Adherence to Integrative Care, Oncology Healthcare Utilization, Opioid Use and Hospitalization

Research on the relationship between integrative oncology (IO) programs and dispensing of chemotherapy agents and supportive care drugs, and hospitalization rates is limited. The present study examined these outcomes in chemotherapy-treated patients with cancer, comparing patients highly adherent to integrative care (high-AIC) to those with low adherence (low-AIC). Data from patients with cancer treated with taxane and/or platinum-based agents participating in an ongoing prospective, controlled pragmatic trial were examined retrospectively. Patients were referred to an IO consultation and weekly treatments at 3 medical centers in Northern Israel, with high-AIC defined as attending ≥4 sessions at 6 weeks; low-AIC, 0-3 sessions. Cancer-related parameters; dispensing of medication (chemotherapy agents, analgesics, anxiolytics and opioids); rates of hospitalizations and emergency room visits were analyzed using generalized linear regression models. Of 615 patients attending the IO consultation, 367 (59.7%) were high-AIC, with both groups having mostly similar baseline characteristics. Dispensing rates for taxanes (P = .336), platinum agents (P = .403), non-opioid analgesics (P = .201), and anxiolytics (P = .350), and number of emergency room visits were similar in both groups at 12 weeks. However, high-AIC patients had fewer dispensed opioid prescriptions (RR = 0.50, 95% CI = 0.30-0.85, P = .010); lower rates of hospitalization (OR = 0.59, 95% CI = 0.39-0.88, P = .010); and fewer hospitalization days (RR = 0.53, 95% CI = 0.31-0.90, P = .019). In conclusion, dispensing of chemotherapy drugs was similar between groups, though high-AIC patients used less opioids and had fewer hospitalizations at 12 weeks. Further research is needed with randomized and prospective studies exploring the relationship between adherence to IO care; adherence to chemotherapy; quality of life; opioid use; and hospitalization.