Enhancing patient activation:a controlled implementation study of an interprofessional evidence-based counseling program for complementary and integrative healthcare in cancer patients(‘CCC-Integrativ’)  

作　　者：Jan Valentini Daniela Froehlich Inka Roesel Regina Stolz Cornelia Mahler Peter Martus Nadja Klafke Markus Horneber Claudia Witte Klaus Kramer Christine Greil Barbara Gruen Katrin Tomaschko-Ubelaender Stefanie Joos on behalf of the CCC-Integrativ Study Group 

机构地区：[1]Institute for General Practice and Interprofessional Care,University Hospital and Faculty of Medicine Tuebingen,Tuebingen,Germany [2]Institute for Clinical Epidemiology and Applied Biostatistics,University Hospital and Faculty of Medicine Tuebingen,Tuebingen,Germany [3]Department of Nursing Science,Institute for Health Sciences,University Hospital and Faculty of Medicine Tuebingen,Tuebingen,Germany [4]Department of General Practice and Health Services Research,University Hospital Heidelberg,Germany [5]Department of Internal Medicine,Division of Pneumology,Paracelsus Medical University,Klinikum Nuernberg,Germany [6]aQua Institute for Applied Quality Improvement and Research in Health Care,Goettingen,Germany [7]Department of Integrative Medicine,University Hospital and Faculty of Medicine Ulm,Germany [8]Department of Medicine I,Medical Centre University of Freiburg,Faculty of Medicine,University of Freiburg,Germany [9]Department of Medical Oncology,National Centre for Tumor Diseases,Heidelberg,Germany [10]AOK Baden-Württemberg Hauptverwaltung,Fachbereich Integriertes Leistungsmanagement,Stuttgart,Germany [11]不详

出　　处：《Frontiers of Medicine》2024年第6期1013-1025,共13页医学前沿(英文版)

基　　金：supported by the Innovationsfonds of the Federal Joint Committee 2019-2022(No.01NVF18004).

摘　　要：Complementary and integrative healthcare(CIH)is increasingly recognized as a valuable approach to empowering and activating cancer patients.Studies have shown that higher patient activation is positively associated with improved health outcomes and reduced healthcare costs.The CCC-Integrativ study aimed to assess the implementation of an evidence-based counseling service on CIH at four Comprehensive Cancer Centers(CCC)in Germany.In this controlled implementation study,the patient-level intervention included three CIH consultations within a 3-month period delivered by interprofessional teams of physicians and nurses.The primary endpoint was patient activation using the PAM-13 at baseline(T1)and post-intervention(T2),and compared between control(CO,receiving routine care)and the intervention group(IG)using an analysis of covariance.Missing data were handled with multiple imputations.Maintenance effects at 6-month follow-up(T3)were investigated using a linear mixed model.A total of n=1128 oncology patients(CO=443,IG=685)with diverse tumor entities and cancer stages were included in the study.The overall mean baseline PAM-13 score was 69.74(SD=14.24)(n=959(85.0%)).A statistically significant between-group difference in post-intervention PAM-13 scores was observed(F_(group)(1,1866.82)=8.634,P=0.003),with an adjusted mean difference of 2.22 PAM-points.Age,gender,tumor entity,disease stage,or CCC study site did not significantly predict post-treatment PAM-13 scores.The maintenance effect of the intervention was not statistically significant(F_(timeXgroup)(1,3316.04)=2.337,P=0.096).Individually tailored counseling on CIH,offered by specifically trained,interprofessional teams,significantly improved patient activation.Given the established positive effects of higher patient activation,the implementation of such a program at cancer centers may yield beneficial outcomes for both patients and the healthcare system.

关 键 词：adult oncology complementary medicine complementary and integrative healthcare herbal medicine nutritional support ONCOLOGY preventive medicine patient activation interprofessional counseling 

分 类 号：R730.5[医药卫生—肿瘤]