Background: Pediatric patients with hematologic and oncologic diagnoses are at high risk of disease- and/or treatment-related symptoms, and families often seek complementary services alongside disease-directed therapy. Integrative medicine (IM) services can be effective holistic tools for symptom management and support, and are included in multiple NCCN supportive care guidelines. Despite recommendations that IM be included in comprehensive cancer care, availability and access remain variable across cancer centers, and the utilization of IM services-specifically for children-remains largely unknown. To address this knowledge gap, we conducted a retrospective review of 18 months of clinical metrics for a newly formed pediatric IM service at St. Jude Children's Research Hospital (St. Jude) to assess referral trends and patterns of IM utilization in a pediatric cancer center.
Methods: A retrospective medical record review was conducted for IM patients from December 2020 to June 2022. Descriptive analysis of the data and tests for significance of association were performed using R version 4.3.0.
Results: Of 174 patients referred for IM consultation, 155 were seen (10.9% no-show rate). Among patients who received an IM consultation, 57.4% (n=89) were receiving primary anticancer therapy. The demographics of IM patients ranged in age from 4 months to 25 years, with 52.9% identifying as female and 67.7% as White. Compared with new patients at St. Jude during the study period, those referred to IM services differed only by having older average age (12.9 vs 9.2 years; P<.001). Neuro-oncology diagnoses were most common among IM-referred patients (31.6%). Following the initial consultation, most patients returned for at least 1 massage or acupoint visit (56.1% and 50.3%, respectively); the mean number of IM encounters per patient was 9.2 (median, 5 [range, 1-84]). The primary reasons for referral were refractory symptoms (49.7%) and interest in complementary therapies (6.5%-20.6%).
Conclusions: During the first 18 months of pediatric IM availability, we observed increasing referrals and repeated utilization of services. Future work will investigate longitudinal trends in IM service utilization and the symptom-related impact of IM within a comprehensive cancer center.
Keywords: Complementary strategies; Implementation Strategies; Pediatric Oncology; Program Development; integrative medicine.