Impact of a complementary/integrative medicine program on the need for supportive cancer care-related medications.

Autor: Shalom-Sharabi I; Integrative Oncology Program, The Oncology Service, Lin Medical Center, Clalit Health Services, 35 Rothschild St., Haifa and Western Galilee District, Israel.; Graduate Studies Authority, Haifa University, Haifa, Israel., Samuels N; Integrative Oncology Program, The Oncology Service, Lin Medical Center, Clalit Health Services, 35 Rothschild St., Haifa and Western Galilee District, Israel.; Tal Center for Integrative Medicine, Institute of Oncology, Sheba Medical Center, Tel Hashomer, Israel., Lev E; Department of Israel Studies, University of Haifa, Haifa, Israel., Lavie O; Department of Obstetrics and Gynecology, Gynecologic Oncology Service, Carmel Medical Center, Haifa, Israel., Keinan-Boker L; School of Public Health, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa, Israel.; Israel Center for Disease Control, Israel Ministry of Health, Jerusalem, Israel., Schiff E; Department of Internal Medicine and Integrative Medicine Service, Bnai-Zion Hospital, Haifa, Israel., Ben-Arye E; Integrative Oncology Program, The Oncology Service, Lin Medical Center, Clalit Health Services, 35 Rothschild St., Haifa and Western Galilee District, Israel. eranben@netvision.net.il.; Complementary and Traditional Medicine Unit, Department of Family Medicine, Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. eranben@netvision.net.il.
Jazyk: angličtina
Zdroj: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer [Support Care Cancer] 2017 Oct; Vol. 25 (10), pp. 3181-3190. Date of Electronic Publication: 2017 Apr 22.
DOI: 10.1007/s00520-017-3726-4
Abstrakt: Objective: Despite the growing evidence supporting the use of complementary/integrative medicine (CIM) in the treatment of chemotherapy-induced toxicities, little is known on CIM impact of these therapies regarding the use of medications for supportive cancer care. In this study, we examined the impact of CIM on the need for supportive cancer care-related medications.
Patients and Methods: Patients with breast or gynecological cancer referred to and attending an integrative physician (IP) consultation for gastrointestinal (GI) concerns were designated as the treatment group; those not attending as controls. Adherence to the integrative care program (AIC) was defined as attending ≥4 CIM interventions. The need for conventional supportive care-related medications and doses was determined from patients' medical files, as well as the implications on the potential for cost reduction.
Results: Of the 205 patients diagnosed with GI concerns, 116 attended the IP consultation and weekly CIM treatments (56.6%; treatment group), of which 85 (73.3%) were adherent to the program (AIC subgroup); 89 did not undergo an IP consultation (43.4%; controls). Within-group analysis found a greater decrease in the use of non-opioid analgesics (NOAs) at 6 weeks in the treatment group (P = 0.01), more so in the AIC subgroup (P = 0.02). A cost analysis suggests that reduced NOA use in the treatment group reduced the cost of supportive care, covering 27.1% of the overall expense of CIM treatments. Controls were less likely to require anti-emetics (P = 0.007). Between-group analysis showed a trend for reduced use of anxiolytics (P = 0.06) and NOAs (P = 0.08) among treated patients, with lower dose equivalents for NOAs than controls (P < 0.001).
Conclusion: CIM treatments may reduce the need for NOAs among patients with breast or gynecological cancer.
Databáze: MEDLINE
Externí odkaz: