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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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Erickson N, Sullivan ES, Kalliostra M, Laviano A, Wesseling J. Nutrition care is an integral part of patient-centred medical care: a European consensus. Med Oncol 2023; 40:112. [PMID: 36881207 PMCID: PMC9992033 DOI: 10.1007/s12032-023-01955-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 01/18/2023] [Indexed: 03/08/2023]
Abstract
While healthcare is becoming more patient-centred, evidence-based nutrition interventions are still not accessible to all patients with cancer. As nutrition interventions directly improve clinical and socioeconomic outcomes, patient-centred care is not complete without nutrition care. While awareness of the negative impact of malnutrition on clinical outcomes, quality of life, and functional and emotional wellbeing in cancer is growing, there is relatively poor awareness amongst patients, clinicians, policymakers, and payers that nutrition interventions -particularly those begun in the early stages of the disease course- are an effective method for improving such outcomes. The European Beating Cancer Plan recognises the need for a holistic approach to cancer but lacks actionable recommendations to implement integrated nutrition cancer care at member state level. When considering nutrition care as a human right, the impact on quality of life and functional status must be prioritized, as these may be equally as important to patients, especially in advanced cancer where improvements in clinical outcomes such as survival or tumour burden may not be attainable. We formulate actions needed at the regional and the European level to ensure integrated nutrition care for all patients with cancer. The 4 main Take Home Messages are as follows: 1. The goals of Europe's Beating Cancer Plan cannot be achieved without integrating nutrition across the cancer care continuum. 2. Malnutrition negatively impacts clinical outcomes and has socioeconomic consequences for patients and healthcare systems. 3. Championing integrating nutrition care into cancer care is therefore the duty and ethical responsibility of clinicians (Hippocratic Oath-primum non nocere) and 4. Nutrition care is a cost effective, evidence-based therapy.
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Affiliation(s)
- Nicole Erickson
- Comprehensive Cancer Center Munich, Ludwig Maximilian University of Munich Hospital, Munich, Germany.
- Writing Group, The European Union Thematic Network on Integrated Nutrition in Cancer Care (INC2), Croydon, UK.
- European Federation of the Associations of Dietitians (EFAD), Naarden, The Netherlands.
| | - Erin Stella Sullivan
- Writing Group, The European Union Thematic Network on Integrated Nutrition in Cancer Care (INC2), Croydon, UK
- School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Marianna Kalliostra
- Writing Group, The European Union Thematic Network on Integrated Nutrition in Cancer Care (INC2), Croydon, UK
- European Federation of the Associations of Dietitians (EFAD), Naarden, The Netherlands
- The European Nutrition for Health Alliance, London, UK
| | - Alessandro Laviano
- Writing Group, The European Union Thematic Network on Integrated Nutrition in Cancer Care (INC2), Croydon, UK
- The European Nutrition for Health Alliance, London, UK
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Joost Wesseling
- Writing Group, The European Union Thematic Network on Integrated Nutrition in Cancer Care (INC2), Croydon, UK
- The European Nutrition for Health Alliance, London, UK
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Akeeb AA, King SM, Olaku O, White JD. Communication Between Cancer Patients and Physicians About Complementary and Alternative Medicine: A Systematic Review. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2023; 29:80-98. [PMID: 36149678 PMCID: PMC10081707 DOI: 10.1089/jicm.2022.0516] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objectives: Complementary and alternative medicine (CAM) has become increasingly popular among cancer patients and is often used concomitantly with standard cancer therapies. Nonetheless, disclosure of CAM utilization by cancer patients to physicians, along with the provision of information on CAM therapies by physicians, is poor. This review explores the literature to synthesize existing information on communication about CAM usage, reasons for nondisclosure, and the clinical implications thereof. Methods: A search of medical literature published between December 1, 2009, and October 1, 2021 (last searched on April 18, 2022), on communications between physicians and cancer patients about CAM treatments was conducted through MEDLINE and EMBASE. Results were screened for inclusion, dually reviewed, and assessed using the QualSyst quality appraisal instrument. Findings were categorized and synthesized for review. Results: A total of 30 articles were located (n = 8721 total participants), which discussed elements related to patient disclosure of CAM use (n = 16), provider experiences or perceptions related to communication about CAM (n = 3), patterns of this communication (n = 6), and recommendations for effectively discussing CAM with cancer patients (n = 5). Reports indicate that nondisclosure is common throughout the cancer care spectrum. Factors influencing nondisclosure range from patient beliefs and attitudes about their provider, demographic characteristics, disease progression, physician-patient relationship, physician noninquiry, and type of CAM used; ultimately creating a gap in care that may have serious medical implications. Discussion: Many of the studies identified are small and confined to a single-center, hospital-network, or geographic setting, thereby limiting the applicability of findings and recommendations. Nonetheless, improving patient-physician communication is essential in delivering evidence-informed, patient-centered care and crucial for achieving patient satisfaction and positive health outcomes. The lack of adequate CAM dialogue about CAM use increases the risk of adverse interactions with conventional cancer treatments and results in missed opportunities for providers and patients to engage in vital information exchange. Future research and education are necessary to further identify barriers surrounding patient-provider communication about CAM treatments.
