Impact of Integrative Medicine in People with Cancer: An Analysis from the BraveNet Practice-Based Research Network

Context: Integrative oncology, derived from the fields of integrative medicine and oncology, uses lifestyle medicine, mind body techniques and therapies from other healing systems to complement conventional cancer therapies. Many people with cancer are interested in utilizing integrative approaches alongside conventional cancer treatments to minimize side effects and promote whole person healing.

Objective: Describe demographics and outcomes of adults with cancer who received services at integrative medicine clinics.

Study Design and Analysis: Multi-site observational cohort study. Descriptive statistics and linear mixed effect modelling tested changes in outcomes over time.

Setting: Integrative medicine centers (n=17) in PRIMIER (Patients Receiving Integrative Medicine Effectiveness Registry) of the BraveNet Practice-Based Research Network.

Population: Adults with cancer (any type), completion of the index visit survey, as well as receipt of >1 integrative medicine encounter and completion of >1 one follow-up survey over 12 months.

Intervention: Integrative medicine services

Outcome Measures: PROMIS-29 domains: pain intensity, physical function, fatigue, pain interference, depressive symptoms, anxiety, ability to participate in social activities, and sleep disturbance; the Patient Activation Measure (PAM), and the Perceived Stress Scale (PSS). Outcomes were assessed at index visit, 2, 4, 6, and 12 months.

Results: The cohort consisted of 264 individuals with cancer of various stages. Most were white (89%), female (84%), with a college or graduate/professional degree (83%). The mean age was 55 years and 72% had commercial insurance. Breast cancer was the most common (51%) diagnosis. Participants had mildly elevated anxiety and fatigue at index. Reasons for integrative medicine use were wellness (29.1%), pain (20.1%), other (17.9%), fatigue (6.1%), and anxiety (5.6%). Acupuncture was the most common service utilized. Significant improvements in anxiety were seen across all time points. Depression improved at 2, 4, and 6 months. Fatigue was reduced at 4 and 12 months. The PSS score significantly improved across all time points and PAM scores improved at 6 and 12 months.

Conclusions: Anxiety, depression, stress and fatigue improved among a cohort of people with cancer receiving care at integrative medicine clinics. Future research should examine potential benefits of integrative medicine interventions for underrepresented groups of people with cancer.