title: Integrating a complementary medicine consultation for women undergoing chemotherapy.
abstract: OBJECTIVE
  To explore oncology healthcare providers' (HCPs') patterns of referral of women undergoing chemotherapy to a complementary medicine (CM) consultation integrated within a conventional oncology service.
  
  
  METHODS
  Oncology HCPs used a structured referral system for referral to an integrative physician (IP) for CM consultation. Referral goals were in accordance with a specified list of quality-of-life (QOL) outcomes.
  
  
  RESULTS
  In total, the study HCPs referred 282 female patients, of whom 238 (84.4%) underwent CM consultation by the study IP: 59 (24.8%) with gynecologic cancer and 179 (75.2%) with non-gynecologic cancer. Use of CM for cancer-related outcomes was significantly higher among referred patients with gynecologic cancer than those with non-gynecologic cancer (69.5% vs 46.9%; P=0.003). Oncologists initiated most of the referrals in the gynecologic oncology group, whereas oncologic nurses referred most patients in the non-gynecologic oncology group. Among patients with gynecologic cancer, the correlation between HCP indication and patient expectation was high for gastrointestinal concerns (κ 0.41).
  
  
  CONCLUSIONS
  The integration of a structured and informed process of referral to CM consultation may enhance patient-centered care and QOL during chemotherapy.
authors.affiliation: Integrative Oncology Program, Oncology Service, Lin Medical Center, Clalit Health Services, Haifa, Israel; Complementary and Traditional Medicine Unit, Department of Family Medicine, Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. Electronic address: eranben@netvision.net.il.
authors.forename: Eran
authors.initials: E
authors.lastname: Ben-Arye
authors.affiliation: Department of Internal Medicine and Integrative Surgery Service, Bnai Zion Hospital, Haifa, Israel.
authors.forename: Elad
authors.initials: E
authors.lastname: Schiff
authors.affiliation: Integrative Oncology Program, Oncology Service, Lin Medical Center, Clalit Health Services, Haifa, Israel; Clalit Complementary Medicine, Clalit Health Services, Haifa, Israel.
authors.forename: Orit G
authors.initials: OG
authors.lastname: Raz
authors.affiliation: Integrative Oncology Program, Oncology Service, Lin Medical Center, Clalit Health Services, Haifa, Israel.
authors.forename: Noah
authors.initials: N
authors.lastname: Samuels
authors.affiliation: Department of Obstetrics and Gynecology, Gynecologic Oncology Service, Carmel Medical Center, Haifa, Israel.
authors.forename: Ofer
authors.initials: O
authors.lastname: Lavie
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D000529:Complementary Therapies; D005260:Female; D005833:Genital Neoplasms, Female / Q000188:drug therapy*; D006801:Humans; D055048:Integrative Medicine; D008875:Middle Aged; D012017:Referral and Consultation / Q000706:statistics & numerical data*
chemical_list: D000970:Antineoplastic Agents
keywords: Complementary medicine; Doctor–patient communication; Gynecologic oncology; Integrative medicine; Quality of life