RNS Praxisgemeinschaft GbR

Wiesbaden, Germany

RNS Praxisgemeinschaft GbR

Wiesbaden, Germany

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Huebner J.,Goethe University Frankfurt | Rose C.,Pierre Fabre | Geissler J.,CML Advocates | Gleiter C.H.,University Hospital of Tuebingen | And 8 more authors.
European Journal of Cancer Care | Year: 2014

Patient-reported outcomes are an important tool in clinical research. In the setting of cancer treatments, benefit of therapy is essentially characterised by improvement of survival as well as quality of life (QoL). A standardised instrument to assess QoL is the standardised QoL questionnaire of the European Organisation for Research and Treatment (EORTC QLQ-C30 questionnaire). QoL instruments provide data on different aspects (domains) of the framework of QoL. Using these questionnaires in studies provides data on how a treatment affects QoL in a group of patients. The goal of our concept is to individualise QoL and to use validated instruments in order to integrate patients' perspectives and aims into treatment assessment, planning and control. We propose to use the domains of the EORTC QLQ-C30 and to ask the patient to determine which objectives besides survival are relevant for him and should be achieved by treatment. These individual goals can be used in a process of shared decision-making to choose and monitor treatment. In clinical studies, this approach would allow to recruit more patients who would most probably benefit from the therapy. In addition, supportive data could be gathered in correlation to treatment goals and actual benefits. © 2013 John Wiley & Sons Ltd.


PubMed | Gemeinschaftspraxis, Goethe University Frankfurt, Ruhr University Bochum, Hospital Nordhausen and 4 more.
Type: Journal Article | Journal: Medical oncology (Northwood, London, England) | Year: 2016

Complementary and alternative medicine (CAM) is widely used by cancer patients. In order to learn more on the usage of CAM, its reasons and motifs as well as sources of information along the trajectory of treatment, we decided to evaluate the prevalence and predictors for the use of CAM by cancer patients while being under active treatment with chemo- or radiotherapy or in aftercare. We distributed a standardized questionnaire among patients attending a department of radio-oncology, an ambulance for oncology and offices of general practitioners (GPs). Five hundred and six patients took part. Most attributed cancer to stress and trauma (23.7 and 16.4%) or genes (20.8%). Forty-four percentage reported knowing a physician with competence in CAM, and in all settings, most patients named the GP. Fifty-one percentage admitted using CAM, 35% informed the oncologist about using CAM, 56% informed the GP, and 26% did not inform any physician. Most often used CAM was vitamin D (17%) and selenium (16%). Most important goals were to strengthen the immune system (59%) and become active (52%). Most patients were satisfied with the CAM methods they used. Yet, with some methods, dissatisfaction was up to 30%. The GP has an important function concerning CAM in oncology as most patients believe the GP to have best knowledge in CAM. In order to integrate complementary medicine into evidence-based medicine, physicians should be trained on how to communicate on CAM with the patient and with each other. Explaining cancer and cancer therapies in a way lay persons are able to understand may be helpful. Physicians should actively address patients needs of involvement not only in decision making, but also actively in the therapy.


Jung B.,Goethe University Frankfurt | Stoll C.,Clinic Herzoghoehe Bayreuth | Feick G.,Bundesverband Prostatakrebs Selbsthilfe e. v. | Prott F.J.,RNS Praxisgemeinschaft GbR | And 3 more authors.
Journal of Cancer Research and Clinical Oncology | Year: 2016

Background: Endocrine therapy is a mainstay of prostate cancer therapy. Given that few data exist on patient physician communication with regard to this field of therapy and adherence, we conducted a survey of patient members of a German support organization. Patients and methods: We developed a structured questionnaire that was tested in a pilot version and then programmed as an online questionnaire. Results: The questionnaire was completed by 694 patients. While 58 % of participants rated the information they received as comprehensive, 42 % did not. Fifty-one percentage stated that they were informed of side effects in detail, and 35 % received information on supportive treatments available in the event of side effects. Patients with higher education more often reported receiving information on side effects (p = 0.036) as well as alternatives for treatment (p = 0.001). Only 13 % stated that their questions were answered in detail, with 43 % receiving no answers or only non-detailed answers. Additional information was sought by 82 %, mostly from the Internet (67 %) and patient support groups (66 %). Seventy-six percentage experienced side effects that imposed limitations on their daily activities. Of those patients with side effects, 60 % reported that their physicians did not react to their complaints. There is a significant association between side effects in general and depression in particular and non-adherence (p < 0.01 and p = 0.002, respectively). In contrast, better information on side effects is associated with better adherence (p < 0001). Conclusion: In order to improve adherence, detailed information on side effects and comprehensive supportive care is most important. Physicians should not rely on written information but should rather mainly engage in direct communication. © 2015, Springer-Verlag Berlin Heidelberg.


