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BMC Complementary Medicine and Therapies
Published in: BMC Complementary Medicine and Therapies 1/2016

Open Access 01-12-2016 | Research article

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

Authors: Trine Stub, Sara A. Quandt, Thomas A. Arcury, Joanne C. Sandberg, Agnete E. Kristoffersen, Frauke Musial, Anita Salamonsen

Published in: BMC Complementary Medicine and Therapies | Issue 1/2016

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Abstract

Background

Communication 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.

Methods

Systematic 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.

Results

Twenty-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.

Conclusion

The 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.
Appendix
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Literature
1.
Kaptchuk TJ, Eisenberg DM. Varieties of healing. 2: a taxonomy of unconventional healing practices. Ann Intern Med. 2001;135(3):196–204.CrossRefPubMed
2.
Fønnebø V. Practitioners of complementary and alternative medicine should value their strengths. Focus Altern Complement Ther. 2015;20:102–3.CrossRef
3.
LOV-2003-06-27-64 Lov om alternativ behandling av sykdom mv; English Act relating to the alternative treatment of disease, illness, etc, Helse- og omsorgsdepartementet, 2002-2003 Sess. (2003).
4.
Stub T. Safety of Treatment Provided by Homeopaths - Homeopathic Aggravations, Adverse Effects and Risk Assessment, PhD thesis. Tromsø: UiT The Arctic University of Norway, Tromsø; 2013.
5.
Wiesener S, Falkenberg T, Hegyi G, Hök J, Fønnebø V. Legal status and regulation of CAM in Europe. Forsch Komplementmed. 2012;19 suppl 2:29–36.CrossRefPubMed
6.
7.
8.
Hansen B, Grimsgaard S, Launsø L, Fønnebø V, Falkenberg T, Rasmussen K. Use of comlementary and alternative medicine in the Scandinavian countries. Scand J Prim Health Care. 2005;23:52–62.CrossRef
9.
Molassiotis A, Fernandez-Ortega P, Pud D. Use of complementary and alternative medicine in cancer patients:a European survey. Ann Oncol. 2005;16(16):655–63.CrossRefPubMed
10.
Epstein RM. Communication between primary care physicians and consultants. Arch Fam Med. 1995;4:403–9.CrossRefPubMed
11.
Williams PT, Peet G. Differences in the value of clinical information: referring physicians versus consulting specialists. J Am Board Fam Pract. 1994;7(4):292–302.PubMed
12.
O’Malley AS, Reschovsky JD. Referral and consultation communication between primary care and specialist physicians: finding common ground. Arch Intern Med. 2011;171(1):56–65.PubMed
13.
Saha S, Beach MC. The impact of patient-centered communication on patients’ decision making and evaluations of physicians: a randomized study using video vignettes. Patient Educ Couns. 2011;84(3):386–92.CrossRefPubMedPubMedCentral
14.
Frenkel M, Ben-Arye E, Cohen L. Communication in cancer care: discussing complementary and alternative medicine. Integr Cancer Ther. 2010;9(2):177–85.CrossRefPubMed
15.
Frenkel M, Ben-Arye E, Baldwin CD, Sierpina V. Approach to communicate with patients about the use of nutrition supplements in cancer care. South Med J. 2005;98(3):289–94.CrossRefPubMed
16.
Roter DL, Hall JA. Doctors Talking with Patients, Patients talking with Doctors. Westport: Auburn House; 1992.
17.
Engel GL. The need for a New medical model: a challenge for biomedicine. Science. 1977;196(4286):129–36.CrossRefPubMed
18.
Salamonsen A. Doctor-patient communication and cancer patient’s choice of alternative therapies as supplement or alternative to conventional care. Scand J Caring Sci. 2013;27(1):70–6.CrossRefPubMed
19.
Boon H, Brown JB, Gavin A, Kennard A, Stewart M. Breast cancer Survivors’ perceptions of complementary and alternative medicine (CAM): making the decision to use or Not to use. Qual Health Res. 1999;9(5):639–53.CrossRefPubMed
20.
Ekholm O, Kjøller M. The use of alternative treatment in denmark: results of the nationally representative health and morbidity study 2005. Tidsskrift for Forskning i Sygdom og Samfund. 2007;6:15–24.
21.
Hansen AH, Kristoffersen AE, Lian OS, Hanlvorsen PA. Continuity of GP care is associated with low use of complementary and alternative medical providers: a populationbased cross-sectional survey. BMC Health Serv Res. 2014;14:629.CrossRefPubMedPubMedCentral
22.