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Affiliation(s)
- Ameenat A. Akeeb
- Office of Cancer Complementary and Alternative Medicine, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Sophia M. King
- Office of Cancer Complementary and Alternative Medicine, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Oluwadamilola Olaku
- Office of Cancer Complementary and Alternative Medicine, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Jeffrey D. White
- Office of Cancer Complementary and Alternative Medicine, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
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Lederer AK, Samstag Y, Simmet T, Syrovets T, Huber R. Complementary medicine usage in surgery: a cross-sectional survey in Germany. BMC Complement Med Ther 2022; 22:263. [PMID: 36221070 PMCID: PMC9552450 DOI: 10.1186/s12906-022-03746-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 09/27/2022] [Indexed: 11/10/2022] Open
Abstract
Background Complementary medicine (CM) is frequently used by patients, but little is known about the usage of CM in surgical patients. The study aimed to elucidate the relevance of CM in surgery. Methods This cross-sectional, multi-center survey utilized a paper-based questionnaire consisting of 21 questions to capture CM usage and interest as well as CM communication in visceral and thoracic surgical patients being hospitalized at the corresponding departments of surgery at the University Medical Centers in Freiburg, Heidelberg und Ulm, Germany. Results Overall, 151 patients consented to the survey. On average, current CM usage was stated by 44% of patients. Most frequently used CM approaches were physical exercise (63%), nutritional supplements (59%) and herbal medicine (56%). Strong interest in CM counselling was stated by 51% of patients. Almost 80% of patients wanted to be treated in a holistic manner and desired for reliable information about CM as well as CM informed physicians. Only 12% of patients communicated CM usage and interest with their attending physician. Review of literature revealed similar results showing an overall CM usage of 43%, preferring nutritional supplements and herbal medicine. Conclusion The results of our cross-sectional study indicate a high percentage of CM users and a strong interest in CM among surgical patients. Indeed, the current communication about CM between patients and surgeons is poor. With respect to safety and quality reasons, but also to pay attention to patients’ demands, physicians should be aware of patients’ CM usage in surgery. Trial registration German Clinical Trial register (DRKS00015445).
