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Supportive Care in Cancer

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01-12-2021 | Care | Original Article

A pre-post evaluation of oncology healthcare providers’ knowledge, attitudes, and practices following the implementation of a complementary medicine practice guideline

Authors: Emilie N. Hayward, Cody Z. Watling, Lynda G. Balneaves

Published in: Supportive Care in Cancer | Issue 12/2021

Abstract

Purpose

Complementary medicine (CM) use is prevalent among cancer patients, yet it is often not assessed by oncology healthcare providers (HCPs). The purpose of this study was to evaluate oncology HCPs’ knowledge, attitudes, and practices surrounding CM use before and after the implementation of a practice guideline focusing on standardizing assessment and documentation of CM.

Methods

Oncology HCPs across a provincial cancer agency were invited to participate in the study. The implementation strategy included an initial education session for HCPs and standardized CM assessment forms. Pre-post surveys assessing knowledge, attitudes, and practices related to CM were completed by HCPs prior to attending the education session and following the 4-month implementation period. Paired t-tests were conducted to determine differences between baseline and follow-up surveys.

Results

A total of 31 oncology HCPs completed both baseline and follow-up surveys, with over 3700 patient CM assessment forms being completed during the 4-month study period. At the end of the study, HCPs reported greater CM knowledge (p < 0.001), readiness to support cancer patients’ CM decisions (p = 0.002), and willingness to consult with another HCP about CM (p = 0.004). No significant change in HCPs’ reported attitudes towards CM, or other clinical practices related to CM were observed.

Conclusion

Implementing a practice guideline, including a CM education session and a standardized assessment form, was found to improve oncology HCPs’ self-reported CM knowledge and readiness to answer cancer patients’ questions about CM. The findings provide support for future knowledge translation research aimed at standardizing how CM is addressed within cancer care settings.

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National Centre for Complementary and Integrative Health. Complementary, alternative, or integrative health: What's in a name https://www.nccih.nih.gov/health/complementary-alternative-or-integrative-health-whats-in-a-name. Accessed 24 Nov 2020

Horneber M, Bueschel G, Dennert G et al (2012) How many cancer patients use complementary and alternative medicine: a systematic review and metaanalysis. Integr Cancer Ther 11:187–203. https://doi.org/10.1177/1534735411423920CrossRefPubMed

Judson PL, Abdallah R, Xiong Y et al (2017) Complementary and alternative medicine use in individuals presenting for care at a comprehensive cancer center. Integr Cancer Ther 16:96–103. https://doi.org/10.1177/1534735416660384CrossRefPubMed

Lyman GH, Greenlee H, Bohlke K et al (2018) Integrative therapies during and after breast cancer treatment: ASCO endorsement of the SIO clinical practice guideline. J Clin Oncol 36:2647–2655. https://doi.org/10.1200/JCO.2018.79.2721CrossRefPubMed

Smith PJ, Clavarino AM, Long JE et al (2016) Complementary and alternative medicine use by patients receiving curative-intent chemotherapy. Asia Pac J Clin Oncol 12:265–274. https://doi.org/10.1111/ajco.12490CrossRefPubMed

Huebner J, Marienfeld S, Abbenhardt C et al (2014) Counseling patients on cancer diets: a review of the literature and recommendations for clinical practice. Anticancer Res 34:39PubMed

Tascilar M, de Jong FA, Verweij J, Mathijssen RHJ (2006) Complementary and alternative medicine during cancer treatment: beyond innocence. Oncologist 11:732–741CrossRef

Werneke U, Earl J, Seydel C et al (2004) Potential health risks of complementary alternative medicines in cancer patients. Br J Cancer 90:408–413CrossRef

Clairet AL, Boiteux-Jurain M, Curtit E, et al (2019) Interaction between phytotherapy and oral anticancer agents: prospective study and literature review. Med Oncol 36:45. https://doi.org/10.1007/s12032-019-1267-z

10.

Schofield P, Diggens J, Charleson C et al (2010) Effectively discussing complementary and alternative medicine in a conventional oncology setting: communication recommendations for clinicians. Patient Educ Couns 79:143–151. https://doi.org/10.1016/j.pec.2009.07.038CrossRefPubMed

11.

Thomson P, Jones J, Evans JM, Leslie SL (2012) Factors influencing the use of complementary and alternative medicine and whether patients inform their primary care physician. Complement Ther Med 20:45–53. https://doi.org/10.1016/j.ctim.2011.10.001CrossRefPubMed

12.

