Integrative Oncology Leadership Collaborative (IOLC): Making tools (and a new PRO) for whole person cancer care to be routine and regular.

Abstract

355 Background: Nearly two-thirds (62%) of people with cancer want to know about non-tumor directed therapies such as exercise, nutrition counseling, massage, and meditation before starting conventional treatment, but only 33% of oncologists agree with that timeline, according to a 2022 online survey . In 2021-2022, Samueli Integrative Health Programs (now Healing Works Foundation) funded a two-year integrative oncology leadership collaborative (IOLC) with a goal to further whole person cancer care, also called integrative oncology. The IOLC adapted a new patient reported outcome (PRO), and patient education and workflow resources used in whole person primary care for use in cancer care. The Personal Health Inventory (PHI), a person-focused PRO intake tool to elicit “what matters”, was made oncology-specific and deployed at several centers including a VA Medical Center. The IOLC created or adapted additional resources, resulting in a set of open-source tools for use in mainstream oncology practice. Methods: 13 cancer care organizations met monthly in 90-min virtual format from April-Dec 2021. From Jan-Dec 2022 sessions were held twice monthly over 1-hr. Year One allowed group cohesion in discussion-based review of the current state of whole person cancer care and covered foundational topics to include guideline-based supportive care and group medical visits. IOLC members suggested changes to the primary care PHI along with development of new oncology-specific whole person care resources. In Year Two, IOLC members were encouraged to beta test the PHI and related-resources in their practice settings and a Patient Empowerment and Advocacy Collaborative (PAEC) was developed as part of the group to bring in direct patient experience. The oncology-specific PHI was trialed within the Dayton VA Whole Health Oncology clinic from Oct 2021-June 2023. It proved feasible for use at any stage of the cancer care experience in 25 intake encounters. Results: PHI oncology-specific adaptations included replacing “Healthy Days” with FACT-G7 and the Patient Dignity Question (PDQ). Nineteen “pocket guides” were created and posted free online to support whole person cancer care. The patient voice was expanded through the formation of the PAEC in Year Two, and the group led two joint sessions where advocates provided input on IOLC tools’ development. Conclusions: A group of cancer care professionals and patients, working together in a sponsored community of practice, created no-cost resources, including a new PRO called the PHI, to further whole person integrative cancer care. The PHI demonstrated feasibility in a veteran population with cancer and can be offered at any time in the oncology trajectory, from diagnosis to end of life, surviving to thriving. Next steps are to formally test these tools in various oncology practice settings.