Effects of training oncology physicians advising patients on complementary and integrative therapies on patient‐reported outcomes: A multicenter, cluster‐randomized trial

• Published in: Cancer 2021-08, Vol.127 (15), p.2683-2692
• Main Authors: Rogge, Alizé A., Helmer, Stefanie M., King, Ryan, Canella, Claudia, Icke, Katja, Pach, Daniel, Witt, Claudia M.
• Format: Article
• Language: English
• Subjects: Cancer; clinical trials; Clusters; Communication; complementary medicine; Complementary Therapies; Decision making; Distributing; Health services; Humans; Integrative Medicine; integrative oncology; Learning; Medicine; Oncology; Patient Reported Outcome Measures; Patient satisfaction; Patients; Physician-Patient Relations; Physicians; physician‐patient communication; Quality of Life; Training; Websites
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/cncr.33562

BACKGROUND Many patients with cancer do not disclose complementary medicine use but want their physician's advice on this matter. This study evaluated whether using blended learning (e‐learning plus a workshop) to train oncology physicians in providing advice on complementary and integrative medicine (CIM) therapies to their patients with cancer, in addition to distributing an information leaflet on reputable CIM websites, had different effects on patient‐reported outcomes for the consultation than only distributing the leaflet. METHODS In this multicenter, cluster‐randomized trial, patients from private practices/hospital departments, recruited by 48 oncology physicians randomly allocated to an intervention group (CIM consultation plus information leaflet) or a control group (information leaflet), received CIM information. Patient‐reported outcomes included satisfaction (Patient Satisfaction With Information on Cancer Treatment), readiness to make a decision (Preparation for Decision Making), and physician‐patient communication (European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire and Communication 26 [EORTC QLQ‐COMU26]) for the consultation. Qualitative interviews were conducted with a physician subsample. RESULTS A total of 291 patients (128 in the intervention group and 169 in the control group) advised by 41 physicians participated. Patients in the intervention group rated physician‐patient communication higher on all EORTC QLQ‐COMU26 scales (mean total score, 84.3 [95% CI, 79.5‐89.2] vs 73.6 [95% CI, 69.3‐78.0]; P = .002), were more satisfied with the advice (mean, 4.2 [95% CI, 4.0‐4.4] vs 3.7 [95% CI, 3.5‐3.8]; P < .001), and were readier to make a decision (mean, 63.5 [95% CI, 57.4‐69.6] vs 53.2 [95% CI, 47.8‐58.7]; P = .016) than the control group. Physicians who reported patients in both settings seemed satisfied with the advice given. CONCLUSIONS This study evaluated a novel education intervention for training oncology physicians in providing CIM advice in routine care. Providing structured CIM consultations had positive effects on patient satisfaction, readiness to make decisions, and physician‐patient communication. This is the first study to implement and evaluate an evidence‐based complementary and integrative medicine (CIM) consultation in routine cancer treatment. Advising patients with cancer according to a structured, evidence‐based consultation manual has positive effects on patient satisfaction, prep