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Affiliation(s)
- Ann-Kathrin Lederer
- grid.7708.80000 0000 9428 7911Center for Complementary Medicine, Department of Medicine II, Faculty of Medicine, Medical Center-University of Freiburg, University of Freiburg, Hugstetter Straße 55 – Haus Frerichs, 79106 Freiburg, Germany ,grid.410607.4Department of General, Visceral and Transplantation Surgery, University Medical Center, Mainz, Germany
| | - Yvonne Samstag
- grid.5253.10000 0001 0328 4908Institute of Immunology, Section Molecular Immunology, University Hospital of Heidelberg, Heidelberg, Germany
| | - Thomas Simmet
- grid.6582.90000 0004 1936 9748Institute of Pharmacology of Natural Products & Clinical Pharmacology, Ulm University, Ulm, Germany
| | - Tatiana Syrovets
- grid.6582.90000 0004 1936 9748Institute of Pharmacology of Natural Products & Clinical Pharmacology, Ulm University, Ulm, Germany
| | - Roman Huber
- grid.7708.80000 0000 9428 7911Center for Complementary Medicine, Department of Medicine II, Faculty of Medicine, Medical Center-University of Freiburg, University of Freiburg, Hugstetter Straße 55 – Haus Frerichs, 79106 Freiburg, Germany
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Lederer AK, Baginski A, Raab L, Joos S, Valentini J, Klocke C, Samstag Y, Hübner K, Andreeva I, Simmet T, Syrovets T, Hafner S, Freisinger A, Storz MA, Huber R. Complementary medicine in Germany: a multi-centre cross-sectional survey on the usage by and the needs of patients hospitalized in university medical centers. BMC Complement Med Ther 2021; 21:285. [PMID: 34814885 PMCID: PMC8609851 DOI: 10.1186/s12906-021-03460-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 11/08/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The results of recent surveys indicate that more than 50% of the German population has experience with complementary and alternative medicine (CAM) or uses CAM regularly. This study investigated the CAM usage and CAM-related needs of hospitalized patients at university medical centres in the state of Baden-Württemberg, Germany. METHODS A multi-centre, paper-based, pseudonymous survey was carried out by the members of the Academic Centre for Complementary and Integrative Medicine. Patients of all ages, regardless of sex, diagnosis and treatment, who were hospitalized in the Department of Cardiology, Gastroenterology, Oncology, Gynaecology or Surgery at the university medical centres in Freiburg, Heidelberg, Tübingen and Ulm were eligible for inclusion. RESULTS Of the 1275 eligible patients, 67% (n = 854) consented to participate in the survey. Forty-eight percent of the study participants stated that they were currently using CAM. The most frequently used therapies were exercise (63%), herbal medicine (54%) and dietary supplements (53%). Only 16% of the patients discussed CAM usage with their attending physician. Half of the patients (48%) were interested in CAM consultations. More than 80% of the patients desired reliable CAM information and stated that physicians should be better informed about CAM. CONCLUSIONS The frequency of CAM usage and the need for CAM counselling among hospitalized patients at university medical centres in Baden-Württemberg are high. To better meet patients' needs, CAM research and physician education should be intensified. TRIAL REGISTRATION German Clinical Trial register ( DRKS00015445 ).
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Affiliation(s)
- Ann-Kathrin Lederer
- Center for Complementary Medicine, Department of Medicine II, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Theodor von Frerichs Haus, Sir-Hans-A.-Krebs-Straße, 79106, Freiburg, Germany.,Chirurgische Klinik, Evangelisches Diakoniekrankenhaus, Freiburg, Germany
| | - Alexandra Baginski
- Center for Complementary Medicine, Department of Medicine II, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Theodor von Frerichs Haus, Sir-Hans-A.-Krebs-Straße, 79106, Freiburg, Germany
| | - Lena Raab
- Center for Complementary Medicine, Department of Medicine II, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Theodor von Frerichs Haus, Sir-Hans-A.-Krebs-Straße, 79106, Freiburg, Germany
| | - Stefanie Joos
- Institute for General Practice and Interprofessional Care, University Hospital Tübingen, Tübingen, Germany
| | - Jan Valentini
- Institute for General Practice and Interprofessional Care, University Hospital Tübingen, Tübingen, Germany
| | - Carina Klocke
- Institute for General Practice and Interprofessional Care, University Hospital Tübingen, Tübingen, Germany
| | - Yvonne Samstag
- Institute of Immunology, Section Molecular Immunology, University of Heidelberg, Heidelberg, Germany
| | - Katrin Hübner
- Institute of Immunology, Section Molecular Immunology, University of Heidelberg, Heidelberg, Germany
| | - Ivana Andreeva
- Institute of Immunology, Section Molecular Immunology, University of Heidelberg, Heidelberg, Germany
| | - Thomas Simmet
- Institute of Pharmacology of Natural Products & Clinical Pharmacology, Ulm University, Ulm, Germany
| | - Tatiana Syrovets
- Institute of Pharmacology of Natural Products & Clinical Pharmacology, Ulm University, Ulm, Germany
| | - Susanne Hafner
- Institute of Pharmacology of Natural Products & Clinical Pharmacology, Ulm University, Ulm, Germany
| | - Anna Freisinger
- Institute of Pharmacology of Natural Products & Clinical Pharmacology, Ulm University, Ulm, Germany
| | - Maximilian Andreas Storz
- Center for Complementary Medicine, Department of Medicine II, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Theodor von Frerichs Haus, Sir-Hans-A.-Krebs-Straße, 79106, Freiburg, Germany
| | - Roman Huber
- Center for Complementary Medicine, Department of Medicine II, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Theodor von Frerichs Haus, Sir-Hans-A.-Krebs-Straße, 79106, Freiburg, Germany.