Huebner J.,Goethe University Frankfurt | Muenstedt K.,Justus Liebig University | Prott F.J.,RNS Praxisgemeinschaft GbR | Stoll C.,Clinic Herzoghohe | And 5 more authors.
Breast Care | Year: 2014

About 50% of cancer patients use complementary and alternative medicine (CAM). Women with breast cancer use CAM more frequently than others. We linked a questionnaire to the largest internet portal for cancer patients in Germany. The questionnaire addresses attitude towards CAM, disclosure to the oncologist, source of information, and objectives for use of CAM. 80 patients with breast cancer took part in our study, 61 currently using CAM. Most frequently used CAM methods were selenium, relaxation techniques, prayer, vitamin C, and meditation. Satisfaction was highest with relaxation techniques, vitamin C, homeopathy, yoga and Chinese herbs, lowest with mistletoe and acupuncture. 70% of participants did not think their oncologist took time to discuss CAM. Only 16% believed that their oncologist was well-informed about CAM. 46% relied on naturopaths and non-medical practitioners concerning CAM. Objectives for the use of CAM were to reduce side effects, boost the immune system, and become active. © 2014 S. Karger GmbH, Freiburg.


Huebner J.,Goethe University Frankfurt | Prott F.J.,RNS Praxisgemeinschaft GbR | Micke O.,Franziskus Hospital | Muecke R.,Ruhr University Bochum | And 3 more authors.
Oncology Research and Treatment | Year: 2014

Introduction: Complementary and alternative medicine (CAM) is often used by cancer patients, yet, communication with the oncologist is poor. The objective of our study was to gather information on patients' usage of CAM, source of information, and aims, in order to derive strategies to improve the communication between physicians and patients on this topic. Materials and Methods: An online survey was conducted by linking a standardized questionnaire to the largest internet portal for cancer patients in Germany. The questionnaire addresses CAM usage, disclosure to physicians, source of information, objectives for using CAM, and perceived reasons for cancer. Results: Of 170 participants, 77% were currently using CAM. Disclosure to a physician was rather high with 63% having informed their oncologist. Asked whether the oncologist took time to discuss CAM, 74% answered 'no'. Most frequently used are biologically based therapies, relaxation techniques, prayer, and meditation. Most patients want to reduce side effects, boost their immune system, and get active. Almost half the participants had positive experiences with some type of CAM before they fell ill. Conclusion: Understanding patients' concepts of the etiology of cancer and accepting their goals for using CAM may help oncologists communicate with their patients and guide them to a safe use of CAM. © 2014 S. Karger GmbH, Freiburg.


Huebner J.,Goethe University Frankfurt | Ebel M.,Goethe University Frankfurt | Muenstedt K.,Justus Liebig University | Micke O.,Franziskus Hospital | And 3 more authors.
Journal of Cancer Education | Year: 2015

About half of all patients with cancer use complementary or alternative medicine (CAM). In 2013, we started a lecture program for patients, followed by evidence-based recommendations on counseling on CAM. These recommendations have been published before by this working group. The aim of the program is to provide scientific facts on the most often used CAM methods in standardized presentations which help patients discuss the topic with their oncologists and support shared decision making. The article presents the evaluation of the pilot phase. Participants received a standardized questionnaire before the start of the lecture. The questionnaire comprises four parts: demographic data, data concerning experience with CAM, satisfaction with the lecture, and needs for further information on CAM. In 2013, seven lectures on CAM were given in cooperation with regional branches of the German Cancer Society in several German states. Four hundred sixty patients and relatives took part (75 % females and 16 % males). Forty-eight percent formerly had used CAM. Most often named sources of information on CAM were print media (48 %) and the Internet (37 %). Most participants rated additional written information valuable. About one third would like to have an individual consultation concerning CAM. A standardized presentation of evidence on CAM methods most often used, together with recommendations on the self-management of symptoms, is highly appreciated. The concept of a highly interactive lecture comprising is feasible and if presented in lay terminology, adequate. In order to give additional support on the topic, written information should be provided as the first step. © 2014, Springer Science+Business Media New York.


