Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Huemer, M.
Complementary and alternative medicine in supportive cancer care: patient perspectives and possible ways for its integration
Doktoratsstudium der Medizinischen Wissenschaft; Humanmedizin; [ Dissertation ] Medizinische Universität Graz; 2024. pp. 92
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- Autor*innen der Med Uni Graz:
- Huemer Matthias
- Betreuer*innen:
- Pichler Martin
- Siebenhofer-Kroitzsch Andrea
- Altmetrics:
- Abstract:
- Background: Cancer patients commonly turn to complementary and alternative medicine (CAM) once they have been diagnosed with cancer. Various factors have been described to contribute to a higher willingness to use CAM during the disease trajectory. However, to date, no thorough assessment of patterns of CAM use has been performed among Austrian cancer patients. This study explored factors influencing CAM use in Austrian cancer patients, focusing on symptom clusters and demographical characteristics as predictors. Additionally, the study assessed the evidence-informed practices and research literacy among CAM practitioners involved in cancer patient care. Gaining a deeper understanding of their clinical practice and the role of research in it will facilitate better interdisciplinary collaboration between oncologists and CAM practitioners to benefit cancer patients. Methods: We designed two comprehensive cross-sectional studies involving Austrian cancer patients and CAM practitioners from Austria, Germany, the United States of America, Australia, and New Zealand. Patient data encompassed socio-demographic details, clinical characteristics, patterns of CAM use, and symptom assessment. To identify distinct symptom clusters, we performed a latent profile analysis. We then used bivariate and multivariate analysis to identify predictive factors for CAM use. CAM practitioners provided insights into their demographics, clinical practices, information sources, and the role of research in their clinical practice through an international online survey. We used descriptive statistics and qualitative analysis to describe differences between the participating countries. Results: Among the 171 cancer patients, 63.7% utilized CAM, with prevalent therapies including homeopathy, supplements, herbs, massage, and acupuncture. However, only 42.2% of CAM users disclosed their utilization to their treating oncologist. Symptom cluster analysis identified four distinct clusters, with the drowsiness-depression-anxiety cluster showing a 3.83-fold higher likelihood of CAM use. Multivariate analysis revealed no additional predictors beyond socio-demographic factors. Of the 404 CAM practitioners, 62.9% treated cancer patients, predominantly utilizing acupuncture and herbal treatments. Effective management of pain, depression, nausea, and fatigue was perceivably best achieved with acupuncture, while herbal medicine was preferred for addressing constipation, according to our study respondents. CAM practitioners commonly used acupuncture and herbs concurrently with biomedicine for supportive care, aiming to alleviate treatment side effects. However, only 28.0% maintained contact with treating oncologists. Among all respondents, 87.4% were interested in research, and 62.6% stated that research influenced their practice of acupuncture. In general, CAM practitioners rated the importance of research in their daily practice as moderate. However, they still rated experts' opinions as the most reliable information source. We further found country-specific differences concerning the educational background of CAM practitioners, with the most significant proportion of medical doctors performing acupuncture in Austria. Conclusion: Our study found symptom clusters representing valuable predictors for CAM use among cancer patients. The development of the drowsiness-depression-anxiety cluster may serve as an indicator to reassess the CAM use of patients by oncologists, suggesting continuous monitoring of the symptom burden during the patient’s disease trajectory. However, we also identified a communication gap between oncologists and patients. Promoting proactive patient-centered communication into clinical practice may identify potentially harmful CAM practices and offer the chance to guide patients in their choice of CAM treatments, further strengthening the physician-patient relationship. Austrian acupuncturists and herbalists commonly treat cancer patients in the