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Counseling cancer patients on complementary and alternative medicine

Background, theory, and implementation of nationwide counseling facilities

Beratung von Krebspatienten zu komplementärer und alternativer Medizin

Hintergrund, Theorie und Umsetzung bundesweiter Beratungshilfen

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Abstract

Background and purpose

Complementary and alternative medicine (CAM) is of high relevance in oncology. Only a minority of professionals feel competent in CAM. Our aim was to provide a strategy for establishing evidence-based counseling on CAM in oncology in the German health system.

Methods

We performed a systematic search of the literature on patient counseling concerning CAM. Of 811 articles identified in this search 51 met our inclusion criteria. Data from these articles were analyzed and adapted to the needs of German patients by a group of experts of the DEGRO (“Deutschen Gesellschaft für Radioonkologie”) and the German Cancer Society. In the next step a strategy about how to integrate evidence-based counseling on CAM at cancer centers and oncological institutions was developed.

Results

First, evidence-based recommendations on CAM counseling were derived. The core of our strategy combines two levels of information provision: level 1 will be oncologists, radiotherapists and other specialists and level 2 oncological CAM experts. The latter group will serve as trainers and backup for complicated or advanced questions and for individual counseling of patients with complex needs. Professionals in level 1 will be offered special training.

Conclusion

Evidence-based counseling on CAM is not only possible but also mandatory in order to meet patient information needs. Our proposal would allow for integrated counseling available at all oncological institutions and guarantee a high quality. Furthermore, provision of information on two different levels allows the effective use of resources (manpower and financing).

Zusammenfassung

Hintergrund

Komplementäre und alternative Medizin (KAM) hat eine hohe Bedeutung in der Onkologie. Nur eine Minderheit der Onkologen fühlt sich kompetent bei KAM. Unser Ziel war es, eine Strategie zu entwickeln, wie innerhalb des deutschen Gesundheitssystems evidenzbasierte Beratungen zu KAM aufgebaut werden können.

Methoden

In einer systematischen Literaturrecherche zum Thema Beratung zu KAM wurden 811 Artikel gefunden, von denen 51 inhaltlich dem Thema unserer Arbeit entsprachen. Aus ihnen wurde von einer Expertengruppe der Deutschen Gesellschaft für Radioonkologie und der Deutschen Krebsgesellschaft eine Strategie entwickelt, wie evidenzbasierte Beratung zu KAM in Tumorzentren und anderen onkologischen Institutionen integriert werden kann.

Ergebnisse

Als erstes wurden evidenzbasierte Empfehlungen zur KAM-Beratung erarbeitet. Der Kern der Strategie besteht in 2 Stufen der Informationsvermittlung. Auf Stufe 1 befinden sich Onkologen, Strahlentherapeuten und andere Fachärzte, Stufe 2 bilden Fachärzte mit onkologischem Hintergrund und Expertise in KAM. Diese stehen sowohl als Ausbilder aber auch als Hintergrund für komplizierte und fortgeschrittene Fragen und für die individuelle Beratung von Patienten mit besonderen Bedürfnissen zur Verfügung. Fachärzte erhalten ein spezielles Training.

Schlussfolgerungen

Evidenzbasierte Beratung zu KAM ist möglich und notwendig, um den Informationsbedarf von Patienten zu befriedigen. Unser Vorschlag ermöglicht es, diese Beratungen in allen onkologischen Institutionen zu integrieren und eine hohe Qualität zu garantieren. Durch das Angebot der Informationen auf 2 unterschiedlichen Stufen werden menschliche und finanzielle Ressourcen gespart.

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Conflict of interest

On behalf of all authors, the corresponding author states that there are no conflicts of interest.

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Authors and Affiliations

  1. Dr. Senckenberg Chronomedical Institute, J.W. Goethe University, Theodor-Stern- Kai 7, 60590, Frankfurt/Main, Germany

    J. Hübner

  2. Clinic for Gynecology and Obstetrics, University Gießen, Gießen, Germany

    K. Muenstedt

  3. Department of Radiooncolgy, Klinikum Lippe, Lippe, Germany

    R. Muecke

  4. Department of Radiooncology, Franziskus Hospital, Bielefeld, Germany

    O. Micke

  5. Clinic Herzoghoehe, Bayreuth, Germany

    C. Stoll

  6. HOPA, Hamburg, Germany

    U.R. Kleeberg

  7. Department of Head and Neck Diseases, Clinic Nordhausen, Nordhausen, Germany

    J. Buentzel

  8. Institute for Transdisciplinary Health Care Research, Berlin, Germany

    G. Dennert

  9. Radiooncology, Wiesbaden, Germany

    F.J. Prott

Authors
  1. J. Hübner
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  2. K. Muenstedt
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  3. R. Muecke
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  4. O. Micke
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  5. C. Stoll
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  7. J. Buentzel
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  8. G. Dennert
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Consortia

On behalf of PRIO (Working group Prevention and Integrative Oncology of the German Cancer Society) and AKTE (Working group Trace Elements of the German Society of Radiooncology (DEGRO)

Corresponding author

Correspondence to J. Hübner.

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Hübner, J., Muenstedt, K., Muecke, R. et al. Counseling cancer patients on complementary and alternative medicine. Strahlenther Onkol 189, 613–617 (2013). https://doi.org/10.1007/s00066-013-0392-4

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  • DOI: https://doi.org/10.1007/s00066-013-0392-4

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