Paul M.,Goethe University Frankfurt | Davey B.,Goethe University Frankfurt | Senf B.,Goethe University Frankfurt | Stoll C.,Clinic Herzoghoehe | And 6 more authors.
Journal of Cancer Research and Clinical Oncology | Year: 2013

Purpose: A total of 40 % of cancer patients use complementary and alternative medicine (CAM), and patients with advanced cancer use CAM more often than others. The aim of our study was to gather data on CAM use and reasons to use CAM of patients with advanced cancer being admitted for residential palliative care and their relatives. Methods: Structured interviews were carried out with 25 patients and 25 relatives of those patients, respectively, of a German comprehensive cancer center based on a standardized questionnaire of the working group Prevention and Integrative Oncology of the German Cancer Society. Results: Median age of patients was 64.5 years (relatives: 53.5); 15 patients were male and 10 were female (relatives: 7 and 18). In total, 40 % of all patients used some CAM method at the time of the study, supplements and prayer being the most frequent method. Main reasons for using CAM were to sustain one's own strength (52 % for patients and 72 % for relatives) and to be able to do something by oneself (36 and 40 %). Sources of information were television/radio (48 and 28 %) and family/friends (40 and 48 %). Relatives also use the Internet (40 %). Conclusions: Also for patients in palliative care and their relatives, CAM is important. Reasons for using CAM are similar for patients with less advanced cancer. As most patients do not discuss using CAM with their physician, side effects and interactions of biologically based treatments may be dangerous. The desire of patients to act autonomously should be encouraged. Yet, physicians should ensure safe administration of complementary methods by including CAM in their communication with the patient and the family. © 2013 Springer-Verlag Berlin Heidelberg.


Conrad A.C.,Goethe University Frankfurt | Muenstedt K.,Justus Liebig University | Micke O.,Franziskus Hospital | Prott F.J.,RNS Praxisgemeinschaft GbR | And 2 more authors.
Journal of Cancer Research and Clinical Oncology | Year: 2014

Background: A high proportion of cancer patients use complementary and alternative medicine (CAM). In oncology, risks of CAM are side effects and interactions. Objective: Our aim was to conduct a survey on professionals in palliative care regarding attitudes toward CAM. Design and subjects: An internet-based survey with a standardized questionnaire was sent to all members of the German Society for Palliative Care. Measurements: The questionnaire collected data on attitude toward CAM and experiences. Results: Six hundred and ninety questionnaires (19 %) were returned (49 % physicians, 35 % nurses, 3 % psychologists). Acceptance of CAM is high (92 % for complementary and 54 % for alternative medicine). Most participants had already been asked on CAM by patients (95 %) and relatives (89 %). Forty-four percent already had used complementary methods and 5 % alternative methods. Only 21 % think themselves adequately informed. Seventy-four percent would use complementary methods in a patient with advanced tumor, and 62 % would use alternative therapy in patients if there was no other therapy. Even from those who are skeptical 45 % would treat a patient with alternative methods. Conclusions: In order to inform patients on CAM and to further patients' autonomy, evidence on benefits and harms of CAM must be provided. As awareness of risks from CAM is low and critical appraisal especially of alternative medicine missing, but interest on information on CAM is high, experts should provide evidence-based recommendations for CAM in palliative care to members of different professions. This could be done by a curriculum focusing on the most often used CAM methods. © 2014 Springer-Verlag.


Ott I.M.,Goethe University Frankfurt | Muenstedt K.,Justus Liebig University | Micke O.,Franziskus Hospital | Muecke R.,Lippe Hospital Lemgo | And 5 more authors.
Trace Elements and Electrolytes | Year: 2015

Objective: 40 - 50% of cancer patients use complementary or alternative medicine (CAM). While oncologists are skeptical regarding CAM, no data has been published with respect to nurses. The objective of our study was to learn about the attitude of nurses with a specialization in cancer care towards CAM. Subjects and methods: A survey was performed on nurses in Germany, Switzerland and Austria using an online questionnaire, which addressed attitude towards, and experiences with CAM. Results: 877 participants filled in the questionnaire. 61% have a very positive or positive attitude towards complementary (CM) and 20% towards alternative medicine (AM). 71% rate their knowledge as high to moderate regarding CM. 43% use some source of information on CAM and 48% would like more training on CAM. The most important reason to use CM is the patient becoming active (50%). CM is a means for reducing side effects (46%), increasing coping (42%), or quality of life (47%). For AM, less than 20% give positive statements. Risks as a result of interactions and side effects are anticipated by 40 (CM) and 50% (AM). Conclusion: In sum, many but not all participants are aware of the pros and cons of CAM. In general, they have a positive attitude towards CM. In order to make CM safer, a structured training should be offered. ©2015 Dustri-Verlag Dr. K. Feistle.

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