An Integrative Medicine Educational Program for Radiation Oncology Patients: Patient-Reported Outcomes

Kareem R Fakhoury; Jungxiao Hu; Ellen Kim; Kathryn A Hansen; Taylor R Koval; Kathleen Wolff; Michelle C Foote-Pearce; Sana Dole Karam; Mark J Stavas

doi:10.1016/j.adro.2023.101350

An Integrative Medicine Educational Program for Radiation Oncology Patients: Patient-Reported Outcomes

Adv Radiat Oncol. 2023 Aug 16;9(2):101350. doi: 10.1016/j.adro.2023.101350. eCollection 2024 Feb.

Authors

Kareem R Fakhoury¹, Jungxiao Hu², Ellen Kim³, Kathryn A Hansen⁴, Taylor R Koval⁴, Kathleen Wolff⁴, Michelle C Foote-Pearce⁴, Sana Dole Karam¹, Mark J Stavas⁵

Affiliations

¹ Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, Colorado.
² Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, Colorado.
³ Department of Radiation Oncology, Brigham and Women's Hospital/Dana-Farber Cancer Institute, Boston, Massachusetts.
⁴ Osher Center for Integrative Health, Vanderbilt University Medical Center, Nashville, Tennessee.
⁵ Cancer Partners of Nebraska, Lincoln, Nebraska.

Abstract

Purpose: Complementary health approaches (CHAs) equip patients to self-manage radiation therapy (RT)-related symptoms and fulfill unmet needs, but few disclose CHA use to their radiation oncologist. An integrative medicine educational program (IMEP) was developed to assess its ability to improve patient self-efficacy for symptom management and CHA use disclosure.

Methods and materials: The IMEP included 4 1-hour sessions covering topics of (1) meditation, (2) yoga, (3) massage therapy, and (4) nutrition. Individuals over age 18 years and actively receiving RT were administered presession and postsession surveys. The primary outcomes were intention to disclose CHA use and self-efficacy. Qualitative data were assessed with a thematic approach.

Results: Overall, 23 patients attended 1 or more sessions, yielding 43 completed surveys. Compared with 35.9% of participants who had disclosed CHA use before the session, 67.4% intended to disclose after the session. Of the 5 self-efficacy statements, there were significant improvements in "I have ownership over my health" (increase of 0.42; 95% CI, 0.07-0.77; P = .01), "I have tools to manage my disease on my own" (1.14; 95% CI, 0.42-1.87; P = .001), and "I have control over my cancer" (0.96; 95% CI, 0.39-1.53; P < .001). Barriers to involvement included transportation, timing relative to RT appointment, and poor performance status.

Conclusions: A radiation-specific IMEP resulted in a high rate of intention to disclose CHA use and improvements in patients' reported self-efficacy to manage radiation-related symptoms. However, substantial resources were needed to deliver the IMEP. Future work must focus on increasing accessibility through telehealth and flexible timing.