The use of complementary medicine in palliative care in France: an observational cross-sectional study
Palliative care for cancer deals with physical, psychosocial, and spiritual issues faced by cancer patients, their families, communities, and healthcare providers. Research on complementary medicine (CM) use in France is limited despite high rates of reported CM use in other countries including by palliative patients. This study describes the use of CM by individuals receiving palliative care in Lyon, France.
This study employed an observational cross-sectional survey design.
The study was conducted in three palliative care centers in Lyon, France; two tertiary hospitals and one palliative care unit (3 sites). Inpatients and outpatients visiting the palliative care clinic with a primary diagnosis of cancer at each study site were invited to participate.
Of 138 eligible patients, 100 completed the survey (RR 72.4%). The majority (90.7%) reported using CM in the previous 6 months or since their primary cancer diagnosis. Participant CM use was either the same (20.7%) or increased since their primary cancer diagnosis (33.7%). Average out-of-pocket expenses associated with CM use in the previous 6 months or since diagnosis were €157.40 (SD €330.15). The most common CM health professional visited was an aromatherapist (72.7%), a Coupeurs de feu (38.6%), osteopath (28.6%) and naturopath (15.3%). The most common CM used were aromatherapy oils (33.7%), homeopathy (30.0%), and vitamins (29.4%).
This second survey on CM use in France; is the first conducted in palliative care centers. Results show people with cancer in Lyon, France, have a very high prevalence of CM utilization.
KeywordsPalliative care Complementary therapies France Health services
The authors would like to thank the clinical staff at Lyon Sud and Lyon Nord and the palliative care unit at the Red Cross for their valuable contribution to this study.
Availability of data and material
The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
JS, HD, and AS contributed to the conception, study design, data collection, analysis and interpretation, and drafting of the manuscript. MF and PJP contributed to the conception, study design, data interpretation, drafting, and critical revision of the paper. JBM was engaged in data collection, interpretation of data, and critical revision of the paper. All authors approved the final version of the manuscript.
Compliance with ethical standards
Ethics approval and consent to participate
All the data were handled according to the guidelines set out in the Declaration of Helsinki, and ethical approval to conduct the study was obtained from the [redacted for blinded review]. The participants were informed that participation was voluntary and that they could discontinue their participation at any time. They were also informed that the data collected would be treated confidentially throughout the study. Written informed consent was obtained from all the participants.
The authors declare that they have no competing interests.
- 1.NIH National Cancer Institute 2017. Palliative care in cancer. [cited 2019 5 Aug]; Available from: https://www.cancer.gov/about-cancer/advanced-cancer/care-choices/palliative-care-fact-sheet
- 2.World Health Organization 1990, Cancer pain relief and palliative care: report of a WHO expert committee [meeting held in Geneva from 3 to 10 July 1989]. Google Scholar
- 4.World Health Organisation 2019. Cancer. [cited 2019 5 Aug]; Available from: https://www.who.int/cancer/en/
- 5.Organization, W.H 2014., Global atlas of palliative care at the end of life. World Wide Palliative Care Alliance & World Health Organization,Google Scholar
- 6.European Commission 2016. Cancer statistics. eurostat Statistics Explained [cited 2019 5 Aug]; Available from: https://ec.europa.eu/eurostat/statistics-explained/index.php/Cancer_statistics
