TY - JOUR
T1 - Practice Patterns on the Incorporation of Integrative Medicine Into the Oncologic Care of Patients With Cancer
AU - Narayanan, Santhosshi
AU - Liu, Wenli
AU - Lopez, Gabriel
AU - Fellman, Bryan
AU - Reddy, Akhila
AU - Subbiah, Ishwaria M.
AU - Cohen, Lorenzo
AU - Bruera, Eduardo
N1 - Publisher Copyright:
© The Author(s) 2023.
PY - 2023/1/1
Y1 - 2023/1/1
N2 - Background: With rising interest in complementary approaches to symptom management, awareness of real-world practice patterns in the incorporation of integrative oncology (IO) into cancer care is limited. Therefore, we examined the reasons for referral, symptom burdens, and clinical outcomes for cancer patients who underwent initial IO consultations. Methods: The records of adult patients with cancer who underwent initial outpatient IO consultations at our cancer center for a representative 10-day period at the start of each month for 12 months starting January 1, 2017, were reviewed retrospectively. Patient demographic and medical characteristics and outpatient IO consultation details, including patient-reported outcome measures of symptom burden, were extracted. Descriptive summary statistics and logistic regression were used to analyze the data. Results: Among the 473 study patients, 71% were women, breast cancer (42%) was the most common cancer type, and 31% had metastatic cancer. Referring clinicians listed an integrative approach (57%) as the most common reason for referral, followed by diet (26%), pain (19%), discussion of herbs and supplements (18%), and stress (18%). In comparison, patients listed their primary concerns as diet (16%), pain (15%), and an integrative approach to overall health (11%). After the IO consultations, the highest likelihood of subsequent recommendations were acupuncture for hot flashes (odds ratio [OR], P =.002) or peripheral neuropathy (OR = 6.59, P <.001), oncology massage for pain (OR = 3.04, P <.001), psychology referral for patient’s self-reported anxiety (OR = 2.35, P <.001), and mind-body therapies for stress (OR = 2.57, P <.001). Conclusion: Cancer patients’ top concerns regarding IO consultation may not always match providers’ reasons for referral. Longitudinal data analysis is needed to determine the effect of integrative interventions on symptom burden.
AB - Background: With rising interest in complementary approaches to symptom management, awareness of real-world practice patterns in the incorporation of integrative oncology (IO) into cancer care is limited. Therefore, we examined the reasons for referral, symptom burdens, and clinical outcomes for cancer patients who underwent initial IO consultations. Methods: The records of adult patients with cancer who underwent initial outpatient IO consultations at our cancer center for a representative 10-day period at the start of each month for 12 months starting January 1, 2017, were reviewed retrospectively. Patient demographic and medical characteristics and outpatient IO consultation details, including patient-reported outcome measures of symptom burden, were extracted. Descriptive summary statistics and logistic regression were used to analyze the data. Results: Among the 473 study patients, 71% were women, breast cancer (42%) was the most common cancer type, and 31% had metastatic cancer. Referring clinicians listed an integrative approach (57%) as the most common reason for referral, followed by diet (26%), pain (19%), discussion of herbs and supplements (18%), and stress (18%). In comparison, patients listed their primary concerns as diet (16%), pain (15%), and an integrative approach to overall health (11%). After the IO consultations, the highest likelihood of subsequent recommendations were acupuncture for hot flashes (odds ratio [OR], P =.002) or peripheral neuropathy (OR = 6.59, P <.001), oncology massage for pain (OR = 3.04, P <.001), psychology referral for patient’s self-reported anxiety (OR = 2.35, P <.001), and mind-body therapies for stress (OR = 2.57, P <.001). Conclusion: Cancer patients’ top concerns regarding IO consultation may not always match providers’ reasons for referral. Longitudinal data analysis is needed to determine the effect of integrative interventions on symptom burden.
KW - cancer
KW - complementary and alternative treatments
KW - implementation research
KW - integrative medicine
KW - integrative oncology
KW - patient reported outcomes
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U2 - 10.1177/15347354231213045
DO - 10.1177/15347354231213045
M3 - Article
C2 - 37978821
AN - SCOPUS:85177026429
SN - 1534-7354
VL - 22
JO - Integrative cancer therapies
JF - Integrative cancer therapies
ER -