Stub T, Salamonsen A, Kristoffersen A, Musial F. How to handle worsening of condition during treatment - risk assessment in homeopathic practice. Forsch Komplementmed. 2015;22(1):30–5.CrossRefPubMed
23.
Salamonsen A. Mind the Gap! Lay and medical perceptions of risks associated with the use of alternative treatment and conventional medicine. Forsch Komplementmed. 2015;22(1):24–9.CrossRefPubMed
24.
Broom A, Adams J. Oncology clinician’s accounts of discussing complementary and alternative medicine with their patients. Health: An interdisciplinary Journal for the Study of Health, Illness and Medicine. 2009;13:317–36.
25.
Schofield P, Diggens J, Charleson C, Marigliani R, Jefford M. Effectively discussing complementary and alternative medicine in a conventional oncology setting: communication recommendations for clinicians. Patient Educ Couns. 2010;79:143–51.CrossRefPubMed
26.
Kvale S. Det kvalitative forskningsintervju. Oslo: Gyldendal Norsk Forlag AS; 2001.
27.
Fontana A, Frey JH. The Interview from Neutral Stance to Political Involvement. In: Knigth V, editor. Collecting and Interpreting Qualitative Materials. London: SAGE Publications; 2008. p. 115–59.
28.
Peräkylä A. Analyzing Talk and Text. In: Knigth V, editor. Collecting and Interpreting Qualitative Materials. London: SAGEPublications; 2008. p. 351–74.
29.
Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res. 2005;15(9):1277–88.CrossRefPubMed
30.
Broom AF, Doron A. Traditional medicine, collective negotiation, and representations of risk in indian cancer care. Qual Health Res. 2013;23(1):54–65.CrossRefPubMed
31.
Klimenko E, Julliard K. Communication between CAM and mainstream medicine: Delphi panel perspectives. Complement Ther Clin Pract. 2007;13(1):46–52.CrossRefPubMed
32.
Maha N, Shaw A. Academic doctor’s views of complementary and alternative medicine (CAM) and its role within the NHS: An exploratory qualitative study. BMC Complement Altern Med. 2007;7(17):1–11.
33.
Roberts D, McNulty A, Caress AL. Current issues in the delivery of complementary therapies in cancer care—policy, perceptions and expectations: An overview. Eur J Oncol Nurs. 2005;9(2):115–23.CrossRefPubMed
34.
Ben-Arye E, Visser A. The role of health care communication in the development of complementary and integrative medicine. Patient Educ Couns. 2012;89:363–7.CrossRefPubMed
35.
Fox P, Butler M, Coughlan B. The role of CAM (Complementary and Alternative Medicine): The Different Perspectives of Patients, Oncology Proffesionals and CAM practitioners. In: Bhattacharya DA, editor. A Compendium of Esseys on Alternative Therapy. Rijeka: InTech Europe; 2012.
36.
Fox P, Butler M, Coughlan B, Murray M, Boland N, Hanan T, et al. Using a mixed methods research design to investigate complementary and alternative medicine (CAM) use among woman with breast cancer in Ireland. Eur J Oncol Nurs. 2013;17(4):490–7.CrossRefPubMed
37.
Popper-Giveon A, Schiff E, Ben-Arye E. We and they in the house of healing: debate among arab complementary medicine practitioners on an integrative versus alternative approach to supportive cancer care. Integr Cancer Ther. 2013;12(6):488–95.CrossRefPubMed
38.
Barrett B, Marchand L, Scheder J, Appelbaum D, Chapman M, Jacobs C, et al. Bridging the Gap between conventional and alternative medicine. J of Fam Pract. 2000;49(3):234–9.
39.
Baynham-Fletcher L, Babiak-Vazquez AE, Cuello D, Frenkel MA. Credentialing complementary practitioners in a large academic cancer center. J Soc Integr Oncol. 2008;6(4):169–75.PubMed
40.
Ben-Arye E, Schiff E, Zollman C, Heusser P, Mountford P, Frenkel M, et al. Integrating complementary medicine in supportive cancer care models across four continents. Med Oncol. 2013;30(2):1–7.CrossRef
41.
Goldstein MS. Complementary and alternative medicine: Its emerging role in oncology. J Psychosoc Oncol. 2003;21(2):1–21.CrossRef
42.
Mackereth P, Carter A, Parkin S, Stringer J, Roberts D, Long A, et al. Complementary therapist’s motivation to work in cancer/supportive and palliative care: a multi-centre case study. Complement Ther Clin Pract. 2009;15(3):161–5.CrossRef
43.
Mazor KM, Gaglio B, Nekhlyudov L, Alexander GL, Stark A, Hornbrook MC, et al. Assessing patient-centered communication in cancer care: stakeholder perspectives. J Oncol Pract. 2013;9(5):e186–93.CrossRefPubMedPubMedCentral
44.
Richardson P. Assessment and implementation of spirituality and religiosity in cancer care. Clin J Oncol Nurs. 2012;16(4):E150–5.CrossRefPubMed
45.
