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

被引:14
作者
Shalom-Sharabi, Ilanit [1 ,2 ]
Samuels, Noah [1 ,3 ]
Lev, Efraim [4 ]
Lavie, Ofer [5 ]
Keinan-Boker, Lital [6 ,7 ]
Schiff, Elad [8 ,9 ]
Ben-Arye, Eran [1 ,10 ]
机构
[1] Clalit Hlth Serv, Lin Med Ctr, Oncol Serv, Integrat Oncol Program, 35 Rothschild St, Haifa, Israel
[2] Univ Haifa, Grad Studies Author, Haifa, Israel
[3] Sheba Med Ctr, Inst Oncol, Tal Ctr Integrat Med, Tel Hashomer, Israel
[4] Univ Haifa, Dept Israel Studies, Haifa, Israel
[5] Carmel Hosp, Dept Obstet & Gynecol, Gynecol Oncol Serv, Haifa, Israel
[6] Univ Haifa, Sch Publ Hlth, Fac Social Welf & Hlth Sci, Haifa, Israel
[7] Israel Minist Hlth, Israel Ctr Dis Control, Jerusalem, Israel
[8] Bnai Zion Hosp, Dept Internal Med, Haifa, Israel
[9] Bnai Zion Hosp, Integrat Med Serv, Haifa, Israel
[10] Technion Israel Inst Technol, Dept Family Med, Complementary & Tradit Med Unit, Fac Med, Haifa, Israel
关键词
Integrative medicine; Supportive care; Medication use; Complementary medicine; Chemotherapy; RANDOMIZED CONTROLLED-TRIAL; CHEMOTHERAPY-INDUCED NAUSEA; BREAST-CANCER; ONCOLOGY; PAIN; ELECTROACUPUNCTURE; ACUPUNCTURE; ARTHRALGIA; PREVENTION; ADHERENCE;
D O I
10.1007/s00520-017-3726-4
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
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 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. 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). CIM treatments may reduce the need for NOAs among patients with breast or gynecological cancer.
引用
收藏
页码:3181 / 3190
页数:10
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