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Self-efficacy in relation to the use of complementary and alternative medicine, lifestyle choices and cancer aetiology. J Cancer Res Clin Oncol 2021; 148:2707-2715. [PMID: 34812932 PMCID: PMC9470719 DOI: 10.1007/s00432-021-03857-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 11/09/2021] [Indexed: 11/28/2022]
Abstract
Purpose This survey assesses cancer patients’ etiological concepts, lifestyle choices, use of complementary and alternative medicine (CAM), and self-efficacy, as well as associations between those. It aims to find patterns which may facilitate communication and understanding between patients and physicians. Methods 353 oncological patients attending lectures on CAM answered a questionnaire. Correlations were examined and an exploratory factor analysis conducted to identify comprehensive lay-etiological concepts among a list of potential carcinogenic factors. Results Patients considered scientifically proven agents as well as other non-carcinogenic influences to be responsible for their disease. An exploratory factor analysis yielded vague indications of possible underlying concepts but factors tend to include items that do not fit the pattern in terms of content. Higher self-efficacy correlated with healthy diet and sports, but not with use of CAM. No conclusive correlations emerged between lay-aetiological concepts and most other variables, but we found a tendency for higher self-efficacy among patients who assigned higher carcinogenic effects to tobacco and lower carcinogenic effects to fasting and physical trauma. Conclusion Interest in CAM can arise for many reasons that are not necessarily related to self-efficacy. Lay-aetiological concepts of cancer differ significantly from scientific ones. They are complex and presumably highly individualistic. Their connection to use of CAM methods, lifestyle choices and self-efficacy should be explored in more detail. Patient information and communication with clinicians need to address cancer patients’ individual aetiological concepts to further patient’s understanding not only of their diagnosis but also of the treatment as well.
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Vogel J, Zomorodbakhsch B, Stauch T, Josfeld L, Hübner J. The role of the general practitioner in cancer care in general and with respect to complementary and alternative medicine for patients with cancer. Eur J Cancer Care (Engl) 2021; 31:e13533. [PMID: 34708899 DOI: 10.1111/ecc.13533] [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: 05/26/2021] [Revised: 08/10/2021] [Accepted: 10/04/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Cancer patients often use complementary and alternative medicine (CAM). The aim of this study was to assess the expectations of cancer patients towards their general practitioner (GP) regarding information on and offers of CAM procedures. METHODS A standardised anonymous questionnaire was developed and handed out to cancer patients in GP practices and oncology clinics in Germany. RESULTS One hundred and eighty questionnaires were evaluable. For 88.1% of the patients, it was important that their GP regularly receives information on cancer therapy. Only a minority consulted with the GP regarding diagnosis and therapy of the cancer (32.4%) or approached him about side effects of the therapy (46.9%). About one fifth of the GPs offered CAM. Before the cancer diagnosis, only 7% of the patients received a CAM offer from the GP; after the diagnosis, it was 14%. A large majority wanted the GP to offer more complementary (70.9%) and alternative (54.3%) medicine. CONCLUSION Our survey points to a clear mismatch of supply and demand regarding CAM for cancer patients in the primary care sector. Training for GPs on scientific evidence of as well as communication skills on CAM will be indispensable in the future to optimise the care of cancer patients by GPs.
