Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia.
School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
PLoS One. 2021 Nov 4;16(11):e0258901. doi: 10.1371/journal.pone.0258901. eCollection 2021.
Chronic conditions are prolonged and complex, leading patients to seek multiple forms of care alongside conventional treatment, including complementary medicine (CM). These multiple forms of care are often used concomitantly, requiring patient-provider communication about treatments used in order to manage potential risks. In response, this study describes rates and reasons for disclosure/non-disclosure of conventional medicine use to CM practitioners, and CM use to medical doctors, by individuals with chronic conditions. A survey was conducted online in July and August 2017 amongst the Australian adult population. Participants with chronic conditions were asked about their disclosure-related communication with CM practitioners (massage therapist, chiropractor, acupuncturist, naturopath) and medical doctors. Patients consulting different professions reported varying disclosure rates and reasons. Full disclosure (disclosed ALL) to medical doctors was higher (62.7%-79.5%) than full disclosure to CM practitioners (41.2%-56.9%). The most strongly reported reason for disclosing to both MDs and CM practitioners was I wanted them to fully understand my health status, while for non-disclosure it was They did not ask me about my CM/medicine use. Reasons regarding concerns or expectations around the consultation or patient-provider relationship were also influential. The findings suggest that patient disclosure of treatment use in clinical consultation for chronic conditions may be improved through patient education about its importance, direct provider inquiry, and supportive patient-provider partnerships. Provision of optimal patient care for those with chronic conditions requires greater attention to patient-provider communication surrounding patients' wider care and treatment use.
慢性疾病病程长且复杂,患者在常规治疗之外还会寻求多种形式的治疗,包括补充医学(CM)。这些多种形式的治疗往往同时使用,这就需要医患双方沟通患者所使用的治疗方法,以管理潜在的风险。为此,本研究描述了慢性病患者向 CM 从业者(按摩治疗师、脊椎按摩师、针灸师、自然疗法师)和向医生披露/不披露常规药物使用情况的比率和原因,以及 CM 的使用情况。2017 年 7 月至 8 月,在澳大利亚成年人中进行了在线调查。患有慢性病的参与者被问及他们与 CM 从业者(按摩治疗师、脊椎按摩师、针灸师、自然疗法师)和医生相关的披露沟通情况。向不同专业人士咨询的患者报告了不同的披露率和原因。向医生完全披露(全部披露)的比例(62.7%-79.5%)高于向 CM 从业者完全披露的比例(41.2%-56.9%)。向医生和 CM 从业者披露的最主要原因是我希望他们全面了解我的健康状况,而不披露的原因是他们没有询问我有关 CM/药物使用的情况。关于咨询或医患关系的担忧或期望方面的原因也有影响。研究结果表明,通过对患者进行关于披露重要性的教育、直接询问提供者、建立支持性的医患关系,可以改善慢性病患者在临床咨询中披露治疗使用情况。为那些患有慢性病的人提供最佳的患者护理,需要更加关注患者围绕更广泛的护理和治疗使用的医患沟通。