Reasons for encounter and recommended interventions in an interprofessional integrative oncology counseling program in outpatient care: a mixed-methods analysis of 1,693 consultation letters.

Abstract

Introduction: Complementary and integrative healthcare (CIH) approaches play an increasingly important role in oncology care, involving a wide range of healthcare professionals and therapeutic methods. While patient demand for CIH and the evidence base for individual interventions have grown considerably, the implementation of structured counseling services for the effective and safe use of CIH remains limited. To address this gap, a controlled, multicenter implementation study was conducted at four Comprehensive Cancer Centers (CCC) in Germany to establish an outpatient, interprofessional, evidence-based counseling service for CIH (CCC-Integrativ). This mixed-methods study investigates the specific reasons for encounter (RfE) and the recommended interventions during these consultations.

Methods: Patients enrolled in the CCC-Integrativ study received three CIH consultations within a three-month period, the first of which was conducted jointly by specifically trained physicians and nurses. After each session, a consultation letter was prepared summarizing the main patient RfE and recommendations. All consultation letters were analyzed using qualitative content analysis, and the results were subsequently analyzed quantitatively.

Results: A total of 1,693 consultation letters from 603 oncology patients were analyzed. The most frequent reasons for encounter included general weakness and fatigue (56%), chemotherapy-induced peripheral neuropathy (40%), sleep disturbances (37%), and general pain (36%). Nearly all patients received counseling on lifestyle modifications, including nutrition (95%), physical activity (93%), and stress management (81%). Additionally, an average of 15 specific CIH interventions were recommended per patient, encompassing naturopathic nursing interventions (97%), herbal medicines and teas (79%), acupressure (79%), and mindfulness-based movement therapies (44%).

Discussion: Interprofessional outpatient counseling on CIH in oncology addresses a wide spectrum of patient RfE, provides guidance on lifestyle modifications, and offers specific, individualized CIH interventions to help patients manage burdensome symptoms. These findings suggest that interprofessional integrative counseling services can play a crucial role in outpatient oncology care by providing a holistic approach tailored to individual needs. Furthermore, structured integrative oncology counseling may serve a valuable navigational role within outpatient care settings.