAM and tested the programme in a pilot randomized study [17].…”

“…Findings from a clinician-led consultation service about CAM, funded by the German Cancer Aid since 1999, showed that a guideline-oriented, patient-centred approach provides physicians with the opportunity to engage in open and supportive dialogues about CAM to help with symptom management, psychological support, and individual self-care [10].…”