Frequency and Characteristics of Integrative Oncology Referrals for Patients With Cancer Receiving Inpatient Rehabilitation

Background: Integrative Oncology (IO) interventions may decrease physical, psychological, and social distress related to cancer and its treatments. Little is known about the frequency and predictors of IO referral for symptom management for cancer rehabilitation inpatients. Methods: A retrospective...

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Main Authors: Ekta Gupta MD, Gabriel Lopez MD, Santhosshi Narayanan MD, Jegy M. Tennison MD, Imran Elahi BS, Aline Rozman de Moraes MD, Bryan M. Fellman MS, Eduardo Bruera MD
Format: Article
Language:English
Published: SAGE Publishing 2024-11-01
Series:Integrative Cancer Therapies
Online Access:https://doi.org/10.1177/15347354241296810
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author Ekta Gupta MD
Gabriel Lopez MD
Santhosshi Narayanan MD
Jegy M. Tennison MD
Imran Elahi BS
Aline Rozman de Moraes MD
Bryan M. Fellman MS
Eduardo Bruera MD
author_facet Ekta Gupta MD
Gabriel Lopez MD
Santhosshi Narayanan MD
Jegy M. Tennison MD
Imran Elahi BS
Aline Rozman de Moraes MD
Bryan M. Fellman MS
Eduardo Bruera MD
author_sort Ekta Gupta MD
collection DOAJ
description Background: Integrative Oncology (IO) interventions may decrease physical, psychological, and social distress related to cancer and its treatments. Little is known about the frequency and predictors of IO referral for symptom management for cancer rehabilitation inpatients. Methods: A retrospective review was performed of patients with cancer who underwent inpatient rehabilitation at a specialized tertiary cancer center from 5/2016 to 3/2020. Patient demographics and IO consultation details, including patient-reported outcome measures of symptom burden using ESAS-FS and functional status using the Activity Measure for Post-Acute Care “6 clicks,” were extracted. Descriptive summary statistics and logistic regression were used to analyze the data. Results: Out of 1196 inpatient rehabilitation admissions, 100 (8.4%) were referred to IO. The Activity Measure for Post-Acute Care “6 clicks” basic mobility admission scores were significant at a 1-point difference between the intervention and control group (39.5 vs 40.8, P  < .05); both scores equate to a ˃50% degree of functional impairment. Referred patients were younger (62, P  = .02) and Hispanics or Latinos ( P  = .02). The top symptoms for IO consultation included pain (N = 73), integrative approach (N = 41), relaxation (N = 38), and stress/anxiety (N = 33). Patients who reported a baseline symptom score ≥ 1 in the ESAS-FS, had both statistically ( P  < .05) and clinically significant improvements (≥1 point change) for pain, fatigue, well-being, anxiety, and sleep after massage therapy. Conclusion: Cancer rehabilitation inpatients were commonly referred to IO to address pain, with observed improvements across multiple symptoms with massage therapy. Lower mobility scores and younger patients received significantly higher referrals to IO. Larger trials are needed to characterize the effects of IO interventions on the inpatient rehabilitation of patients with cancer.
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spelling doaj-art-2bfc91eb7a7b4b19afd257cf1e0dd6bc2025-08-20T02:26:40ZengSAGE PublishingIntegrative Cancer Therapies1552-695X2024-11-012310.1177/15347354241296810Frequency and Characteristics of Integrative Oncology Referrals for Patients With Cancer Receiving Inpatient RehabilitationEkta Gupta MD0Gabriel Lopez MD1Santhosshi Narayanan MD2Jegy M. Tennison MD3Imran Elahi BS4Aline Rozman de Moraes MD5Bryan M. Fellman MS6Eduardo Bruera MD7University of Texas MD Anderson Cancer Center, Houston, TX, USAUniversity of Texas MD Anderson Cancer Center, Houston, TX, USAUniversity of Texas MD Anderson Cancer Center, Houston, TX, USAUniversity of Texas MD Anderson Cancer Center, Houston, TX, USAUniversity of Texas, Austin, TX, USAUniversity of Texas MD Anderson Cancer Center, Houston, TX, USAUniversity of Texas MD Anderson Cancer Center, Houston, TX, USAUniversity of Texas MD Anderson Cancer Center, Houston, TX, USABackground: Integrative Oncology (IO) interventions may decrease physical, psychological, and social distress related to cancer and its treatments. Little is known about the frequency and predictors of IO referral for symptom management for cancer rehabilitation inpatients. Methods: A retrospective review was performed of patients with cancer who underwent inpatient rehabilitation at a specialized tertiary cancer center from 5/2016 to 3/2020. Patient demographics and IO consultation details, including patient-reported outcome measures of symptom burden using ESAS-FS and functional status using the Activity Measure for Post-Acute Care “6 clicks,” were extracted. Descriptive summary statistics and logistic regression were used to analyze the data. Results: Out of 1196 inpatient rehabilitation admissions, 100 (8.4%) were referred to IO. The Activity Measure for Post-Acute Care “6 clicks” basic mobility admission scores were significant at a 1-point difference between the intervention and control group (39.5 vs 40.8, P  < .05); both scores equate to a ˃50% degree of functional impairment. Referred patients were younger (62, P  = .02) and Hispanics or Latinos ( P  = .02). The top symptoms for IO consultation included pain (N = 73), integrative approach (N = 41), relaxation (N = 38), and stress/anxiety (N = 33). Patients who reported a baseline symptom score ≥ 1 in the ESAS-FS, had both statistically ( P  < .05) and clinically significant improvements (≥1 point change) for pain, fatigue, well-being, anxiety, and sleep after massage therapy. Conclusion: Cancer rehabilitation inpatients were commonly referred to IO to address pain, with observed improvements across multiple symptoms with massage therapy. Lower mobility scores and younger patients received significantly higher referrals to IO. Larger trials are needed to characterize the effects of IO interventions on the inpatient rehabilitation of patients with cancer.https://doi.org/10.1177/15347354241296810
spellingShingle Ekta Gupta MD
Gabriel Lopez MD
Santhosshi Narayanan MD
Jegy M. Tennison MD
Imran Elahi BS
Aline Rozman de Moraes MD
Bryan M. Fellman MS
Eduardo Bruera MD
Frequency and Characteristics of Integrative Oncology Referrals for Patients With Cancer Receiving Inpatient Rehabilitation
Integrative Cancer Therapies
title Frequency and Characteristics of Integrative Oncology Referrals for Patients With Cancer Receiving Inpatient Rehabilitation
title_full Frequency and Characteristics of Integrative Oncology Referrals for Patients With Cancer Receiving Inpatient Rehabilitation
title_fullStr Frequency and Characteristics of Integrative Oncology Referrals for Patients With Cancer Receiving Inpatient Rehabilitation
title_full_unstemmed Frequency and Characteristics of Integrative Oncology Referrals for Patients With Cancer Receiving Inpatient Rehabilitation
title_short Frequency and Characteristics of Integrative Oncology Referrals for Patients With Cancer Receiving Inpatient Rehabilitation
title_sort frequency and characteristics of integrative oncology referrals for patients with cancer receiving inpatient rehabilitation
url https://doi.org/10.1177/15347354241296810
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