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Effectively discussing complementary and alternative medicine in a conventional oncology setting: Communication recommendations for clinicians
Patient Education and Counselling, 09/29/09

Schofield P et al. – This represents the first comprehensive guidelines for discussing CAM. Given the concerns surrounding CAM use, it is critical to encourage informed decision–making about CAM and ultimately, improve outcomes for patients.

• A systematic review was conducted, covering relevant literature from 1997 to 2007.
• The level of evidence was rated using a standardized rating system.
• The evidence was qualitatively synthesised into structured recommendations by a multidisciplinary team including a consumer.

• The search identified 78 original papers; 36 directly related to discussing CAM.
• No randomized controlled trials specifically addressing the methods or benefits of discussing CAM were identified.
• Evidence based guidelines are presented as a sequence of recommended steps: (1) Elicit the person's understanding of their situation; (2) Respect cultural and linguistic diversity and different epistemological frameworks; (3) Ask questions about CAM use at critical points in the illness trajectory; (4) Explore details and actively listen; (5) Respond to the person's emotional state; (6) Discuss relevant concerns while respecting the person's beliefs; (7) Provide balanced, evidence–based advice; (8) Summarize discussions; (9) Document the discussion; (10) Monitor and follow–up.

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