Frequencies and predictors of health psychology referrals after integrative oncology consultation

Objective: Health psychology (HP) plays a critical role within a multidisciplinary, integrative oncology team. HP in integrative oncology is not well established and criteria for referral have not been examined. This study examined characteristics of referral to HP. Methods: A chart review of 1827 patients in the Integrative Medicine Center (IMC) between 2019 and 2020 was conducted. Patient assessments included the Edmonton Symptom Assessment Scale, Measure Yourself Concerns and Well-being, and PROMIS10. Chi-square tests were used to compare categorical variables, Mann-Whitney test for non-normally distributed continuous variables, and t-tests for normally distributed continuous variables comparing those referred and not referred to HP. Results: Patients referred (n = 316) were mostly female (85.4%), White (67.1%), married/partnered (67.7%), obese (42.1%), and with breast cancer (52.2%). When comparing the two groups, patients referred to HP and patients not referred to HP, patients referred had a higher proportion of female and Black patients than expected (p ≤.01); patients referred were also younger and had higher BMIs (p ≤.01). Referred patients reported worse fatigue, sleep, depression, anxiety, well-being, spiritual pain, financial distress, memory, overall mental health, physical health, and global health (p ≤.01). Most common concerns of referrals were diet/nutrition, overall health, and stress/anxiety. Compared to non-referred, HP referrals were more likely to prioritize depression, spirituality, and stress/anxiety (p ≤.01). Conclusions: Patient characteristics are well-suited treatment targets for HP, including addressing emotional distress, healthy lifestyle, and quality of life. Our findings can help programs develop strategies to facilitate engagement with psychological counseling.