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ONCOLOGY

Advising Cancer Patients on Natural Health Products—A Structured Approach

Provincial Drug Information Coordinator, Provincial Systemic Therapy Program, British Columbia Cancer Agency, Vancouver, British Columbia, Canada

Leela John, PharmD

at time of writing, Pharmacy Education Coordinator, Vancouver Centre, British Columbia Cancer Agency; now, Assistant Professor and Clinical Coordinator, Doctor of Pharmacy Program, Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver

Lynne Nakashima, PharmD

Pharmacy Professional Practice Leader, Vancouver Centre, British Columbia Cancer Agency

Robin K. O'Brien, PharmD BCOP

at time of writing, Drug Information Specialist, Provincial Systemic Therapy Program, British Columbia Cancer Agency; now, Pharmacotherapy Consultant, Pharmacotherapy Consulting Group, Vancouver

Suzanne CM Taylor, PharmD BCSP

Pharmacoeconomics Pharmacist, Provincial Systemic Therapy Program, British Columbia Cancer Agency

Reprints: Mário L de Lemos PharmD MRPharmS, Provincial Systemic Therapy Program, British Columbia Cancer Agency, 600 W. 10th Ave., Vancouver V5Z 4E6, BC, Canada, fax 604/708-2024, mdelemos{at}bccancer.bc.ca

BACKGROUND: Many patients with cancer (45–60%) use natural health products (NHPs). Pharmacists often find it difficult to advise these patients effectively.

OBJECTIVE: To explore pharmacists' perceptions of the information needed to advise cancer patients on NHPs and develop a structured counseling approach.

METHODS: A qualitative study was conducted using a focus group of pharmacists from an integrated cancer care organization in Canada. The outcome measures were the definitions of and reasons for the information needed to advise patients on NHPs and a counseling approach using laymen terms.

RESULTS: Eight focus group sessions took place, from which 6 categories of information emerged: role of the advisor, evaluation of evidence, assessment of efficacy, assessment of toxicity, monitoring parameters, and provision of a closure. A patient counseling approach was developed based on this information.

CONCLUSIONS: The findings provided a description of and rationale for categories of information needed to advise cancer patients on NHPs. A structured, step-by-step approach to counseling these patients was developed.

Key Words: cancer, complementary therapies, counseling, evidence-based medicine, patient education

Published Online, July 13, 2004. www.theannals.com, DOI 10.1345/aph.1E062

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