Development of Evidence-Based Chinese Medicine Clinical Service Recommendations for Cancer Palliative Care Using Delphi Approach Based on the Evidence to Decision Framework

Charlene H. L. Wong; Irene X. Y. Wu; Jon Adams; Amie Steel; Jon Wardle; Justin C. Y. Wu; Ting Hung Leung; Vincent C. H. Chung

doi:10.1177/1534735420940418

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Development of Evidence-Based Chinese Medicine Clinical Service Recommendations for Cancer Palliative Care Using Delphi Approach Based on the Evidence to Decision Framework

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Development of Evidence-Based Chinese Medicine Clinical Service Recommendations for Cancer Palliative Care Using Delphi Approach Based on the Evidence to Decision Framework

Charlene H. L. Wong, Irene X. Y. Wu, Jon Adams, Amie Steel, Jon Wardle, Justin C. Y. Wu, Ting Hung Leung and Vincent C. H. Chung

Integrative cancer therapies, Vol.19, pp.1-13

10/07/2020

DOI: https://doi.org/10.1177/1534735420940418

PMID: 32646246

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Abstract

acupuncture

Chinese herbal drugs

Delphi technique

GRADE approach

neoplasms

palliative care

traditional Chinese medicine

Objectives: Existing evidence supports the use of certain Chinese medicine (CM) interventions for symptom management among palliative cancer patients. However, evidence-based service recommendations tailored to the local context are needed for CM planning and implementation. In response, we aimed to establish consensus on CM clinical service recommendations for cancer palliative care among Hong Kong experts. Methods: Seven CM interventions showing statistically significant favorable results in existing systematic reviews (SRs) and overviews of SRs were subjected to a GRADE-ADOLOPMENT–based 2-round Delphi survey. Twelve Hong Kong experts in cancer palliative care, including conventionally trained physicians, CM practitioners, and nurses (n = 4 from each category), were invited to participate. Use of the Evidence to Decision framework within the GRADE-ADOLOPMENT approach enabled experts to consider aspects of problem priority, benefits, harms, equity, acceptability, and feasibility when making CM recommendations in cancer palliative care. Results: Three evidence-based CM interventions reached positive consensus as service recommendations, namely: (1) acupuncture for reducing fatigue among palliative cancer patients; (2) acupressure for reducing fatigue among palliative cancer patients; and (3) moxibustion for reducing nausea and vomiting among patients receiving chemotherapy. Median rating of recommendation ranged from 2.5 to 3.0 (interquartile range = 0.00-1.00) on a 4-point Likert-type scale, and the percentage agreement ranged from 83.4% to 91.7%. Conclusions: The GRADE-ADOLOPMENT approach facilitates a consensus-based process of reaching 3 evidence-based CM recommendations for cancer palliative care. Future studies may develop tailored strategies to implement these recommendations in the Hong Kong health system.

Details

Title: Development of Evidence-Based Chinese Medicine Clinical Service Recommendations for Cancer Palliative Care Using Delphi Approach Based on the Evidence to Decision Framework
Creators: Charlene H. L. Wong - Chinese University of Hong Kong
Irene X. Y. Wu - Central South University
Jon Adams - University of Technology Sydney
Amie Steel - University of Technology Sydney
Jon Wardle - University of Technology Sydney
Justin C. Y. Wu - Chinese University of Hong Kong
Ting Hung Leung - Chinese University of Hong Kong
Vincent C. H. Chung - Chinese University of Hong Kong
Publication Details: Integrative cancer therapies, Vol.19, pp.1-13
Publisher: SAGE Publications
Grant note: No. 502045003 / ;
Identifiers: 991013035757102368
Copyright: © The Author(s) 2020. Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution- NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/)
Academic Unit: National Centre for Naturopathic Medicine
Language: English
Resource Type: Journal article

Development of Evidence-Based Chinese Medicine Clinical Service Recommendations for Cancer Palliative Care Using Delphi Approach Based on the Evidence to Decision Framework

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