- 7.Joussellin C, Silove L (2016) A new national plan for palliative care raises high hopes in France. Eur J Palliat Care 23(2):101–103Google Scholar
- 8.Shiel WC 2019. Medical definition of complementary medicine. [cited 2019 5 Aug]; Available from: https://www.medicinenet.com/script/main/art.asp?articlekey=31077
- 11.Chung VC et al (2016) Chinese herbal medicine for symptom management in cancer palliative care: systematic review and meta-analysis. Medicine 95(7)Google Scholar
- 17.Schloss JM, Colosimo M, Airey C, Masci P, Linnane AW, Vitetta L (2017) A randomised, placebo-controlled trial assessing the efficacy of an oral B group vitamin in preventing the development of chemotherapy-induced peripheral neuropathy (CIPN). Support Care Cancer 25(1):195–204PubMedCrossRefGoogle Scholar
- 19.Molassiotis A, Fernández-Ortega P, Pud D, Ozden G, Scott JA, Panteli V, Margulies A, Browall M, Magri M, Selvekerova S, Madsen E, Milovics L, Bruyns I, Gudmundsdottir G, Hummerston S, Ahmad AM, Platin N, Kearney N, Patiraki E (2005) Use of complementary and alternative medicine in cancer patients: a European survey. Ann Oncol 16(4):655–663PubMedCrossRefGoogle Scholar
- 21.Morisson J 2016. Les Coupeurs de Feu a l’Hopital. [cited 2019 5 Aug]; Available from: https://www.lateledelilou.com/jocelinmorisson/Les-Coupeurs-de-Feu-a-l-Hopital_a10.html
- 25.Women’s Health Australia 2012. Australian longitudinal study on women’s health. 06/11/2012]; Available from: http://www.alswh.org.au/
- 28.Berretta M, Della Pepa C, Tralongo P, Fulvi A, Martellotta F, Lleshi A, Nasti G, Fisichella R, Romano C, de Divitiis C, Taibi R, Fiorica F, di Francia R, di Mari A, del Pup L, Crispo A, de Paoli P, Santorelli A, Quagliariello V, Iaffaioli RV, Tirelli U, Facchini G (2017) Use of Complementary and Alternative Medicine (CAM) in cancer patients: an Italian multicenter survey. Oncotarget 8(15):24401–24414PubMedCrossRefGoogle Scholar
- 33.Muecke R, Paul M, Conrad C, Stoll C, Muenstedt K, Micke O, Prott FJ, Buentzel J, Huebner J, PRIO (Working Group Prevention and Integrative Oncology of the German Cancer Society) (2016) Complementary and alternative medicine in palliative care: a comparison of data from surveys among patients and professionals. Integra Cancer Ther 15(1):10–16CrossRefGoogle Scholar
- 35.Link AR et al (2013) Use of self-care and practitioner-based forms of complementary and alternative medicine before and after a diagnosis of breast cancer. Evid Based Complement Alternat Med 2013Google Scholar
- 37.Wardle J, Adams J (2012) Indirect risks of complementary and alternative medicine. In: Traditional, Complementary and Integrative Medicine. Palgrave Macmillan, Hampshire, pp 212–219Google Scholar
- 40.Tisserand, H 2017. Grasse Phyt’Armo - What we learned in France about French Aromatherapy. 2017 [cited 2019 5 Aug]; Available from: https://tisserandinstitute.org/grasse-french-aromatherapy/
- 43.Willsher K (2019) French healthcare system ‘should not fund homeopathy’. In: The Guardian, ParisGoogle Scholar
- 46.World Naturopathic Federation, Global Naturopathic Regulation. 2018, World Naturopathic Federation: Toronto, OntarioGoogle Scholar
- 48.Schloss J, McIntyre E, Steel A, Bradley R, Harnett J, Reid R, Hawrelak J, Goldenberg J, van de Venter C, Cooley K (2019) Lessons from outside and within: exploring advancements in methodology for naturopathic medicine clinical research. J Altern Complement Med 25(2):135–140PubMedPubMedCentralCrossRefGoogle Scholar
- 49.Marvibaigi M et al (2014) Preclinical and clinical effects of mistletoe against breast cancer. Biomed Res Int 2014Google Scholar
- 50.Heusser P, Kienle GS (2009) Anthroposophic medicine, integrative oncology, and mistletoe therapy of cancer. In: Integrative Oncology, vol 2014, 2nd edn. Oxford University press, New YorkGoogle Scholar