A blended-learning training approach could help physicians discuss CM with their patients

A training program in complementary medicine (CM) can help oncology physicians better communicate with their patients about the role it can play in treating cancer.

The study, which evaluated a blending-learning training concept called KOKON-KTO, was published in Cancer.

According to research, cancer patients use complementary/alternative medicine for a number of reasons, including a hope for a therapeutic response, a desire to reduce the side effects associated with cancer treatment, or the chance to gain personal control over their treatment. And, cancer patients seeking out information and using complementary medicine is more the exception than the rule. According to one study, approximately half of cancer patients have used complementary medicine at least once.

However, Claudia M. Witt, MD, MBA, University Hospital Zurich and University of Zurich, Zurich, Switzerland, and colleagues, pointed out that other research has shown that when these CM therapies are administered by nonmedical personnel it can lead to worse outcomes, such as reduced adherence to scheduled cancer treatments.

’This finding, which is also supported by previous research, highlights the importance of discussing CM during oncology consultations,” wrote Witt and colleagues. “Because alternative medicine usually refers to therapies that are used as an alternative to conventional cancer treatment in an unmonitored context, it is important to support patients in translating their needs and wishes into a complementary and integrative model of care to reduce possible safety-related risk issues.”

At the same time, Witt and colleagues noted that oncology physicians are often hesitant to initiate consultations about complementary and integrative medicine (CIM) because of a lack of knowledge about these therapies. Therefore, they wrote, oncologists have an “urgent need” to feel competent in guiding their patients through the field of CIM.

The study authors evaluated KOKON-KTO (a German acronym for Competence Network for Complementary Medicine — Consultation Training for Oncology Physicians). Forty-seven oncology physicians from across Germany were included in the study. They received online learning on complementary and integrative medicine topics and were assessed regarding their understanding of those topics. They also attended a 2-day workshop designed to put their knowledge into practice.

According to the authors, after the e-learning session oncology physicians should have been able to:

  • Classify the need for and challenges of CIM in oncology.
  • Differentiate between various CIM therapies and other supportive therapies.
  • Apply essential elements of a KOKON-KTO consultation in case studies.

And after the on-site skills training workshop, those physicians should have been capable of:

  • Applying knowledge about CIM therapies and other supportive therapies to specific situations.
  • Implementing elements of a KOKON-KTO conversation in role-play exercises.
  • Dealing practically with the challenges of CIM therapies and other supportive therapies in consultations.
  • Conducting a KOKON-KTO consultation with a standardized patient.

Ultimately, the goal was to enable the oncologists to have a meaningful 20-minute conversation/intervention regarding CIM use with their patients.

Witt and colleagues found that by the end of the e-learning session and on-site training the oncologists were satisfied with its content and its presentation, and they were able to successfully conduct a KOKON-KTO consultation. In addition, the patients who were involved in the study felt positive about the intervention.

The authors also observed that the KOKON-KTO consultation should be both easy to implement, and cost-effective, because it is designed to be applied during a physician’s daily workflow.

“We have demonstrated that the KOKON-KTO framework is suitable for training oncology physicians to give CIM advice to their patients with cancer, and its implementation could lead to better physician-patient communication,” Witt and colleagues concluded.

In an editorial accompanying the study, Richard T. Lee, MD, Case Western Reserve University School of Medicine, Cleveland, Ohio, and Heather Greenlee, ND, PhD, Fred Hutchinson Cancer Research Center, Seattle, Washington, wrote that the next step for the field is the widespread implementation of this kind of intervention.

They added that while the possibility of providing this kind of training to oncologists is welcome, the time commitment could be prohibitive and prevent wider uptake.

“However, the main long-term solution is the incorporation of this education early in the medical school curriculum and continuing it through fellowship,” wrote Lee and Greenlee. “Including [complementary, alternative, and integrative medicine] as a required topic in Accreditation Council for Graduate Medical Education fellowships would guarantee that oncology clinicians are exposed to the information.”

  1. A training program in complementary medicine called KOKON-KTO should help oncologists converse more effectively with their patients about the role it can play in cancer treatment.

  2. The study found that after an e-learning session and a 2-day onsite workshop that oncologists were able to successfully conduct a 20-minute consultation on complementary medicine with patients.

Michael Bassett, Contributing Writer, BreakingMED™

The experts cited in this article disclosed no relevant relationships.

Cat ID: 116

Topic ID: 78,116,116,120,935,192,94,925