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

Abstract

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. 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. 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). 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.