System Maintenance Notice

Please note that maintenance work is scheduled between 4 AM and 5 AM - CET. During this time, you may experience reduced performance. Thanks for your patience.

Publications

Journal Article Ahead of print

PubMed: 42385109 DOI: 10.1200/OP-26-00274

Implementation and Patient-Reported Outcomes of an Insurance-Supported Integrative Oncology Symptom Management Program.

JCO Oncol Pract

Authors: Meha Srivastava, Samuel N Rodgers-Melnick, Jacob Wolf, Jane Smith, Santosh Rao

Affiliations

  • Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH. Connor Whole Health, University Hospitals of Cleveland, Cleveland, OH.
  • Connor Whole Health, University Hospitals of Cleveland, Cleveland, OH.
  • Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, OH.
  • Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH.
  • Connor Whole Health, University Hospitals of Cleveland, Cleveland, OH. Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH.

Abstract

PURPOSE

While integrative oncology (IO) modalities are recommended for symptom management, few models describe guideline-supported or sustainable care. This study (1) describes the initial implementation of a hybrid insurance-supported, guideline-informed IO symptom management clinic incorporating low-cost self-pay services; (2) evaluates single treatment effects on patient-reported outcome measures (PROMs); and (3) assesses clinic acceptability.

METHODS

An IO symptom management clinic was established, providing individualized treatment plans through insurance-covered physician consults and massage therapy, low-cost group acupuncture, reiki, and group medical visits. Utilization and demographic data were extracted from electronic health records. Oncology diagnosis and PROM data (ie, PROMIS-29 and Edmonton Symptom Assessment Scale) were analyzed within a subset of visits in the first 3 months. Single treatment effects were calculated among patients with moderate-to-severe pretreatment scores. An acceptability survey was administered to a subset of 62 patients.

RESULTS

Between June 2023 and September 2024, 1924 IO treatments occurred among 291 patients (mean age 60.8 years, 73.2% female, 80.8% White). Clinically meaningful improvements in symptoms (mean and 95% CI) were observed across all modalities in pain (-2.08 [95% CI, -2.51 to -1.66]), stress (-2.70 [95% CI, -3.20 to -2.20]), anxiety (-2.28 [95% CI, -2.90 to - 1.66]), depression (-2.54 [95% CI, -3.22 to -1.87]), nausea (-3.61 [95% CI, -4.43 to -2.78]), and fatigue (-1.42 [95% CI, -2.33 to -0.52]). Acceptability survey results demonstrated that the clinic helped patients use integrative therapies (62.3% strongly agree) and that patients would refer others to this clinic (85.5% strongly agree).

CONCLUSION

This clinical model offers a potentially adaptable, hybrid insurance-based framework for effective, guideline-concordant IO symptom management care. Patients reported high satisfaction, and utilization increased over time. Further research on similar insurance-supported models can help optimize accessibility and patient satisfaction.

MeSH

Neoplasms, Integrative Oncology, Insurance, Patient Reported Outcome Measures, Therapeutics, Massage