Patients, Providers Embrace Integrative Palliative Care

A growing patient demand is fueling the emergence of integrative palliative care, a blend of traditional biomedical care for serious illness and a suite of complementary therapies aimed at improving patient quality of life. 

Dr. William Collinge, associate director of the Integrative Palliative Care Institute in Washington, said most palliative care organizations evolved as basic, mainstream medical care provided by doctors, nurses and social workers. The integrative model highlights an ongoing evolution. 

“Patients and family members hear about all these what used to be called alternative therapies or complementary therapies, and say, ‘Come on, can we get some massage from my mother, or can we get acupuncture? Would that help my loved one?’ The organizations are now looking at bringing on integrative therapies,” he told Palliative Care News.  

Dr. Brieze Bell, assistant clinical professor for palliative care at the University of California, San Francisco Medical Center, works with cancer patients. Over the years, she has seen a steady growth in the demand for alternative therapies among her patients. The interest stems from patients’ desire to feel as good as possible as they go through the treatment and recovery process, she said. 

A range of complementary therapies is available in the integrative palliative care model, including aromatherapy, massage, acupuncture, dietary changes and mindfulness-based treatments, among others.

“So simple aerobic exercise is one example. Also, mindful movement exercises such as yoga, for example, have also been shown to help with common symptoms that are associated with serious illness, such as fatigue,” Bell told Palliative Care News. 

The Integrative Palliative Care Institute has developed a curriculum designed for health care workers in the palliative field to become more confident in using the complementary therapies.

“We’re trying to help this transformation of the organizational culture of palliative care organizations to embrace integrative therapies at an organizational level in the interest of better patient care and patient satisfaction,” Collinge said.

But it is still an emerging field. According to Bell, there is a huge evidence base supporting the effectiveness, but more study needs to be done. That research, she believes, with further fuel interest in the integrative palliative care model.

Part of the way to garner interest in and support for doing that research is to call attention to the potential for these therapies to work by looking at the literature that already exists,“ Bell said. “And in doing so, that can also lead to more enthusiasm for funding future rigorous research studies.”

Part of that literature is a top-10 guide for palliative care physicians that Bell wrote for the Center to Advance Palliative Care (CAPC).

Bell said she is among a scarce handful of providers using the integrative model. But interest is growing among colleagues.

According to Collinge, evidence of the growing interest is found in the National Institutes of Health’s National Center for Complementary and Integrative Health and the National Cancer Institute’s integrative therapy programs.

As is the case with more traditional, mainstream palliative care programs, a lack of trained providers – and in some instances a lack of funding – for integrative palliative care programs, had proven a stumbling block.

Bell called the work of building and funding a sustainable, long-term palliative care program under the United States commercial insurance model “challenging.” However, she does see upside: Patients are voting with their feet and moving toward programs offering integrative palliative medicine.

“Not only is there a demand from patients to expand the treatments that we’re offering, there really is a health care and financial and moral imperative to look beyond the opioid prescription, to look at other tools that we can use to help individuals who are living with serious illness live their lives as fully as possible,” Bell said. “Many of these interventions are low cost or no cost and are also low-risk in terms of thinking about the long-term adverse effects that we are often concerned about when it comes to prescription medications like opioids and benzodiazepines.

As the idea of integrative palliative care has emerged, so have questions about funding.

Collinge said there are a number of patients on Medicare, which pays for some complementary therapies. There are some private insurers, also, that pay for the integrative, complementary therapies. The third leg of the funding stool is philanthropy. Donations have funded some of the integrated therapy sites at Harvard, for example, he said.

“Also, many of these integrative therapies can be delivered by conventional health care professionals like doctors, nurses and social workers in the course of their regular care sessions,” Collinge said.

Check Also

Alternative medicine needs more publicity

49 Courtesy of Pexels According to the Cleveland Clinic, Western medicine can be understood as …