Perception of risk and communication among conventional and complementary health care providers involving cancer patients’ use of complementary therapies: a literature review

Abstract

BackgroundCommunication between different health care providers (conventional and complementary) and cancer patients about their use of complementary therapies affects the health and safety of the patients. The aim of this study was to examine the qualitative research literature on the perception of and communication about the risk of complementary therapies between different health care providers and cancer patients.MethodsSystematic searches in six medical databases covering literature from 2000 to 2015 were performed. The studies were accessed according to the level of evidence and summarized into different risk situations. Qualitative content analysis was used to analyze the text data, and the codes were defined before and during the data analysis.ResultsTwenty-nine papers were included in the primary analysis and five main themes were identified and discussed. The main risk situations identified were 1. Differences in treatment concepts and philosophical values among complementary and conventional health care providers. 2. Adverse effects from complementary products and herbs due to their contamination/toxicity and interactions with conventional cancer treatment. 3. Health care physicians and oncologists find it difficult to recommend many complementary modalities due to the lack of scientific evidence for their effect. 4. Lack of knowledge and information about complementary and conventional cancer treatments among different health care providers.ConclusionThe risk of consuming herbs and products containing high level of toxins is a considerable threat to patient safety (direct risk). At the same time, the lack of scientific evidence of effect for many complementary therapies and differences in treatment philosophy among complementary and conventional health care providers potentially hinder effective communication about these threats with mutual patients (indirect risk). As such, indirect risk may pose an additional risk to patients who want to combine complementary therapies with conventional treatment in cancer care. Health care providers who care for cancer patients should be aware of these risks.Electronic supplementary materialThe online version of this article (doi:10.1186/s12906-016-1326-3) contains supplementary material, which is available to authorized users.

Attitudes and knowledge about direct and indirect risks among conventional and complementary health care providers in cancer care

“…The complementary therapists believed that to a lesser extent. However, the assumption that risk associated with many complementary modalities is indirect is in accordance with Fisher [13], Dantas [21], and Stub [17]. They found that the main risks associated with homeopathy and other complementary modalities were indirect; that is, related to the therapists and clinical practice rather than the medicine.…”

“…Moreover, more than half of the medical doctors and nurses neither discouraged nor encouraged the use of complementary modalities. Advice may depend on the situation, the medical doctor’s knowledge of the complementary therapy and cancer type [17]. …”

“…The questionnaire was based on information retrieved from a literature review [17]. The final version included 86 questions in 8 categories (inclusion, communication with patients, risk in clinical practice, perception about complementary and conventional treatment modalities, information gathering about complementary and conventional modalities, personal demographics, and clinical practice or hospital work).…”

“…On the other hand, when the evidence for safety and efficacy is weak, it is sensible to discourage the patients from using the modality. The evidence of safety and efficacy for many complementary modalities is mixed and weak [2, 8], and studies shows that medical doctors find it difficult to recommend many complementary modalities due to a lack of scientific evidence on effect [15–17]. …”

Complementary and conventional providers in cancer care: experience of communication with patients and steps to improve communication with other providers

“…The Vanguard Study questionnaire was based on information retrieved from a literature review performed by our research group [16]. During a 7 month research stay in the US, TS participated in weekly meetings with SQ, JS, and TA, where the questions were discussed and refined with input from a reference group of US conventional and complementary providers.…”