title: Expectations from an integrative medicine consultation in breast cancer care: a registry protocol-based study.
abstract: OBJECTIVE
  The purpose of this study is to compare the rationale given by oncology health care practitioners (HCPs) for referral of their patients with breast cancer to a complementary medicine (CM) consultation with patient expectations from the CM treatment process.
  
  
  METHODS
  We conducted a prospective, registry protocol-based, open-label study. We compared the indications given by oncology HCPs for their referral of patients to the CM consultation with patient expectations from the CM therapeutic process. Patients were asked regarding prior CM use for cancer- and non-cancer-related indications.
  
  
  RESULTS
  A total of 127 patients referred to the CM consultation were studied, with half reporting prior CM use. The most popular treatment for non-cancer-related indications was acupuncture (46.9 %), with only 20.3 % reporting herbal medicine use (P ≤ 0.04). For cancer-related indications, herbal medicine was the most popular modality (42.4 %), with 11.6 % reporting acupuncture use. The most frequently cited indications for referral were general symptom reduction (19.7 %), emotional/spiritual relief (18.1 %), alleviation of weakness and fatigue (17.3 %), and reduction of gastrointestinal symptoms (10.2 %). For patients, the most important outcome was alleviation of weakness and fatigue (70.4 %), followed by emotional/spiritual relief (50 %), and the reduction of gastrointestinal symptoms (33.3 %). The correlation between HCP indications for referral and patient expectations was poor (Cohen's kappa of 0.19, 0.328, and 0.20, respectively).
  
  
  CONCLUSIONS
  The findings suggest that expectations from a CM treatment process differ greatly between oncology HCPs and patients with breast cancer. The use of a structured clinical referral process and a better understanding of patient concerns are factors which play a central role in the CM referral process.
authors: Integrative Oncology Program, Oncology Service, Lin Medical Center Clalit Health Services, Haifa and Western Galilee District, Israel, refplus@netvision.net.il.
authors: Noah
authors: N
authors: Samuels
authors: Elad
authors: E
authors: Schiff
authors: Ofer
authors: O
authors: Lavie
authors: Orit Gressel
authors: OG
authors: Raz
authors: Eran
authors: E
authors: Ben-Arye
mesh_terms: D015670:Acupuncture Therapy; D000368:Aged; D001943:Breast Neoplasms / Q000150:complications* / Q000628:therapy; D000529:Complementary Therapies / Q000706:statistics & numerical data*; D005221:Fatigue / Q000209:etiology / Q000628:therapy*; D005260:Female; D029001:Herbal Medicine; D006801:Humans; D055048:Integrative Medicine; D008297:Male; D008875:Middle Aged; D018908:Muscle Weakness / Q000209:etiology / Q000628:therapy*; D011446:Prospective Studies; D011788:Quality of Life; D012017:Referral and Consultation; D012042:Registries