Cancer Patient Disclosure and Patient-Doctor Communication of Complementary and Alternative Medicine Use: A Systematic Review

Abstract

After completing this course, the reader will be able to:1. Discuss the danger inherent in nondisclosure of complementary and alternative medicine (CAM) use due to the potential for herb-or vitamin-drug interactions with conventional treatment.2. Explain the need for greater patient-doctor communication about CAM use in oncology settings in order to maintain patient safety and wellbeing.This article is available for continuing medical education credit at CME.TheOncologist.com. CME CME Results. A total of 21 studies were located, which reported a prevalence of CAM use among patients with cancer ranging between 11% and 95%; of these patients, 20% to 77% did not disclose their CAM use. The main reasons for nondisclosure were the doctor's lack of inquiry; patient's anticipation of the doctor's disapproval, disinterest, or inability to help; and patient's perception that disclosure of CAM use is irrelevant to their conventional care. There is some evidence to suggest that patient-doctor communication about the use of CAM was associated with an enhanced patient-doctor relationship and higher patient satisfaction. ABSTRACT Conclusions. Although the use of CAM by patients with

Looking beyond the barriers: Practical and symbolic factors associated with disclosure of complementary and alternative medicine (CAM) use

“…The sociodemographic factors associated with non-disclosure include lower education [12], younger age [7], and gender [5,11], although the findings for the latter factor are inconsistent. Among the reasons for not disclosing CAM use noted in current research, perceiving that physicians will disapprove or react negatively to CAM use [12][13][14][15], and that disclosing CAM use wasn't important for their care [13][14][15][16][17], figure prominently.…”

Introduction to Complementary, Alternative, and Traditional Therapies

“…The main reasons given for lack of disclosure included the physician's lack of inquiry; the patient's anticipation of the physician's disapproval, disinterest, or inability to help; and the patient's perception that disclosure of CAM use is irrelevant to conventional care. 13,15 Disclosure seems to be particularly lower among African Americans, Latinos, and Asian Americans than among non-Latino whites (P<.05), most likely related to differences in access to and quality of conventional care. 16 The lack of disclosure of CAM use is concerning for several reasons.…”

“…Disclosure rates in the United Kingdom are 20% to 40%. 13,14 A systematic review 15 of disclosure of CAM use by cancer patients and patient-doctor communication about CAM use revealed that 20% to 77% of the patients did not disclose that they used CAM. The main reasons given for lack of disclosure included the physician's lack of inquiry; the patient's anticipation of the physician's disapproval, disinterest, or inability to help; and the patient's perception that disclosure of CAM use is irrelevant to conventional care.…”

Provider and Patient Expectations for Dietary Supplement Discussions

“…Given these concordant views, it is surprising that the majority of patients do not disclose their supplement use to their providers. [35][36][37][38] Both parties are to blame-providers frequently do not ask about patients' supplement use, 35,39 and patients may not think to let their providers know. 40 Although providers may have inadequate information or suboptimal training regarding supplements, 41,42 in their interviews they much more frequently cited the importance of discussing certain topics than did patients.…”