Physicians’ Knowledge and Experiences of Counseling on Complementary, Alternative, and Integrative Medicine in Cancer Care: a Qualitative Systematic Review

Abstract Background Despite the increasing use of complementary, alternative, and integrative medicine (CAIM) use among cancer patients, there remains ambiguity surrounding physicians’ understanding and counseling practices in this area. The objective of this qualitative systematic review was to identify the knowledge and experiences of physicians who counsel patients on CAIM in the context of cancer. Methods MEDLINE, EMBASE, and AMED were systematically searched from inception to May 27, 2023. Reference lists of relevant review articles were also hand- searched. Eligible articles contained qualitative data focused on physicians’ perceived knowledge and experience pertaining to CAIM counseling for cancer care. Relevant findings were extracted and analyzed using a narrative synthesis approach to identify key themes and subthemes. Results Thirty-five articles were included (30 from database searching and 5 from hand-searching reference lists). Four main themes were identified: lack of knowledge and formal training on CAIM; distrust and concern about CAIM safety and/or efficacy; accepting CAIM as an important part of cancer care; and the communication dynamics between patients and physicians. Conclusions This study highlights that physicians recognize CAIM as an important component of person-centered and holistic cancer care; however, they have concerns about the safety and/or efficacy of these therapies. Accordingly, there is a need for improved education for physicians on the safety and effectiveness of CAIMs, to better equip them to effectively counsel patients in this area. Future research exploring the perspectives of medical trainees and other healthcare providers on CAIM for cancer is also warranted.