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Affiliation(s)
- Johanna Vogel
- Medizinische Klinik II, Hämatologie und Internistische Onkologie, Universitätsklinikum Jena, Jena, Germany
| | | | - Thomas Stauch
- Medizinische Klinik II, Hämatologie und Internistische Onkologie, Universitätsklinikum Jena, Jena, Germany
| | - Lena Josfeld
- Medizinische Klinik II, Hämatologie und Internistische Onkologie, Universitätsklinikum Jena, Jena, Germany
| | - Jutta Hübner
- Medizinische Klinik II, Hämatologie und Internistische Onkologie, Universitätsklinikum Jena, Jena, Germany
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Crichton M, Strike K, Isenring E, McCarthy AL, Marx W, Lohning A, Marshall S. "It's natural so it shouldn't hurt me": Chemotherapy patients' perspectives, experiences, and sources of information of complementary and alternative medicines. Complement Ther Clin Pract 2021; 43:101362. [PMID: 33740590 DOI: 10.1016/j.ctcp.2021.101362] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 01/27/2021] [Accepted: 03/07/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND PURPOSE Minimal evidence regarding the safety and efficacy of complementary and alternative medicine (CAM) use during chemotherapy is accompanied with a high prevalence of use and nondisclosure to health professionals. This study aimed to explore patients' perspectives, experiences, support needs, and sources of information regarding CAM use during chemotherapy. MATERIALS AND METHODS Semi-structured interviews with ten adult participants who recently completed chemotherapy treatment at a large hospital in Australia were transcribed verbatim. Three investigators thematically analysed the interviews. RESULTS These participants receiving chemotherapy valued CAMs as a natural complement to chemotherapy to improve wellbeing, with their use most strongly influenced by past experiences rather than expert advice. CONCLUSION Health professionals would benefit from education on how to best inform patients of the potential risks, harms and lack of efficacy for CAM use during chemotherapy in a way that does not lead to patient non-disclosure of CAM use.
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Affiliation(s)
- Megan Crichton
- Bond University Nutrition and Dietetics Research Group, Faculty of Health Science & Medicine, Bond University, Robina, Queensland, Australia; Bond University, Building 5, Level 2, 14 University Drive, Robina, Queensland, 4226, Australia.
| | - Katelyn Strike
- Bond University Nutrition and Dietetics Research Group, Faculty of Health Science & Medicine, Bond University, Robina, Queensland, Australia
| | - Elizabeth Isenring
- Bond University Nutrition and Dietetics Research Group, Faculty of Health Science & Medicine, Bond University, Robina, Queensland, Australia; Department of Nutrition and Dietetics, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | - Alexandra L McCarthy
- School of Nursing, Midwifery and Social Work, University of Queensland and Mater Health Services, Brisbane, Queensland, Australia
| | - Wolfgang Marx
- Bond University Nutrition and Dietetics Research Group, Faculty of Health Science & Medicine, Bond University, Robina, Queensland, Australia; Deakin University, Food and Mood Centre, IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Geelong, Victoria, Australia
| | - Anna Lohning
- Bond University Nutrition and Dietetics Research Group, Faculty of Health Science & Medicine, Bond University, Robina, Queensland, Australia
| | - Skye Marshall
- Bond University Nutrition and Dietetics Research Group, Faculty of Health Science & Medicine, Bond University, Robina, Queensland, Australia; Nutrition Research Australia, Sydney, New South Wales, Australia
