目的:许多癌症患者希望由他们的肿瘤科医生领导的补充和综合医学(CIM)咨询。在KOKON-KTO研究中,干预组的肿瘤科医师接受了混合学习培训,除了向癌症患者提供CIM咨询外,还分发了有关CIM网站的传单.控制肿瘤学医生只分发了传单。培训对患者水平显示出积极的影响。截至目前,在癌症治疗期间,没有一致的证据证明这种一次性CIM咨询的长期效果.
方法:在KOKON-KTO随访研究中,先前参与KOKON-KTO研究的癌症患者(干预组:IG和对照组:CG)接受,至少24个月后,一份邮寄的后续问卷,使用原始研究中提供的措施评估KOKON-KTO咨询的长期效果(患者-医师沟通(EORTC-QLQ-COMU2),对癌症治疗的满意度(PS-CaTE),与医疗保健提供者(HCP)的CIM披露,并且在癌症治疗期间需要CIM咨询)。
结果:总计,102名癌症患者参加了随访研究(IGn=62;CGn=40)。总体反应率约为36%(IG:48.4%;CG:23.7%)。在后续研究中,组间差异增加且仍显示(EORTC-QLQ-COMU26,0-100点量表,≥10点-组差异)在一些分量表:患者的主动行为(均值;IG:73.6(95%CI,63.8-83.5);CG:61.1(95%CI,52.4-69.8));临床医生-患者关系(IG:80.9(95%CI,71.8-90.0);CG:68.7(95%CI,59.3-78.0))。对于某些结果,差异随着时间的推移而减少(例如,EORTC-QLQ-COMU26分量表“考虑了患者的偏好”和“纠正误解”)。更多的CG患者在没有肿瘤医师知识的情况下使用CIM(IG:13.7%,CG:24.0%)。
结论:这项研究首次发现,仅一次性CIM咨询可能会长期增强患者与患者的关系和CIM披露。为了进一步支持癌症患者对CIM咨询的愿望,培训计划应该为肿瘤科医师提供针对不同癌症阶段的CIM能力,包括癌症幸存者.
OBJECTIVE: Many cancer patients wish for complementary and integrative medicine (CIM) consultations led by their oncology physician. Within the KOKON-KTO study, oncology physicians in the intervention group were trained in a blended learning to provide CIM consultations to their cancer patients in addition to distributing a leaflet about CIM websites. Control oncology physicians only distributed the leaflet. The training showed positive effects on the patient-level. As of now, no consistent evidence exists on the long-term effects of such one-time-only CIM consultation during cancer treatment.
METHODS: In the KOKON-KTO follow-up study, cancer patients previously participating in the KOKON-KTO study (intervention group:IG and control group: CG) received, at least 24 months later, a follow-up questionnaire by post, evaluating long-term effects of the KOKON-KTO consultation using the measures provided in the original study (patient-physician communication (EORTC-QLQ-COMU2), satisfaction with cancer treatment (PS-CaTE), CIM disclosure with healthcare provider (HCP), and need for CIM consultation during cancer therapy).
RESULTS: In total, 102 cancer patients participated in the follow-up study (IG n = 62; CG n = 40). The overall reponse rate was around 36% (IG: 48.4%; CG: 23.7%). In the follow-up study, differences between groups had increased and were still shown (EORTC-QLQ-COMU26, 0-100 point scale, ≥10-point-group difference) in some subscales: patient\'s active behavior (in means; IG:73.6 (95% CI, 63.8-83.5); CG:61.1 (95% CI, 52.4-69.8)); clinician-patient relationship (IG:80.9 (95% CI, 71.8-90.0); CG:68.7 (95% CI, 59.3-78.0)). For some outcomes, differences decreased over time (e.g., EORTC-QLQ-COMU26 subscales \"takes into account patient\'s preference\" and \"corrects misunderstandings\"). More patients in the CG used CIM without oncology physicians\' knowledge (IG: 13.7%, CG: 24.0%).
CONCLUSIONS: This study presents first findings that one-time-only CIM consultations may enhance patient-physican relationship and CIM disclosure long-term. To further support cancer patients\' in their wish for CIM consultations, training programs should provide oncology physicians with CIM competencies for different cancer stages including cancer survivors.