Aims
To understand the clinical documentation and management of patients’ use of CAM during anti-cancer treatment and the potential gaps.
Methods
A retrospective study was undertaken from 1st January to 31st January 2017, comparing patient CAM use documented in their medication chart by doctors with the comprehensive medication lists documented by the pharmacists in the patient electronic record. Inconsistencies in the documentation between doctors and pharmacists were noted. The review time period ensured the group represented typical patients irrespective of the treatment intent (curative or palliative) or type of cancer treatment involved (e.g. intravenous, oral).
Results
171 patients were reviewed with 86 patients identified during the review to be using CAM. The mean age was 67.3 years (SD=12.2), 65.1% (56/86) were female, 29% (25/86) and 71% (61/86) received curative and palliative treatment respectively. Only 5 patients had their CAM use documented by the doctor in their medication chart, whereas the pharmacists’ lists showed 50.3% (86/171) of the patients used CAM during treatment. There was no robust evidence to support the use or indication for 25% (11/44) of CAM agents listed on the medication lists (e.g. red clover, shark cartilage for prostate cancer).
Conclusions
The results of this study highlighted a large discrepancy in CAM documentation and a lack of clear management plan for patients and health professionals. While the pharmacists’ medication list aims to assist with medication management and serve as a tool to exchange information with other health professionals it did not appear to be utilized effectively in patient management. Patterns and reasons for patients’ CAM use should be explored prospectively to establish clear roles of health professionals in managing patients’ CAM use during treatment.