Complementary and alternative medicine (CAM) use in terminally ill patients

Objective: The use of complementary and alternative methods is common in oncology, but nothing is known about the role of CAM in the last days of a patient's life. Material and methods: Between 1-2007 and 10-2008 the palliative care team treated 85 patients (50 male, 35 female, median age 62 years) on out-door basis. All families were asked to complete a structured questionnaire regarding the use of CAM during the last period of the patient's life. Patients suffered from cancer in 83/85 patients (98%), 2 patients had neurologic disorders. Results: Only 20 families (31%) have not used any CAM. Spiritual support (praying, hospice services) was asked for by 60/85 families (71%). 25/85 families (29%) reported drug use. Favorite methods were vitamins (n = 11, 13%), trace elements (n = 9, 11%), and mistletoe (n = 8, 9%). 30 patients (35%) were treated by physiotherapy (28 oncology patients, 2 neurology patients). Logopedy and ergotherapy were used in 10 patients (12%). 12 families (14%) reported use of aroma-therapy in patient's care. The main information source was the GP (house physician) (45/85, 53%), followed by the palliative care team (30/85, 35%) and pharmacies (27/85, 32%). Internet, journals or self-service information were only used by 25/85 families (29%). The effectivity of the categorized methods was estimated between 1 and 5 (very good - worthy) by the patients or their families. The following ranking was registered: spiritual support 2.4; physical therapy 2.7, logopedy/ergotherapy 3.1, drugs 3.3. 65/85 families (76%) were satisfied with the information received from the health care practitioners. Conclusion: Complementary methods are often practiced during the last days of a patients life. Families and friends are looking for valid information and need help from the professionals. The different methods have been evaluated regarding effectivity as well as acceptance by the patients.