Characteristics and Challenges of Providing Acupuncture and Chinese Herbal Medicine in Oncology Treatment: Report of Survey Data and Experience of Five Unique Clinical Settings

Veleber, Susan; Cohen, Misha Ruth; Weitzman, Matthew; Maimon, Yair; Adamo, Christine A.; Siman, Jonathan; Lu, Weidong; Sajdyk, Tammy; Stone, Jennifer A.M.

doi:10.1177/15347354241226640

Cited by 2 publications

References 30 publications

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Factors Associated with Completion and Improvement Following Integrative Oncology Acutherapy in a Racially-Diverse Population

Zelaya,

Nicaise,

Hartsoe

et al. 2024

Preprint

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Background Acutherapy is an important integrative therapy in oncology settings as an adjunctive management option for cancer-related adverse effects. However, barriers to utilization of acupuncture in minority populations have been reported. This study sought to assess factors that impact completion of a recommended acutherapy regimen in a racially diverse cohort of cancer patients, along with determining the usefulness of functioning and well-being questionnaires in evaluating acupuncture outcomes. Methods We prospectively enrolled 432 patients who completed at least one acutherapy visit from the Integrative Oncology Program at the Winship Cancer Institute. Demographic characteristics were collected. PROMIS-29 questionnaire was administered at baseline and follow-up to measure patient-reported outcomes across domains of functioning and well-being. Logistic regression models were created to examine factors associated with regimen completion among all patients, and domain improvement among patients with reported symptoms following regimen completion. Results There were 432 patients included: 153 (35.1%) attended 8 or more sessions. Multivariable logistic regression showed that non-white race (OR 0.63; p = 0.047) and active treatment status (OR 0.54; p = 0.005) were associated with decreased adherence to the recommended acutherapy regimen. No differences in rate of posttreatment improvement were observed across race or cancer status. Non-white patients had greater moderate/severe scores in the domains of physical functioning (baseline: 54.2% vs. 32.4%; p = 0.019 | posttreatment: 50.0% vs. 18.1%; p < .001) and pain interference (baseline: 34.3% vs. 62.5%; p = 0.005 | posttreatment: 60.4% vs. 27.6%; p = 0.001). Additional analyses suggest obesity and delay in treatment cadence were factors associated with any improvement of PROMIS-29 domains after regimen completion. Conclusions Race and active cancer treatment were notable barriers to completing a recommended acutherapy regimen. Although effective in managing cancer-related symptoms, non-white patients faced greater impairment in physical functioning, social participation, and pain interference. Future efforts to address these disparities and ensure appropriate schedule adherence can maximize the benefit of acutherapy among cancer patients.

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Factors Associated with Completion and Improvement Following Integrative Oncology Acutherapy in a Racially-Diverse Population

Zelaya,

Nicaise,

Hartsoe

et al. 2024

Preprint

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The State of 21st Century Acupuncture in the United States

Smith,

Reddy,

Wolf

et al. 2024

JPR

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The term “acupuncture” commonly refers to a non-pharmacologic therapy that is increasingly employed by diverse segments of the population for a wide variety of complaints including pain, insomnia, anxiety, depression, frozen shoulder, and other issues. The term is also used as a short-hand for the wider medical system from which the placement of needles into the skin for therapeutic benefit and related techniques evolved. Thus “acupuncture” refers both to the therapeutic technique and the therapeutic system of Acupuncture and Herbal Medicine (AHM). The other modalities included within AHM include a wide variety of physical and mechanical manipulations, herbal medicines, dietary recommendations, and lifestyle modifications. Clinically, acupuncture is increasingly offered in a variety of conventional medical settings such as hospitals, medical school clinics, veterans’ healthcare centers, oncology facilities, and rehabilitation centers, and its safety profile is excellent overall. Barriers to further incorporation of acupuncture into biomedical sites include insurance coverage of acupuncture, education of conventional medical practitioners and other stakeholders about the utility, efficacy, and evidence base of acupuncture. Acupuncturists in the United States are skilled practitioners who are highly educated in the complex therapeutic system from which acupuncture arose and in the technical aspects of its utility as a treatment modality. The training, certification, licensure, and regulation of acupuncturists is similar to that of conventional providers such has physician’s assistants, advanced practice nurses, and medical and osteopathic doctors. While clinical use and acceptance of acupuncture continues to grow, there is to date no definitive composite document explaining the utility of acupuncture in various healthcare settings, the current understanding of how acupuncture works, and the training, professional regulation, and certification of acupuncture practitioners. This article will address these topics and strive to create a reference for practitioners, administrators, legislators, insurance providers, patients and their families, and other stakeholders.

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Characteristics and Challenges of Providing Acupuncture and Chinese Herbal Medicine in Oncology Treatment: Report of Survey Data and Experience of Five Unique Clinical Settings

Cited by 2 publications

References 30 publications

Factors Associated with Completion and Improvement Following Integrative Oncology Acutherapy in a Racially-Diverse Population

Factors Associated with Completion and Improvement Following Integrative Oncology Acutherapy in a Racially-Diverse Population

The State of 21st Century Acupuncture in the United States

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