Integrating Herbal Medicine into Oncology Care Delivery: Development, Implementation and Evaluation of a Novel Program

Abstract

Objective To develop, implement and evaluate a novel program facilitating patient-provider communication about, and appropriate use of, herbal medicine at a large academic cancer center. Methods In the Herbal Oncology Program (HOP), integrative medicine providers counseled patients about unmet symptom needs and prescribed traditional Chinese medicine (TCM) herbs when indicated, taking into consideration the clinical context, patient preference, and research evidence. Follow-ups assessed use and tracked outcomes. Medical record data included symptoms and other concerns that motivated patients to seek herbal products; types and numbers of dispensed TCM herbs; and demographic characteristics. A survey assessed patient experience and satisfaction. Results All 851 participants were outpatients, with 712 (84%) in active treatment. HOP dispensed 1266 herbal prescriptions for a range of symptoms, most commonly GI symptoms (467, 37%); pain (353, 28%); and treatment-related fatigue, sleep and mood disorders (346, 27%). Of 269 patients invited to the survey, 107 (40%) completed it. A majority 70.9% (73/103) were satisfied with the effectiveness of dispensed herbs in relieving their symptoms, and few 6.7% (7/104) had experienced mild adverse events that resolved after discontinuing herbal use. Conclusions HOP demonstrates the feasibility of integrating herbal medicine into an academic oncology setting. Patient satisfaction with HOP was high, with limited adverse events. The patterns of herbal prescriptions in HOP suggest future areas for clinical research to strengthen the evidence base around safe and effective use.