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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.

Methods

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.

Results

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.