Institute for Social Medicine, Epidemiology, and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
Institute for Health and Nursing Science, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
Cancer. 2021 Aug 1;127(15):2683-2692. doi: 10.1002/cncr.33562. Epub 2021 Apr 27.
Many patients with cancer do not disclose complementary medicine use but want their physician's advice on this matter. This study evaluated whether using blended learning (e-learning plus a workshop) to train oncology physicians in providing advice on complementary and integrative medicine (CIM) therapies to their patients with cancer, in addition to distributing an information leaflet on reputable CIM websites, had different effects on patient-reported outcomes for the consultation than only distributing the leaflet.
In this multicenter, cluster-randomized trial, patients from private practices/hospital departments, recruited by 48 oncology physicians randomly allocated to an intervention group (CIM consultation plus information leaflet) or a control group (information leaflet), received CIM information. Patient-reported outcomes included satisfaction (Patient Satisfaction With Information on Cancer Treatment), readiness to make a decision (Preparation for Decision Making), and physician-patient communication (European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire and Communication 26 [EORTC QLQ-COMU26]) for the consultation. Qualitative interviews were conducted with a physician subsample.
A total of 291 patients (128 in the intervention group and 169 in the control group) advised by 41 physicians participated. Patients in the intervention group rated physician-patient communication higher on all EORTC QLQ-COMU26 scales (mean total score, 84.3 [95% CI, 79.5-89.2] vs 73.6 [95% CI, 69.3-78.0]; P = .002), were more satisfied with the advice (mean, 4.2 [95% CI, 4.0-4.4] vs 3.7 [95% CI, 3.5-3.8]; P < .001), and were readier to make a decision (mean, 63.5 [95% CI, 57.4-69.6] vs 53.2 [95% CI, 47.8-58.7]; P = .016) than the control group. Physicians who reported patients in both settings seemed satisfied with the advice given.
This study evaluated a novel education intervention for training oncology physicians in providing CIM advice in routine care. Providing structured CIM consultations had positive effects on patient satisfaction, readiness to make decisions, and physician-patient communication.
许多癌症患者不会透露他们使用补充医学的情况，但希望医生能就此事提供建议。本研究评估了在为癌症患者提供补充和整合医学（CIM）治疗建议方面，除了分发有关信誉良好的 CIM 网站的信息传单外，使用混合学习（电子学习加研讨会）培训肿瘤医生是否会对咨询的患者报告结果产生与仅分发传单不同的效果。
在这项多中心、集群随机试验中，由 48 名随机分配到干预组（CIM 咨询加信息传单）或对照组（信息传单）的肿瘤医生招募的来自私人诊所/医院科室的患者收到了 CIM 信息。患者报告的结果包括对咨询的满意度（癌症治疗信息患者满意度）、决策准备程度（决策准备程度）和医患沟通（欧洲癌症研究与治疗组织生活质量问卷和沟通 26 项[EORTC QLQ-COMU26]）。对医生进行了亚组定性访谈。
共有 291 名患者（干预组 128 名，对照组 169 名）接受了 41 名医生的咨询。干预组患者在所有 EORTC QLQ-COMU26 量表上的医患沟通评分更高（总分平均，84.3 [95%CI，79.5-89.2] vs 73.6 [95%CI，69.3-78.0]；P =.002），对建议的满意度更高（平均 4.2 [95%CI，4.0-4.4] vs 3.7 [95%CI，3.5-3.8]；P <.001），并且准备做出决定的意愿更强（平均 63.5 [95%CI，57.4-69.6] vs 53.2 [95%CI，47.8-58.7]；P =.016）比对照组。报告在两种环境下的患者都对提供的建议感到满意的医生。
本研究评估了一种新型教育干预措施，用于培训肿瘤医生在常规护理中提供 CIM 建议。提供结构化的 CIM 咨询对患者满意度、决策准备程度和医患沟通均产生积极影响。
