Cancer care

Hospital cancer services have inconsistent policies on complementary therapy


Despite complementary medicine being used widely by people with cancer, most cancer services lack clear policies on the use of such therapies, an Australian study has found.

Consistent policies and strong leadership are needed for the oversight of complementary medicine use in cancer services, according to the authors of a survey that found only a third of services routinely documented complementary medicine use that was initiated by patients.

The 2016 survey, covering 262 public and private hospital and clinic cancer services offering chemotherapy, radiotherapy, supportive care and palliative care, found that less than half (47%) routinely provided information to patients on the use of complementary medicines.

Results of the survey, published in the MJA, indicated that only  a third of cancer services were aware of the national position statement on complementary medicine services in cancer developed by the Council of Australian Therapeutic Advisory Groups  (CATAG) and only a small minority aligned their policies with the CATAG statement.

Most cancer services had some kind of policy for documenting complementary medicine use, but most only related to services recommended by staff and only 16% documented complementary therapies initiated by patients on medication charts, while in 21% of centres complementary medicine use was documented in the patient’s clinical history.

Only 10% of cancer services had a clear policy on referral of patients to complementary medicine services outside the hospital, with 16% saying they would make decisions on a case by case basis.

Likewise only a minority of cancer services had clear policies on the scope of practice (21%) and credentialling (28%) of visiting complementary medicine practitioners.

However the findings were more positive for the 25% of cancer services that offered complementary medicine services, which were significantly more likely to have policies on complementary medicine practitioners and documenting complementary medicines.

The study authors, from the University of Western Sydney, said about 60% of patients starting chemotherapy reported using some kind of complementary therapy, so the lack of policies on their use seen in hospital cancer services was concerning.

Patients often did not discuss their use of complementary therapies with their healthcare practitioner, and could potentially be using treatments that were harmful, ineffective or inappropriate, they said.

“Irrespective of whether a cancer service provides complementary medicine, consistent policies across Australian hospitals, and staff and patient awareness of these policies, are important because of the widespread use of complementary medicine,” they wrote.

“Stronger leadership is needed from peak bodies, such as the Australian Commission on Safety and Quality in Health Care and CATAG, to encourage Australian cancer services and hospitals to update or review their complementary medicine policies,” they concluded.

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