Eran Ben-Arye1, Elad Schiff2, Orit G Raz3, Noah Samuels4, Ofer Lavie5. 1. Integrative Oncology Program, Oncology Service, Lin Medical Center, Clalit Health Services, Haifa, Israel; Complementary and Traditional Medicine Unit, Department of Family Medicine, Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. Electronic address: eranben@netvision.net.il. 2. Department of Internal Medicine and Integrative Surgery Service, Bnai Zion Hospital, Haifa, Israel. 3. Integrative Oncology Program, Oncology Service, Lin Medical Center, Clalit Health Services, Haifa, Israel; Clalit Complementary Medicine, Clalit Health Services, Haifa, Israel. 4. Integrative Oncology Program, Oncology Service, Lin Medical Center, Clalit Health Services, Haifa, Israel. 5. Department of Obstetrics and Gynecology, Gynecologic Oncology Service, Carmel Medical Center, Haifa, Israel.
Abstract
OBJECTIVE: To explore oncology healthcare providers' (HCPs') patterns of referral of women undergoing chemotherapy to a complementary medicine (CM) consultation integrated within a conventional oncology service. METHODS: Oncology HCPs used a structured referral system for referral to an integrative physician (IP) for CM consultation. Referral goals were in accordance with a specified list of quality-of-life (QOL) outcomes. RESULTS: In total, the study HCPs referred 282 female patients, of whom 238 (84.4%) underwent CM consultation by the study IP: 59 (24.8%) with gynecologic cancer and 179 (75.2%) with non-gynecologic cancer. Use of CM for cancer-related outcomes was significantly higher among referred patients with gynecologic cancer than those with non-gynecologic cancer (69.5% vs 46.9%; P=0.003). Oncologists initiated most of the referrals in the gynecologic oncology group, whereas oncologic nurses referred most patients in the non-gynecologic oncology group. Among patients with gynecologic cancer, the correlation between HCP indication and patient expectation was high for gastrointestinal concerns (κ 0.41). CONCLUSION: The integration of a structured and informed process of referral to CM consultation may enhance patient-centered care and QOL during chemotherapy.
OBJECTIVE: To explore oncology healthcare providers' (HCPs') patterns of referral of women undergoing chemotherapy to a complementary medicine (CM) consultation integrated within a conventional oncology service. METHODS: Oncology HCPs used a structured referral system for referral to an integrative physician (IP) for CM consultation. Referral goals were in accordance with a specified list of quality-of-life (QOL) outcomes. RESULTS: In total, the study HCPs referred 282 female patients, of whom 238 (84.4%) underwent CM consultation by the study IP: 59 (24.8%) with gynecologic cancer and 179 (75.2%) with non-gynecologic cancer. Use of CM for cancer-related outcomes was significantly higher among referred patients with gynecologic cancer than those with non-gynecologic cancer (69.5% vs 46.9%; P=0.003). Oncologists initiated most of the referrals in the gynecologic oncology group, whereas oncologic nurses referred most patients in the non-gynecologic oncology group. Among patients with gynecologic cancer, the correlation between HCP indication and patient expectation was high for gastrointestinal concerns (κ 0.41). CONCLUSION: The integration of a structured and informed process of referral to CM consultation may enhance patient-centered care and QOL during chemotherapy.