Verhoef MJ, Boon HS, Page SA. Talking to cancer patients about complementary therapies: is it the physicians’s responsibility? Curr Oncol. 2008;15(2):18–23.
46.
Jason SL. Complementary and alternative medicine (CAM): discourse in an oncology clinic setting. Diss Abstr Int Sect A: Humanit Soc Sci. 2009;70(6-A):2260.
47.
Madjar I, Kacen L, Ariad S, Denham J. Telling their stories, telling Our stories: Physician’s experiences with patients Who decide to forgo or stop treatment for cancer. Qual Health Res. 2007;17(4):428–41.CrossRefPubMed
48.
Popper-Giveon A, Schiff E, Ben-Arye E. I will always be with you: traditional and complementary therapist’s perspectives on patient-therapist-doctor communication regarding treatment of Arab patients with cancer in israel. Patient Educ Couns. 2012;89(3):381–6.CrossRefPubMed
49.
Verhoef M, Weeks L, Brazier A, Leis A. Evaluating supportive cancer care: Are we missing an opportunity? Support Cancer Care. 2007;15:905–7.CrossRef
50.
Mackereth PA, Parkin S, Donald G, Antcliffe N. Clinical supervision and complementary therapists: an exploration of the rewards and challenges of cancer care. Complementary Ther Clin Pract. 2010;16:143–8.CrossRef
51.
Ben-Arye E, Ali-Shtayeh MS, Nejmi M, Schiff E, Hassan E, Mutafoglu K, et al. Integrative oncology research in the middle east: weaving traditional and complementary medicine in supportive care. Supp Care Cancer. 2012;20(3):557–64.CrossRef
52.
Schiff E, Frenkel M, Shilo M, Levy M, Schachter L, Freifeld Y, et al. Bridging the physician and CAM practitioner communication gap: suggested framework for communication between physicians and CAM practitioners based on a cross professional survey from Israel. Patient Educ Couns. 2011;85(2):188–93.CrossRefPubMed
53.
European Coalition on Homeopathic and Anthroposophic medicinal products ECHAMP E.E.I.G. Homeopathic and Anthroposophic Medicine in the European Union. Facts and Figures 2011. Brussels: ECHAMP; 2011.
54.
Mackereth P, Carter A, Parkin S, Stringer J, Caress A, Todd C, et al. Complementary therapists’ training and cancer care: a multi-site study. Eur J Oncol Nurs. 2009;13(5):330–5.CrossRefPubMed
55.
Kemper KJ, Amata-kynvi A, Sanghavi D, Whelan JS, Dvorkin L, Woolf A, et al. Randomized trial of an internet curriculum on herbs and other dietary supplements for health care professionals. Acad Med. 2002;7(9):882–9.CrossRef
56.
Markman M. Safety issues in using complementary and alternative medicine. J Clin Oncol. 2002;20(18s):39s–41.PubMed
57.
Saper RB, Phillips RS, Sehgal A, Khouri N, Davis RB, Paquin J, et al. Lead, mercury, and arsenic in US- and indian-manufactured ayurvedic medicines sold via the internet. Am Med Assoc. 2008;300(8):915–23.CrossRef
58.
Brown PR, Alaszewski A, Swift T, Nordin T. Actions speak louder than words: the embodiment of trust by healthcare professionals in gynae-oncology. Sociol Health Illn. 2011;33(2):280–95.CrossRefPubMed
59.
Lüdke R, Musial F. Wie kann man komplementärmedizinische Verfahren in ihrer Wirksamkeit erforschen? Komplementärmedizinische Methoden. 2008;2:76–81.
60.
Paterson C, Baarts C, Launsø L, Verhoef MJ. Evaluating complex health interventions: a critical analysis of the ‘outcomes’ concept. BMC Complement Altern Med. 2009;9:18.CrossRefPubMedPubMedCentral
61.
Fønnebø V, Verhoef M, Paterson C. Cancer and complementary medicine: an international perspective. Support Care Cancer. 2007;15(8):999–1002.CrossRefPubMed
62.
Wardle JL, Adams J. Indirect and non-health risks associated with complementary and alternative medicine use: an integrative review. Eur J Integr Med. 2014;6(2014):409–22.CrossRef
63.
Wiesener S. Disharmonized Regulation of Complementary and Alternative Medicine (CAM) in Europe - Implications for Patients Safety. Stavanger: University of Stavanger; 2013.
64.
Christie VM. Den andre medisinen. Oslo: Universitetsforlaget; 1991.
Metadata
Title
Perception of risk and communication among conventional and complementary health care providers involving cancer patients’ use of complementary therapies: a literature review
Authors
Trine Stub
Sara A. Quandt
Thomas A. Arcury
Joanne C. Sandberg
Agnete E. Kristoffersen
Frauke Musial
Anita Salamonsen
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Complementary Medicine and Therapies / Issue 1/2016
Electronic ISSN: 2662-7671
DOI
https://doi.org/10.1186/s12906-016-1326-3

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