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

Abstract

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.