Samuels Noah, Cohen Neora, Katz Daniela, Ben-Arye Eran
Center for Integrative Complementary Medicine, Shaare Zedek Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, P.O.B. 3235, 9103102, Jerusalem, Israel.
Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
J Cancer Res Clin Oncol. 2023 Sep;149(12):10143-10148. doi: 10.1007/s00432-023-04912-x. Epub 2023 Jun 2.
Integrative oncology (IO) provides complementary and integrative medicine within conventional supportive and palliative cancer care. The present study set out to identify barriers to attending an integrative physician (IP) consultation, provided without charge within an IO treatment program.
Electronic files of adult oncology patients undergoing chemotherapy were studied. Patient-related characteristics were examined to identify factors associated with attendance at the IP consultation: socio-demographic (age, gender, country of birth, place of residence, primary language spoken); health- related (BMI, smoking, independent functioning); and cancer- related (primary tumor site, localized vs. metastatic).
Only 257 of the 1912 patients studied (13.4%) attended the IP consultation, with female patients more likely to attend (p < 0.001), as well as younger patients (p = 0.002); those residing outside the Jerusalem municipality (p = 0.008); and patients whose primary language was Hebrew (p < 0.001). Non-smokers and functionally independent patients were also more likely to attend (p = 0.007 and 0.008, respectively), as were those diagnosed with breast/gynecological (p = 0.005) or gastrointestinal tumors (p = 0.002). Multivariate analysis showed a significantly greater likelihood of attending the consultation among females (OR 1.619, 95% CI 1.065-2.460; p = 0.024); younger patients (OR 1.019, 95% CI 1.007-1.031; p = 0.001); non-Arabic speakers (OR 8.220, 95% CI 3.310-20.413; p < 0.001); and patients diagnosed with a tumor other than lung cancer (OR 2.954, 95% CI 1.259-6.933; p = 0.013).
Further prospective research addressing socio-demographic, personal health- and cancer-related characteristics of oncology patients is needed to address potential barriers to the provision of IO care within a diverse, equitable and inclusive setting of care.
整合肿瘤学（IO）在传统的癌症支持治疗和姑息治疗中提供补充和整合医学。本研究旨在确定在IO治疗项目中免费提供的整合医生（IP）咨询服务的就诊障碍。
对接受化疗的成年肿瘤患者的电子病历进行研究。检查患者相关特征，以确定与IP咨询就诊相关的因素：社会人口统计学特征（年龄、性别、出生国家、居住地点、主要语言）；健康相关特征（体重指数、吸烟状况、独立功能）；以及癌症相关特征（原发肿瘤部位、局部与转移）。
在1912名研究患者中，只有257名（13.4%）参加了IP咨询，女性患者更有可能参加（p<0.001），年轻患者也是如此（p = 0.002）；居住在耶路撒冷市以外的患者（p = 0.008）；以及主要语言为希伯来语的患者（p<0.001）。不吸烟者和功能独立的患者也更有可能参加（分别为p = 0.007和0.008），被诊断患有乳腺癌/妇科肿瘤（p = 0.005）或胃肠道肿瘤（p = 0.002）的患者也是如此。多因素分析显示，女性（比值比1.619，95%置信区间1.065 - 2.460；p = 0.024）、年轻患者（比值比1.019，95%置信区间1.007 - 1.031；p = 0.001）、非阿拉伯语使用者（比值比8.220，95%置信区间3.310 - 20.413；p<0.001）以及被诊断患有非肺癌肿瘤的患者（比值比2.954，95%置信区间1.259 - 6.933；p = 0.013）参加咨询的可能性显著更高。
需要进一步开展前瞻性研究，探讨肿瘤患者的社会人口统计学、个人健康和癌症相关特征，以解决在多样化、公平和包容的护理环境中提供IO护理的潜在障碍。
