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The Complementary Medicine Education and Outcomes (CAMEO) Program: Taking the knowledge to the bedside Verhoef, Marja; Truant, Tracy; Balneaves, Lynda; Porcino, Antony; Ross, Brenda 2009

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Supported by:Lynda Balneaves1, Tracy Truant2, Marja Verhoef3 , Brenda Ross2, Antony Porcino11UBC School of Nursing; 2BC Cancer Agency3University of Calgary, Dept. of Community Health SciencesThe Complementary Medicine Education and Outcomes (CAMEO) Program: Taking the Knowledge to the BedsideNEXUS Spring InstituteApril 16, 2009Acknowledgements| Lotte & John Hecht Memorial Foundation| CIHR New Investigator Awardz Dr. Lynda Balneaves| CIHR/Canadian Research Chair in Complementary Medicinez Dr. Marja VerhoefOutline| 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 stepsWhat 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-basedMind-bodyBiologically-basedEnergyAncient healing systemsCAM ContinuumCAM Information & Decision Support Needs: Patient Survey* (N=359)| 47% use/have used CAM during cancer experiencez 30 % biologically basedz 23 % mind-body basedz 17 % body basedz 16 % energy basedz 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, BCCAPatient 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 bookletz 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)MissionTo 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.VisionTheoretical Underpinnings| Decision theoryz 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 ObjectivesThe CAMEO Program will explore the most effective ways to:1) Support people with cancer and their significant others in making CAM decisions2) Strengthen health professionals’ knowledge and clinical decision support skills related to CAM3) 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 supportz Telephone support| Decisional aid and workbook2. Strengthen health professionals’ CAM knowledge and decision support skills| Group education seminars on CAM| Website development| CAM therapy monographs| Clinical resourcesz Assessment formsz Clinical guidelinesz Practice standards| Referral process to CAMEO3. Facilitate the development of new CAM research.| Patient CAM database | Partnershipsz Within BC Cancer Agency• CAMEO Steering Groupz Community• InspireHealth• VGH Prostate Centrez National• CAM curriculum for Oncology Nursesz International• Cancer & CAM Pathways Study (Canada, Norway, UK, AU)Primary OutcomesImproved CAM knowledge Improved Patient SatisfactionReduced Decisional ConflictzKeeping it simple!!Impact of CAMEO| Shift the culture regarding CAMz Openness, spirit of inquiry, and evidence-base| Raise the bar of clinical practice related to CAMz 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 cancerWhere are we at now?2008: Laying the Foundation2009: Development and Pilot Testing2009-2010: Implementation2010-2011: Evaluation and SustainabilityChallenges facing CAMEO| Structure & culture of BC Cancer Agency| Diversity of BC population| Limited evidence CAMEO & KT|Next Steps‘The Research Team’Dr. Lynda BalneavesMs. Tracy TruantDr. Marja VerhoefMs. Brenda RossMr. Antony PorcinoMs. Marie-Louise MartinMs. Teresa LambertMs. Leah LambertMs. Jennifer YoungDr. Alison BrazierThank you!!lynda.balneaves@nursing.ubc.cattruant@bccancer.bc.cawww.bccancer.bc.ca/cameo

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