Do complementary and integrative medicine therapies reduce healthcare utilization among oncology patients? A systematic review of the literature and recommendations.
Rachel Tillery, Meghan E McGrady
PMID 30322499WHAT IT FOUND
Findings were mixed: complementary and integrative therapies for cancer patients were associated with lower medication use or costs in four included studies, but hospitalization results were inconsistent.
Evidence is too limited to prove these therapies reduce healthcare use.
Key findings
01All four studies that examined medication use reported reduced medication use or medication costs with complementary and integrative medicine interventions.
02Hospitalization findings were inconsistent: one study reported fewer infection-related hospitalizations, three reported no association with length of stay, and one reported longer end-of-life stays.
03The evidence base was small and heterogeneous: 10 articles met inclusion criteria, 3 lacked sufficient data for effect sizes, and 7 studies were analyzed.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only 10 articles met inclusion criteria, and 3 could not provide enough data for effect sizes; attempts to obtain missing data were unsuccessful, so 7 studies were analyzed. The studies varied widely in cancer population, complementary therapy type, and healthcare utilization outcome, so no single overall effect could be estimated. Healthcare utilization was usually a secondary outcome, not the primary target of the complementary therapy intervention. Several positive medication findings came from observational cohorts or multi-component programs, such as yoga plus other relaxation strategies or acupuncture plus ginger moxibustion during chemotherapy, so the contribution of any single component cannot be separated. The quality checklist was designed for economic evaluations, and only two studies were fully applicable to it. None of the included studies was a full economic evaluation. Screening and full-text review were performed by one author, and the search was limited to PubMed, EBSCO, and English-language original research.
Declared interests
Rachel Tillery and Meghan McGrady declared no conflicts of interest.
The easy way to misread this
Do not conclude that complementary and integrative medicine therapies reduce hospitalizations or overall healthcare use in cancer patients. The medication findings were consistent, but hospitalization results were inconsistent, and the review included only seven analyzed studies with heterogeneous interventions.