Balneaves LG, Truant TLO, Verhoef MJ et al (2012) The Complementary Medicine Education and Outcomes (CAMEO) program: a foundation for patient and health professional education and decision support programs. Patient Educ Couns 89:461–466. https://doi.org/10.1016/j.pec.2012.01.005CrossRefPubMed

13.

Davis EL, Oh B, Butow PN et al (2012) Cancer patient disclosure and patient-doctor communication of complementary and alternative medicine use: a systematic review. Oncologist 17:1475–1481. https://doi.org/10.1634/theoncologist.2012-0223;10.1634/theoncologist.2012-0223CrossRefPubMedPubMedCentral

14.

Lee RT, Barbo A, Lopez G et al (2014) National survey of US oncologists’ knowledge, attitudes, and practice patterns regarding herb and supplement use by patients with cancer. J Clin Oncol 32:4095–4101. https://doi.org/10.1200/JCO.2014.55.8676CrossRefPubMedPubMedCentral

15.

Roter D, Yost K, O’Byrne T et al (2016) Communication predictors and consequences of complementary and alternative medicine (CAM) discussions in oncology visits. Patient Educ Couns 99:1519–1525. https://doi.org/10.1016/j.pec.2016.06.002CrossRefPubMedPubMedCentral

16.

Güthlin C, Holmberg C, Klein G (2016) Oncologists’ experiences of discussing complementary and alternative treatment options with their cancer patients. A qualitative analysis Support Care Cancer 24:3857–3862. https://doi.org/10.1007/s00520-016-3205-3CrossRef

17.

Stan DL, Wahner-Roedler DL, Yost KJ et al (2018) Absent and discordant electronic health record documentation of complementary and alternative medicine in cancer care. J Altern Complement Med 24:988–995. https://doi.org/10.1089/acm.2018.0141CrossRefPubMedPubMedCentral

18.

Klein GE, Guethlin C (2018) Information and training needs regarding complementary and alternative medicine: a cross-sectional study of cancer care providers in Germany. Integr Cancer Ther 17:380–387. https://doi.org/10.1177/1534735416666372CrossRefPubMed

19.

Richardson MA, Mâsse LC, Nanny K, Sanders C (2004) Discrepant views of oncologists and cancer patients on complementary/ alternative medicine. Support Care Cancer 12:797–804. https://doi.org/10.1007/s00520-004-0677-3CrossRefPubMed

20.

Hessig RE, Arcand LL, Frost MH (2004) The effects of an educational intervention on oncology nurses’ attitude, perceived knowledge, and self-reported application of complementary therapies. Oncol Nurs Forum 31:71–78CrossRef

21.

Wahner-Roedler DL, Vincent A, Elkin PL et al (2006) Physicians’ attitudes toward complementary and alternative medicine and their knowledge of specific therapies: a survey at an academic medical center. Evidence-Based Complement Altern Med 3:495–501. https://doi.org/10.1093/ecam/nel036CrossRef

22.

Admi H, Eilon-Moshe Y, Ben-Arye E (2017) Complementary medicine and the role of oncology nurses in an acute care hospital: the gap between attitudes and practice. Oncol Nurs Forum 44:553–561. https://doi.org/10.1188/17.ONF.553-561CrossRefPubMed

23.

Chang KH, Brodie R, Choong MA et al (2011) Complementary and alternative medicine use in oncology: a questionnaire survey of patients and health care professionals. BMC Cancer 11:196. https://doi.org/10.1186/1471-2407-11-196CrossRefPubMedPubMedCentral

24.

Ben-Arye E, Shulman B, Eilon Y et al (2017) Attitudes among nurses toward the integration of complementary medicine into supportive cancer care. Oncol Nurs Forum 44:428–434. https://doi.org/10.1188/17.ONF.428-434CrossRefPubMed

25.

Harnett J, Le TQ, Smith L, Krass I (2017) Perceptions, opinions and knowledge of pharmacists towards the use of complementary medicines by people living with cancer. Int J Clin Pharm 40:1272–1280. https://doi.org/10.1007/s11096-018-0645-5CrossRef

26.

Roberts CS, Baker F, Hann D et al (2008) Patient-physician communication regarding use of complementary therapies during cancer treatment 23:35–60. https://doi.org/10.1300/J077v23n04CrossRef

27.

