Acute care and overall survival results of a randomized trial of a virtual health intervention during routine cancer treatment.

Abstract

1503 Background: Despite rapid development of virtual health interventions, little is known of their impact on acute healthcare utilization and survival outcomes. This study aimed to evaluate the effectiveness of Integrative Medicine at Home (IM@Home), a virtual mind-body fitness program, on unplanned hospital admission and overall survival among patients undergoing systemic cancer treatment. Methods: We conducted a randomized clinical trial of IM@Home (choice of 23 weekly virtual live mind-body and fitness classes) compared with an enhanced usual care (EUC) control intervention consisting of asynchronous recordings (standard of care plus access to 17 pre-recorded online meditation resources) for patients with melanoma, thoracic, gynecological, or head/neck cancers on systemic treatment who reported moderate or greater fatigue. The study intervention lasted up to 12 weeks, and patients were followed thereafter for clinical events. Admission to a hospital over the study period was collected from patient-reported-outcomes and the electronic medical records and compared between arms. Overall survival was estimated using the Kaplan-Meier method. Results: Between October 2021 and March 2023,128 patients were randomized: (mean age 64 years) 109 (85.2%) were female, 106 (82.8 %) white, 10 (7.8%) Black, 7 (5.5%) Asian, and 118 (92.2%) non-Hispanic. 49 (38.3%) patients had thoracic, 44 (34.4%) gynecological, 25 (19.5%) head/neck, and 10 (7.8%) melanoma cancer. 58 (45.3%) were receiving chemotherapy, 45 (35.2%) immunotherapies, and 29 (22.7%) targeted therapies. Compared to EUC, patients in the IM@Home group were less likely to be hospitalized (4/64 [6.3%] vs. 12/63 [19.1%], p=0.038) and spent fewer days in the hospital (4.3 vs. 10.5 mean days per patient, p<0.001) during the 12-week study period. Overall survival results were assessed in Feb 2024 after a median follow up of 20.3 months. Median overall survival was 24.3 months in the EUC arm and was not reached in the IM@Home intervention arm (p=0.06). Conclusions: Participation in the virtual IM@Home program reduced unplanned hospitalizations and number of hospitalization days among patients with cancer receiving systemic treatment. Larger studies with longer follow-up are needed to confirm the effect of virtual supportive care on improving overall survival and reducing acute healthcare utilization. Clinical trial information: NCT05053230 .