title: Survey of practices and policies relating to the use of complementary and alternative medicines and therapies in New South Wales cancer services.
abstract: OBJECTIVE
  To examine policies and practices relating to the provision, prescription and monitoring of complementary and alternative medicine and therapies (CAM) in conventional cancer services in NSW.
  
  
  METHODS
  Self-administered questionnaire sent to directors of all 65 eligible cancer services in NSW in 2009.
  
  
  RESULTS
  Forty-three services responded to the survey (response rate 66%). Only six (14%) services reported having formal policies about CAM. Most (n = 33, 77%) expected that patients would be asked about CAM use during their initial assessment. Eight services (19%) provided and/or prescribed CAM for patients, and most of these (n = 7) recorded details of CAM use in patients' records. Only four (9%) services permitted CAM practitioners from the community to attend inpatients, whereas 24 (56%) permitted inpatients to bring in their own CAM. Most of these services (n = 17) required medical approval for the use of CAM. Of the latter, most (n = 13) recorded the use of approved CAM, but only seven recorded use of unapproved CAM and only three refused permission to continue use of unapproved CAM.
  
  
  CONCLUSIONS
  Most cancer services in NSW recognise potential CAM use by patients and expect medical staff to ask patients about their use of CAM. While few cancer services provided or prescribed CAM, over half permitted inpatients to bring their own CAM into hospital. There was little control over the use of CAM, however, and monitoring was lax. Given the wide usage of CAM by patients with cancer, this lack of control may compromise clinical outcomes, with potentially dangerous consequences.
authors: Centre for Values, Ethics and the Law in Medicine, School of Public Health, University of Sydney, Sydney, New South Wales, Australia. veronica.raszeja@sydney.edu.au
authors: V M
authors: VM
authors: Raszeja
authors: C F C
authors: CF
authors: Jordens
authors: I H
authors: IH
authors: Kerridge
mesh_terms: D002173:Cancer Care Facilities / Q000941:ethics / Q000706:statistics & numerical data*; D003131:Combined Modality Therapy; D000529:Complementary Therapies / Q000941:ethics / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006753:Hospital Records; D016304:Hospitals, Private / Q000941:ethics / Q000706:statistics & numerical data; D006779:Hospitals, Public / Q000941:ethics / Q000706:statistics & numerical data; D006780:Hospitals, Rural / Q000941:ethics / Q000706:statistics & numerical data; D006786:Hospitals, Urban / Q000941:ethics / Q000706:statistics & numerical data; D006801:Humans; D007297:Inpatients / Q000523:psychology; D009369:Neoplasms / Q000523:psychology / Q000628:therapy*; D009517:New South Wales; D016134:Organizational Policy; D057240:Patient Preference; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012648:Self Care; D012651:Self Medication; D011795:Surveys and Questionnaires; D014789:Visitors to Patients