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Toukabri I, Said AB, Hamdi A, Mokrani A, Gabsi A, Ayed WB, Tounsi K, Limayem I. Patterns of complementary and alternative medicine use among Tunisian cancer patients. J Oncol Pharm Pract 2020; 27:1948-1957. [PMID: 33323022 DOI: 10.1177/1078155220980131] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The use of complementary and alternative medicine (CAM) among cancer patients is prevalent worldwide as cancer patient are perpetually seeking for a way to improve their quality of life and to cure their disease. Unfortunately, the majority ignore the danger that can resort when they use CAM currently with conventional therapies. The purpose of this study is to assess prevalence and predictors of CAM use in cancer patients. METHODS Cross-sectional study using a questionnaire administered to cancer patients, who were attending Salah Azaiz institute, Tunis, Tunisia. The study took place from September to December 2018. RESULTS In 222 cancer patients, the overall prevalence of CAM use was 40.54%. On univariate analysis, patients who had university education level were less likely to use CAM (p = 0.05). Based on multivariate analysis, CAM users had more likely metastatic tumor (p = 0.047; OR = 1.913).It is reported that the majority of the population used herbal medicine. The most common herbal products consuming by patients, included Ephedra foeminea (51.8%), Annona muricata (12%) and Curcuma longa L. (10.84%).The main source of information was entourage (family, friends, hospital entourage) (74.44%).The majority of CAM users (61.11%) reported to consume CAM currently with conventional therapies. CONCLUSION This survey revealed a high prevalence of CAM use. The most common type of CAM use is herbal products. Some of the used herbal products are known to interact with conventional anticancer medication. This emphasizes the importance of patients disclosure of CAM use to health professionals in order to avoid herb-medications interactions.
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Affiliation(s)
- Imen Toukabri
- Department of Pharmacy, Salah Azaiez Institute, Tunis, Tunisia
| | - Azza Ben Said
- Department of Pharmacy, Salah Azaiez Institute, Tunis, Tunisia.,Faculty of Pharmacy, University of Monastir, Monastir, Tunisia
| | - Adel Hamdi
- Department of Pharmacy, Salah Azaiez Institute, Tunis, Tunisia.,Faculty of Pharmacy, University of Monastir, Monastir, Tunisia
| | - Amina Mokrani
- Department of Oncology, Salah Azaiez Institute, Tunis, Tunisia
| | - Azza Gabsi
- Department of Oncology, Salah Azaiez Institute, Tunis, Tunisia
| | - Wiem Ben Ayed
- Department of Pharmacy, Salah Azaiez Institute, Tunis, Tunisia
| | | | - Imen Limayem
- Department of Pharmacy, Salah Azaiez Institute, Tunis, Tunisia.,Faculty of Pharmacy, University of Monastir, Monastir, Tunisia
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Kilper A, Müller A, Huber R, Reimers N, Schütz L, Lederer AK. Complementary medicine in orthopaedic and trauma surgery: a cross-sectional survey on usage and needs. BMJ Open 2020; 10:e037192. [PMID: 32895280 PMCID: PMC7477982 DOI: 10.1136/bmjopen-2020-037192] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Complementary and alternative medicine (CAM) is frequently used in Western countries within general medicine and internal medicine. Information on the use in orthopaedic and trauma surgery is widely lacking. The aim of this study was to investigate usage and needs regarding CAM for these patients. DESIGN Prospective paper-based, pseudoanonymous, cross-sectional survey. SETTING From August to December 2018, a questionnaire composed of 17 questions was distributed to all eligible patients. PARTICIPANTS In-house patients in orthopaedic and trauma surgery at a high-volume medical centre in Germany. PRIMARY AND SECONDARY OUTCOME MEASURES Previous or current usage of CAM, interest and requests towards CAM as well as communication about CAM. RESULTS Overall, 457 orthopaedic and trauma surgical patients took part in the survey. They were on average 52 years old and 54% were male. Most of the patients were admitted due to bone fractures and most underwent operative therapy. Previous or current CAM usage was stated by 76% and 30% of patients, respectively. Most of the patients stated to be interested in usage of CAM and demanded for more clinical usage of CAM and reliable information about CAM. More than 90% of patients did not discuss CAM interest or usage with their treating physicians. Patients stated that physicians should have knowledge about CAM. They wish to be treated in a holistic manner and want to strengthen self-efficacy. CONCLUSIONS Usage of CAM of patients in orthopaedic and trauma surgery appears to be high. Only a few patients discuss their interest and usage of CAM with their treating physician. Therefore, surgeons should ask their patients about CAM and should consider evidence-based CAM approaches for complementary treatment. TRIAL REGISTRATION NUMBER DRKS0001544.
