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Assessing patient adherence to a complementary medicine treatment regimen in an integrative supportive care setting
Authors:Eran Ben-Arye  Dikla Kruger  Noah Samuels  Lital Keinan-Boker  Tamar Shalom  Elad Schiff
Affiliation:1. Integrative Oncology Program, The Oncology Service, Lin Medical Center, Clalit Health Services, Haifa and Western Galilee District, 35 Rothschild St, Haifa, Israel
2. Complementary and Traditional Medicine Unit, Department of Family Medicine, Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
3. Clalit Health Services, Haifa and Western Galilee District, Haifa, Israel
4. Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
5. The Oncology Service, Lin Medical Center, Clalit Health Services, Haifa and Western Galilee District, Haifa, Israel
6. Israel Center for Disease Control, Israel Ministry of Health, Jerusalem, Israel
7. School of Public Health, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa, Israel
8. Department of Internal Medicine, and Integrative Medicine Service, Bnai-Zion Hospital, Haifa, Israel
9. Department for Complementary Medicine, Law and Ethics, International Center for Health, Law and Ethics, Haifa University, Haifa, Israel
Abstract:

Introduction

Patients with cancer are frequently turning to complementary medicine (CM), often with the goal of improving quality of life outcomes. The purpose of the present study was to assess the adherence of patients referred by oncology practitioners to a CM consultation and treatment program.

Patients and methods

A prospective registry protocol-based, preference study was conducted at a conventional oncology department. Patients undergoing chemotherapy were referred by participating oncology practitioners to a CM-trained integrative physician (IP) for consultation. Adherence to the integrative care (AIC) program was defined as attendance by patients at ≥4 CM treatment sessions, with an interval of no more than 30 days between each session.

Results

A total of 282 patients were referred by the study health-care professionals (HCPs), of whom 243 (85.8 %) were eventually seen by the study IP. Of these, 160 were found to be adherent to the treatment plan (AIC group), and 83 were nonadherent (non-AIC group). No significant differences were found between the two groups with respect to demographic characteristics, medical history, site of malignancy and/or recurrence, chemotherapy regimen, or severity of symptoms at baseline. The AIC group reported significantly greater rates of CM use for noncancer-related indications than the non-AIC group (EXP(B)?=?2.174, 95 % confidence interval (C.I.)?=?1.1–4.295, p?=?0.025). Patients in the non-AIC group were referred more frequently by their HCP for gastrointestinal concerns than those in the AIC group (p?=?0.022).

Conclusions

Previous use of CM for noncancer-related outcomes was found to be predictive of patient adherence to a CM treatment regimen provided within conventional oncology service.
Keywords:
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