Gall A, Anderson K, Adams J, et al (2019) An exploration of healthcare providers’ experiences and perspectives of traditional and complementary medicine usage and disclosure by Indigenous cancer patients. BMC Complement Altern Med 19:259. https://doi.org/10.1186/s12906-019-2665-7

28.

Balneaves LG, Watling CZ, Hayward EN et al (2021) Addressing complementary and alternative medicine ase among individuals with cancer: an integrative review and clinical practice guideline. J Natl Cancer Inst. https://doi.org/10.1093/jnci/djab048CrossRefPubMed

29.

Brazier ASA, Balneaves LG, Seely D et al (2008) Integrative practice of Canadian oncology health professionals. Curr Oncol 15:S87

30.

King N, Balneaves LG, Levin GT et al (2015) Surveys of cancer patients and cancer health care providers regarding complementary therapy use, communication, and information needs. Integr Cancer Ther 14:515–524. https://doi.org/10.1177/1534735415589984CrossRefPubMed

31.

Gruppen L, Benn R, White C, Fantone J, Smith K, Warber S (2013) Psychometric characteristics of an attitude instrument for complementary and alternative medicine. Paper presented at: Research in Medical Education (RIME) Conference; November 7–12, 2003; Washington, DC

32.

Hsiao AF, Hays RD, Ryan GW et al (2005) A self-report measure of clinicians’ orientation toward integrative medicine. Health Serv Res 40:1553–1569. https://doi.org/10.1111/j.1475-6773.2005.00425.xCrossRefPubMedPubMedCentral

33.

Delaney LJ, Manley SJ (2019) Complementary and alternative therapy use in a regional radiation oncology treatment centre: can staff knowledge, views, confidence and documentation be improved? J Med Radiat Sci 66:191–199. https://doi.org/10.1002/jmrs.344CrossRefPubMedPubMedCentral

34.

Conrad AC, Muenstedt K, Micke O et al (2014) Attitudes of members of the German Society for Palliative Medicine toward complementary and alternative medicine for cancer patients. J Cancer Res Clin Oncol 140:1229–1237. https://doi.org/10.1007/s00432-014-1656-9CrossRefPubMed

35.

Ben-Arye E, Frenkel M, Bar-Sela G et al (2008) Teaching complementary medicine at an academic oncology department. J Cancer Educ 23:46–50. https://doi.org/10.1080/08858190701821261CrossRefPubMed

36.

Broom A, Adams J (2009) Oncology clinicians’ accounts of discussing complementary and alternative medicine with their patients. Health 13:317–336. https://doi.org/10.1177/1363459308101806CrossRefPubMed

37.

Ben-Arye E, Schiff E, Zollman C, et al (2013) Integrating complementary medicine in supportive cancer care models across four continents. Med Oncol 30:511. https://doi.org/10.1007/s12032-013-0511-1

38.

Klein E, Beckmann MW, Bader W et al (2017) Gynecologic oncologists’ attitudes and practices relating to integrative medicine: results of a nationwide AGO survey. Arch Gynecol Obstet 296:295–301. https://doi.org/10.1007/s00404-017-4420-yCrossRefPubMedPubMedCentral

39.

Rojas-Cooley MT, Grant M (2009) Complementary and alternative medicine: oncology nurses’ knowledge and attitudes. Oncol Nurs Forum 36:217–224. https://doi.org/10.1188/09.ONF.217-224CrossRefPubMed

40.

River J, McKenzie H, Levy D et al (2018) Convergent priorities and tensions: a qualitative study of the integration of complementary and alternative therapies with conventional cancer treatment. Support Care Cancer 26:1791–1797. https://doi.org/10.1007/s00520-017-4021-0CrossRefPubMed

41.

Tovey P, Broom A (2007) Oncologists’ and specialist cancer nurses’ approaches to complementary and alternative medicine and thier impact on patient action. Soc Sci Med 64:2550–2564. https://doi.org/10.1016/j.socscimed.2007.02.010CrossRefPubMed

Title: A pre-post evaluation of oncology healthcare providers’ knowledge, attitudes, and practices following the implementation of a complementary medicine practice guideline
Authors: Emilie N. Hayward
Cody Z. Watling
Lynda G. Balneaves
Publication date: 01-12-2021
Publisher: Springer Berlin Heidelberg
Keyword: Care
Published in: Supportive Care in Cancer / Issue 12/2021
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-021-06318-2

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