Perelman School of Medicine at the University of Pennsylvania, Department of Radiation Oncology, University of Pennsylvania Health System, Philadelphia, Pennsylvania 19104, USA.
Int J Radiat Oncol Biol Phys. 2013 Jan 1;85(1):e1-6. doi: 10.1016/j.ijrobp.2012.08.018. Epub 2012 Oct 3.
Despite the extensive use of complementary and alternative medicine (CAM) among cancer patients, patient-physician communication regarding CAM therapies remains limited. This study quantified the extent of patient-physician communication about CAM and identified factors associated with its discussion in radiation therapy (RT) settings.
We conducted a cross-sectional survey of 305 RT patients at an urban academic cancer center. Patients with different cancer types were recruited in their last week of RT. Participants self-reported their demographic characteristics, health status, CAM use, patient-physician communication regarding CAM, and rationale for/against discussing CAM therapies with physicians. Multivariate logistic regression was used to identify relationships between demographic/clinical variables and patients' discussion of CAM with radiation oncologists.
Among the 305 participants, 133 (43.6%) reported using CAM, and only 37 (12.1%) reported discussing CAM therapies with their radiation oncologists. In multivariate analyses, female patients (adjusted odds ratio [AOR] 0.45, 95% confidence interval [CI] 0.21-0.98) and patients with full-time employment (AOR 0.32, 95% CI 0.12-0.81) were less likely to discuss CAM with their radiation oncologists. CAM users (AOR 4.28, 95% CI 1.93-9.53) were more likely to discuss CAM with their radiation oncologists than were non-CAM users.
Despite the common use of CAM among oncology patients, discussions regarding these treatments occur rarely in the RT setting, particularly among female and full-time employed patients. Clinicians and patients should incorporate discussions of CAM to guide its appropriate use and to maximize possible benefit while minimizing potential harm.
尽管癌症患者广泛使用补充和替代医学(CAM),但医患之间关于 CAM 治疗的沟通仍然有限。本研究量化了患者与医生之间关于 CAM 的沟通程度,并确定了与在放射治疗(RT)环境中讨论 CAM 相关的因素。
我们在一家城市学术癌症中心对 305 名接受 RT 的患者进行了横断面调查。在 RT 最后一周招募了不同类型癌症的患者。参与者自我报告了他们的人口统计学特征、健康状况、CAM 使用情况、患者与医生之间关于 CAM 的沟通情况,以及与医生讨论 CAM 治疗的理由。使用多变量逻辑回归来确定人口统计学/临床变量与患者与放射肿瘤学家讨论 CAM 之间的关系。
在 305 名参与者中,有 133 名(43.6%)报告使用了 CAM,只有 37 名(12.1%)报告与他们的放射肿瘤学家讨论了 CAM 治疗。在多变量分析中,女性患者(调整后的优势比 [AOR] 0.45,95%置信区间 [CI] 0.21-0.98)和全职工作的患者(AOR 0.32,95%CI 0.12-0.81)与放射肿瘤学家讨论 CAM 的可能性较小。与非 CAM 用户相比,CAM 用户(AOR 4.28,95%CI 1.93-9.53)更有可能与他们的放射肿瘤学家讨论 CAM。
尽管癌症患者普遍使用 CAM,但在 RT 环境中很少讨论这些治疗方法,尤其是在女性和全职工作的患者中。临床医生和患者应讨论 CAM,以指导其合理使用,并在最大程度地发挥可能的益处的同时最大限度地减少潜在的危害。