Virtual mind-body program cuts need for emergency care among patients with cancer
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Key takeaways:
- Patients assigned a virtual mind-body program experienced a lower likelihood for hospitalizations and fewer days in the hospital.
- Patients in the program had about half as many urgent care visits.
A virtual mind-body fitness program reduced unplanned hospitalizations, number of hospitalization days and urgent care visits among patients undergoing active cancer treatment, study results showed.
The findings — presented during ASCO Quality Care Symposium — indicate that additional research is needed to determine whether the program could be further scaled to improve patient survival outcomes and reduce health care costs, researchers concluded.
Rationale and methods
“Evidence shows that fitness, meditation, yoga, tai chi and music therapy can improve common symptoms of cancer treatment such as fatigue, insomnia, anxiety and depression,” Jun J. Mao, MD, MSCE, chief of integrative medicine service at Memorial Sloan Kettering Cancer Center, said in an ASCO-issued press release. “However, there is no research examining how to make these activities accessible to patients with cancer from the comfort of their homes. Further, no research has evaluated whether practicing these therapies from home can reduce a patient’s likelihood of being admitted to the hospital.”
Investigators sought to assess the effectiveness of a virtual mind-body fitness program, dubbed Integrative Medicine at Home (IM@Home) on unplanned hospitalizations and urgent care visits among 200 patients (mean age, 59.9 years; 90.5% women; 77.5% white) undergoing active cancer treatment for breast (36.5%), gynecologic (21.5%), head/neck (12.5%) or thoracic cancer (24.5%) or melanoma (5%). Patients reported moderate or greater fatigue while undergoing cancer treatment.
The pragmatic randomized clinical trial consisted of a novel basket study design where researchers randomly assigned 99 patients to the IM@Home program, including a choice of 20 or more weekly virtual mind-body and fitness classes, and 101 patients to enhanced usual care, which included standard of care plus access to 20 or more prerecorded online meditation resources.
Researchers collected data from electronic medical records on use of hospitalization services during the 12-week study period and compared them between the two groups.
Findings
Results showed that patients assigned to the IM@Home program experienced a lower likelihood for hospitalizations (4.4% vs. 12.9%; P = .025) and fewer days in the hospital compared with the enhanced usual care group (mean, 4.25 days vs. 10 days per patient; P < .001).
Researchers also observed similarities in the proportion of urgent care visits for those included in the IM@Home program (9.1%) vs. enhanced usual care (11.9%), although patients in the program had about half as many urgent care visits (RR = 0.52; 95% CI, 0.26-0.98).
Additional analysis of patient-reported outcomes showed the IM@Home program significantly improved patient fatigue levels, symptoms of depression and physical symptoms compared with enhanced usual care.
Future research
“This trial demonstrated that a virtual mind-body fitness program can be delivered seamlessly for patients with cancer and reduce complications from treatment,” Charu Aggarwal, MD, MPH, FASCO, assistant professor for lung cancer excellence at University of Pennsylvania's Perelman School of Medicine and Healio | HemOnc Today Editorial Board member — who was not involved with the study — said in the release. “Future research is needed to evaluate whether this type of program can be implemented at larger practices.”
The researchers plan to conduct additional analyses to determine if the IM@Home program can improve patients’ adherence to cancer treatment, health care use and survival for specific tumor types. They additionally plan to replicate the results in trials of larger sample sizes to further study how this type of intervention can improve patient and health system outcomes, according to release.
References:
Mao JJ, et al. Abstract 473. Presented at: ASCO Quality Care Symposium; Oct. 27-28, 2023; Boston.
Mind-body fitness classes during cancer treatment reduced unplanned hospitalizations, urgent care visits (press release). Available at: https://old-prod.asco.org/about-asco/press-center/news-releases/mind-body-fitness-classes-during-cancer-treatment-reduced . Published Oct. 23, 2023. Accessed Oct. 28, 2023.
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Mao JJ, et al. Abstract 473. Presented at: ASCO Quality Care Symposium; Oct. 27-28, 2023; Boston.
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