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The Complementary Medicine Education and Outcomes (CAMEO) Program: Taking the knowledge to the bedside Verhoef, Marja 2009

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Supported by: Lynda Balneaves1, Tracy Truant2, Marja Verhoef3 , Brenda Ross2, Antony Porcino1 1UBC School of Nursing; 2BC Cancer Agency 3University of Calgary, Dept. of Community Health Sciences The Complementary Medicine Education and Outcomes (CAMEO) Program: Taking the Knowledge to the Bedside NEXUS Spring Institute April 16, 2009 Acknowledgements | Lotte & John Hecht Memorial Foundation | CIHR New Investigator Award z Dr. Lynda Balneaves | CIHR/Canadian Research Chair in Complementary Medicine z Dr. Marja Verhoef Outline | What is Complementary Medicine (CAM)? | What is CAMEO? | How will CAMEO “bridge the gap” for cancer patients, families, health care professionals & researchers in British Columbia? | Next steps What is CAM? "a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine” *National Centre for Complementary and Alternative Medicine (NCCAM) Body-based Mind-body Biologically-based Energy Ancient healing systems CAM Continuum CAM Information & Decision Support Needs: Patient Survey* (N=359) | 47% use/have used CAM during cancer experience z 30 % biologically based z 23 % mind-body based z 17 % body based z 16 % energy based z 16 % ancient healing systems | 28 % discussed CAM with oncology HCP | 18 % got enough support from their oncology HCP in making CAM decisions *Nov 2008, Vancouver Centre, BCCA Patient Survey, con’t (N=359) | Top 3 learning needs: z What CAM therapies are helpful? z How to safely combine CAM & cancer treatment? z When is it safe to use CAM through the cancer journey? | Top 3 services that would be helpful: z CAM information booklet z website z 1:1 decision support service | 74 % would attend CAM education/decision support programs if available. Welcome to CAMEO! • Complementary Medicine Education & Outcomes Program •Collaborative UBC School of Nursing and BC Cancer Agency research program •A “living laboratory” The goal is to support individuals in making informed CAM decisions, not recommending or offering specific therapies. Why CAMEO? | Up to 80% of Canadians with cancer use CAM during their cancer experience. | BC Provincial Ambulatory Oncology Patient Satisfaction Survey (2007) “Approximately half of patients… felt comfortable talking with health care providers about complementary, alternative, or non- traditional treatment (53%).” | Our research has shown cancer patients, families and oncology health professionals struggle with making safe and informed decisions about CAM. The Patient’s Voice …at the stage where we are there is no co-operation between complementary medicine and official medicine… there is sort of a barrier between and the information we have is only partial. Its confusing… (man with early-stage prostate cancer) Everything happened for me so fast. I literally had six weeks for everything, diagnosis, surgery, chemo…it was so compressed. I would have like to have had more time so I could have spent more time talking to people [about CAM] and getting kind of a more rounded opinion, but I couldn’t. I was desperate. My cancer was moving along and I had no choice. (woman with advanced breast cancer)  Mission To develop, integrate, and evaluate evidence–informed complementary medicine education and decision support strategies within the context of everyday conventional cancer care at the Vancouver Centre, BC Cancer Agency. Vision Theoretical Underpinnings | Decision theory z Ottawa Decision Support Framework (O’Connor et al.) | Shared decision making (Charles & Gafni) z Patient autonomy | Supportive Care Needs Framework (Fitch et al.) | Patient safety (Baumann et al.) CAMEO Objectives The CAMEO Program will explore the most effective ways to: 1) Support people with cancer and their significant others in making CAM decisions 2) Strengthen health professionals’ knowledge and clinical decision support skills related to CAM 3) Facilitate the development of new CAM research 1. Support People with Cancer in Making CAM Decisions | Website development (www.bccancer.bc.ca/cameo) | CAM in BC pamphlet | Group education series on CAM | One-on-one decisional support z Telephone support | Decisional aid and workbook 2. Strengthen health professionals’ CAM knowledge and decision support skills | Group education seminars on CAM | Website development | CAM therapy monographs | Clinical resources z Assessment forms z Clinical guidelines z Practice standards | Referral process to CAMEO 3. Facilitate the development of new CAM research. | Patient CAM database | Partnerships z Within BC Cancer Agency • CAMEO Steering Group z Community • InspireHealth • VGH Prostate Centre z National • CAM curriculum for Oncology Nurses z International • Cancer & CAM Pathways Study (Canada, Norway, UK, AU) Primary Outcomes Improved CAM knowledge Improved Patient Satisfaction Reduced Decisional Conflict zKeeping it simple!! Impact of CAMEO | Shift the culture regarding CAM z Openness, spirit of inquiry, and evidence-base | Raise the bar of clinical practice related to CAM z Assessment, referrals, and decision support | Empower patients to make evidence-informed CAM decisions | Establish a platform for CAM research | Position BCCA as a leader in the Canadian cancer community re: CAM and cancer Where are we at now? 2008: Laying the Foundation 2009: Development and Pilot Testing 2009-2010: Implementation 2010-2011: Evaluation and Sustainability Challenges facing CAMEO | Structure & culture of BC Cancer Agency | Diversity of BC population | Limited evidence CAMEO & KT | Next Steps ‘The Research Team’ Dr. Lynda Balneaves Ms. Tracy Truant Dr. Marja Verhoef Ms. Brenda Ross Mr. Antony Porcino Ms. Marie-Louise Martin Ms. Teresa Lambert Ms. Leah Lambert Ms. Jennifer Young Dr. Alison Brazier Thank you!! lynda.balneaves@nursing.ubc.ca ttruant@bccancer.bc.ca www.bccancer.bc.ca/cameo


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