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将草药医学纳入肿瘤学护理服务中:一个新方案的制定、实施和评估。

Integrating herbal medicine into oncology care delivery: development, implementation, and evaluation of a novel program.

机构信息

Integrative Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

出版信息

Support Care Cancer. 2023 Jan 21;31(2):128. doi: 10.1007/s00520-023-07577-x.

Abstract

OBJECTIVE

To evaluate the feasibility of a novel program facilitating patient-provider communication about appropriate use of herbal medicine at a large academic cancer center and its impact on patient wellbeing.

METHODS

In the Herbal Oncology Program (HOP), integrative medicine providers counseled patients about unmet symptom needs and prescribed traditional Chinese medicine (TCM) herbs when indicated, taking into consideration the clinical context, patient preference, and research evidence. To evaluate the feasibility and outcomes, we performed a retrospective analysis using medical record data (symptoms and other concerns that motivated patients to seek herbal products, types and numbers of dispensed TCM herbs, and demographic characteristics). We also conducted a survey to assess patient experience and satisfaction.

RESULTS

All 851 participants were outpatients, with 712 (84%) in active treatment. HOP dispensed 1266 herbal prescriptions for a range of symptoms, most commonly GI symptoms (467, 37%); pain (353, 28%); and treatment-related fatigue, sleep, and mood disorders (346, 27%). Of 269 patients invited to the survey, 107 (40%) completed it. A majority of respondents 70.9% (73/103) were satisfied with the effectiveness of dispensed herbs in relieving their symptoms, and few 6.7% (7/104) had experienced mild adverse events that resolved after discontinuing herbal use.

CONCLUSIONS

The study's findings support the feasibility of integrating herbal medicine into an academic oncology setting. Patient satisfaction with HOP was high, with limited adverse events. The patterns of herbal prescriptions in HOP suggest future areas for clinical research to strengthen the evidence base around safe and effective use.

摘要

目的

评估在大型学术癌症中心实施一项新的项目以促进医患之间关于草药合理使用的沟通的可行性,及其对患者健康状况的影响。

方法

在草药肿瘤学计划(HOP)中,整合医学提供者根据临床背景、患者偏好和研究证据,就未满足的症状需求对患者进行咨询,并在有指征时开具中药(TCM)草药。为了评估可行性和结果,我们使用病历数据(促使患者寻求草药产品的症状和其他关注点、开具的 TCM 草药的类型和数量以及人口统计学特征)进行了回顾性分析。我们还进行了一项调查,以评估患者的体验和满意度。

结果

所有 851 名参与者均为门诊患者,其中 712 名(84%)正在接受积极治疗。HOP 开具了 1266 种草药处方,用于治疗各种症状,最常见的是胃肠道症状(467,37%);疼痛(353,28%);以及与治疗相关的疲劳、睡眠和情绪障碍(346,27%)。在 269 名受邀参加调查的患者中,有 107 名(40%)完成了调查。大多数受访者(70.9%,73/103)对所开草药缓解症状的有效性感到满意,少数患者(6.7%,7/104)经历了轻微的不良反应,在停止使用草药后得到缓解。

结论

研究结果支持将草药医学纳入学术肿瘤学环境的可行性。患者对 HOP 的满意度很高,且不良反应有限。HOP 中开具的草药处方模式表明,未来有必要开展临床研究,以加强安全有效使用草药的证据基础。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6167/9860233/339ca486d100/520_2023_7577_Fig1_HTML.jpg

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