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Identifying a need and knowledge gap of osteopathic medicine in pediatric oncology providers

Journal: Pediatric Blood and Cancer Date: 2019/06, 66Pages: S195-S196. doi: Subito , type of study: cross sectional study

Full text    (https://onlinelibrary.wiley.com/doi/abs/10.1002/pbc.27713)

Keywords:

childhood cancer [1]
OMT [2951]
child [312]
children [228]
pediatric oncologist [1]
drug combination [1]
drug safety [2]
conference abstract [108]
clinical practice [19]
osteopathic medicine [1540]

Abstract:

Background: Children receiving chemotherapy often struggle with detrimental side effects including constipation, nausea, neuropathy, and decreased quality of life. As we continue to make great strides in medications to help minimize chemotherapy side effects, there remains a need for additional adjunctive supportive care. Since the advent of osteopathic medicine in the 1890's, this adjunctive therapy has been implemented successfully in both adult and pediatric populations for a myriad of illnesses. To date, there has been no literature on the need for osteopathic manipulative treatments (OMT) in oncology. Additionally, there have been no studies examining practitioner knowledge and implementation of osteopathic medicine specifically in the pediatric oncology population. Objectives: To investigate a knowledge gap and potential need for osteopathic medicine in pediatric oncology. Design/Method: Twenty-one pediatric oncology providers at Nationwide Children's Hospital were approached for participation. Of those approached, 20 total providers completed the survey. Following a description and video of OMT, participants completed quantitative surveys in REDcap and 1:1 semi-structured qualitative interviews. Providers were asked about their personal knowledge of OMT, hesitations and barriers regarding OMT utilization, and their experiences with difficult to control chemotherapy side effects. Interviews were audio-recorded, transcribed, and independently coded by two investigators to determine consensus thematic content. Descriptive statistics were used to summarize quantitative data. Results:We surveyed 20 oncology providers (7 male), including 15 attending physicians and 5 nurse practitioners with a median of 6.5 years of clinical practice (range: 1-24 years). All attending physicians were allopathic trained pediatric oncologists and had knowledge of osteopathicmedicine, with a varying degree of understanding. No provider reported they knew 'a lot' about OMT. Providers supported further research to study the benefits of OMT, with 100% reporting a desire to have OMT available as a supportive care option. Family frustration secondary to uncontrolled symptoms requiring multiple failed medication regimens was an underlying theme from providers. Additional major themes included 1) provider frustration with current available treatments for managing chemotherapy side effects such as nausea, neuropathy, and constipation, 2) attractiveness ofOMTas a non-invasive home intervention with low-risk and high reward, and 3) minimal provider hesitation for incorporating OMT into their patients' supportive care. Conclusion: Pediatric oncology providers reported a need for better management of chemotherapy-associated side effects and an openness to non-pharmacological therapies with supporting data. These findings support the need to further investigate the safety and feasibility, as well as efficacy of OMT in the pediatric oncology clinical setting.


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