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Affiliation(s)
- Anica Kilper
- Department of Orthopedics, Trauma and Hand Surgery, Chemnitz Hospital, Chemnitz, Sachsen, Germany
| | - Alexander Müller
- Center for Complementary Medicine, Institute for Infection Prevention and Hospital Epidemiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Baden-Württemberg, Germany
| | - Roman Huber
- Center for Complementary Medicine, Institute for Infection Prevention and Hospital Epidemiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Baden-Württemberg, Germany
| | - Niklas Reimers
- Department of Orthopedics, Trauma and Hand Surgery, Chemnitz Hospital, Chemnitz, Sachsen, Germany
| | - Ludwig Schütz
- Department of Orthopedics, Trauma and Hand Surgery, Chemnitz Hospital, Chemnitz, Sachsen, Germany
| | - Ann-Kathrin Lederer
- Center for Complementary Medicine, Institute for Infection Prevention and Hospital Epidemiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Baden-Württemberg, Germany
- Chirurgische Klinik, Evangelisches Diakoniekrankenhaus Freiburg, Freiburg, Baden-Württemberg, Germany
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Jablotschkin M, Bartsch HH, Gschwendtner K, Hauer J, Horneber M, Weis J. Educational Program in Complementary and Alternative Medicine for Cancer Self-Help Groups. Complement Med Res 2019; 27:222-229. [PMID: 31743921 DOI: 10.1159/000504315] [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: 01/11/2019] [Accepted: 10/23/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND The use of complementary and alternative medicine (CAM) among cancer patients is estimated to be approximately 40%. In self-help groups there is a need for information about CAM. This pilot study aimed to develop and evaluate a CAM educational program for cancer self-help groups. METHODS The educational program was developed in cooperation with health professionals and representatives of cancer self-help organizations. Participants were trained to increase their knowledge about CAM, to reflect their user behavior, and to use evidence-based information. Self-help group leaders were educated along the curriculum and motivated to carry out the course in their groups. Using questionnaires it was evaluated in terms of acceptance, feasibility, and satisfaction by participants. RESULTS A total of 171 self-help group leaders were educated. In a pilot run 7 implemented the course in their groups, with a total of 70 participants. Most of them (n = 60, 85.7%) appreciated its contents and material and would recommend it. Overall acceptance and satisfaction were high. CONCLUSIONS The educational program was implemented successfully in a small sample and showed positive results for acceptance and feasibility. In addition to consultation by experts, it can be a good option to inform cancer survivors about CAM.
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Affiliation(s)
- Martina Jablotschkin
- Comprehensive Cancer Center, Department of Cancer Self-Help Research, Medical Center, University Clinic Center Freiburg, Freiburg i.Br., Germany,
| | - Hans Helge Bartsch
- UKF Reha gGmbH, Department of Oncological Rehabilitation, Medical Center, University Clinic Center Freiburg, Freiburg i.Br., Germany
| | - Kathrin Gschwendtner
- Department of General Internal Medicine and Psychosomatics, Center for Psychosocial Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | | | - Markus Horneber
- Department of Internal Medicine, Divisions of Oncology/Hematology and Pneumology, Paracelsus Medical University, Klinikum Nürnberg, Nuremberg, Germany
| | - Joachim Weis
- Comprehensive Cancer Center, Department of Cancer Self-Help Research, Medical Center, University Clinic Center Freiburg, Freiburg i.Br., Germany
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Dubois C, Eisfeld H, Bauer F, Schmidt T, Kastrati K, Hochhaus A, Hübner J. Not all cancer patients with an interest in CAM are the same. Differences between patients with a CAM interest prior to the cancer diagnosis and those with first-time interest since diagnosis. Complement Ther Med 2019; 45:167-171. [DOI: 10.1016/j.ctim.2019.06.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Accepted: 06/13/2019] [Indexed: 01/02/2023] Open
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