Development of a One-On-One Complementary Medicine (CAM) Decision Support Coaching Intervention for Cancer Patient and Families

Tracy Truant, Lynda Balneaves, Brenda Ross, Margurite Wong, Carla Hilario, Marja Verhoef, Antony Porcino

Abstract


Background: Up to 80% of cancer patients use complementary medicine (CAM), yet most do not receive adequate decision support from health professionals to safely integrate CAM into their cancer treatment plan. This gap in care leads to concerns about safety when combining CAM with cancer treatments, and possible missed benefits from CAM therapies for which positive evidence exists.

Purpose: This presentation outlines the development and pilot testing of a nurse-led intervention to address this gap in care.  The one-on-one CAM decision support coaching intervention (CAM DSCI) offers cancer patients with complex CAM decision support needs (e.g. multiple CAM therapy use, high distress levels, considering conventional treatment delays) a structured approach to accessing and contextualizing evidence-informed CAM information to their unique clinical and personal situation.

Methods: Using a convenience sample and mixed methods approach, the pilot study evaluated a) participants’ CAM decision support needs, b) how the CAM DSCI affects select patient outcomes, and c) CAM DSCI feasibility (time, resources, expertise).

Findings: All participants (N=20) demonstrated improvements post CAM DSCI in CAM knowledge, decision quality, and decisional regret and described reduced anxiety and confusion when making CAM decisions. A range of CAM decision support needs were identified and feasibility of the intervention for the practice setting was established, including development of a practice-ready CAM assessment and decision support tool for health professionals.

Implications: The pilot study offers preliminary support for feasibility and effectiveness of the CAM DSCI to meet complex patient CAM decision support needs. This intervention also highlights an innovative role for nurses in the growing field of CAM/Integrative Medicine.


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