TY - JOUR
T1 - Impact of a complementary/integrative medicine program on the need for supportive cancer care-related medications
AU - Shalom-Sharabi, Ilanit
AU - Samuels, Noah
AU - Lev, Efraim
AU - Lavie, Ofer
AU - Keinan-Boker, Lital
AU - Schiff, Elad
AU - Ben-Arye, Eran
N1 - Publisher Copyright: © 2017, Springer-Verlag Berlin Heidelberg.
PY - 2017/10/1
Y1 - 2017/10/1
N2 - 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.
AB - 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.
KW - Chemotherapy
KW - Complementary medicine
KW - Integrative medicine
KW - Medication use
KW - Supportive care
UR - http://www.scopus.com/inward/record.url?scp=85018821742&partnerID=8YFLogxK
U2 - https://doi.org/10.1007/s00520-017-3726-4
DO - https://doi.org/10.1007/s00520-017-3726-4
M3 - Article
C2 - 28434097
SN - 0941-4355
VL - 25
SP - 3181
EP - 3190
JO - Supportive Care in Cancer
JF - Supportive Care in Cancer
IS - 10
ER -