Physicians need more resources, tools and education to counsel patients about emerging stem cell therapies, a study in Mayo Clinic Proceedings concludes. Interest in regenerative procedures is mushrooming along with an increase in chronic diseases that have few therapeutic options. The study examined how physicians at the intersection of complex conditions, regenerative discoveries and responsible translation counsel patients who are seeking alternatives when standard care doesn't provide relief.

"Our study highlights a clear need to educate and inform physicians about stem cell and regenerative interventions, to enhance skills in patient-physician shared decision-making and to provide resources for patients," says Zubin Master, Ph.D., a Mayo Clinic bioethicist for Mayo Clinic's Center for Regenerative Medicine. "If patients feel their questions and concerns are dismissed by physicians and clinical teams, this may drive them to seek unproven, costly and potentially harmful treatments elsewhere."

Mayo Clinic's Center for Regenerative Medicine supports Dr. Master's work as part of its objective of advancing validated regenerative therapies that address unmet patient needs.

The research 

Dr. Master's team interviewed 25 specialists at Mayo Clinic in the areas of cardiology, ophthalmology, orthopedics, pulmonology and neurology over a period of 11 months.  The data were broken into two analyses. The first paper published in Cytotherapy outlined the attitudes of physicians toward stem cell and regenerative interventions that are not approved by the Food and Drug Administration. Besides physician concerns about scientific validation, cost and safety, the analysis found:

• Most providers did not feel it was appropriate to offer unapproved regenerative stem cell interventions within standard clinical care.
• Some orthopedists said it could be appropriate to offer regenerative procedures that are proven to be safe, if there is some likelihood of benefit, costs are reasonable, and when all standard treatments have been exhausted.

The Mayo Clinic Proceedings paper found that providers took informational and relational approaches to counsel patients requesting regenerative interventions.

Informational approach

All the specialists, especially orthopedists, used an informational approach to counseling patients interested in regenerative interventions. Providers explained to patients the known risks, benefits, and what is unknown about stem cell and regenerative medicine procedures.

"Physicians aimed to give the facts to patients by describing the current state of science, safety and financial costs of unapproved procedures," says Dr. Master. "Some specialists report using analogies to explain the complexity of stem cell procedures in an attempt to establish realistic expectations about them."

Relational approach

Specialists also used a relational counseling approach that acknowledges patients' pain and suffering, and also empowers them to make decisions on their care. This type of counseling comes with a reassurance that the physician wants what is best for the patients, underscoring Mayo's main value that the needs of the patient come first.

"Given that patients who are suffering from chronic illnesses for which current conventional treatments are limited, it is important for a physician to address patient queries in an empathic manner realizing the potential limits of their recommendations and to continue to support them on their therapeutic journey," says Dr. Master. "Physicians emphasized that no matter what the patient decides, they would continue their care and support the patient."

The Mayo Clinic Proceedings study concludes that the scientific and clinical communities need to do more work to better understand how to guide patients to responsible applications of regenerative therapies. Dr. Master's team recommends more education through seminars, webinars and short courses for physicians with the long-term goal to build a robust arsenal of resources and tools that help patients and providers understand how to safely harness the potential of regenerative interventions.

Patients considering whether regenerative therapeutics are right for them can contact Mayo Clinic’s Regenerative Medicine Consult Service for a free consultation.

####

Related Articles