Survival Results From the Integrative Medicine for Patient-Reported Outcomes, Values, and Experience (IMPROVE) Trial

PURPOSE We previously reported that a 12-week digital integrative medicine intervention, Integrative Medicine at Home (IM@Home), reduced fatigue severity, symptom distress, anxiety, and depression relative to enhanced usual care (EUC) in patients with solid tumors experiencing fatigue during systemic cancer treatment. Patients in the IM@Home arm also had reduced acute care utilization, including fewer emergency department visits, hospitalizations, and shorter hospital stay. Here, we report the results of an overall survival (OS) analysis of IM@Home. METHODS One hundred and twenty-seven patients with solid tumors experiencing fatigue during systemic therapy were randomly assigned to IM@Home (n = 64) or EUC (n = 63). OS data (status and date of death) were obtained from patients' electronic health records and estimated using the Kaplan-Meier method and compared with the log-rank test. Cox regression was used to estimate the hazard ratio (HR) for treatment arm adjusting for tumor type, and, as a sensitivity analysis, adjusting for tumor type and stage. RESULTS At a median follow-up of 28.6 months, median OS was not reached in the IM@Home arm versus 26.3 months in the EUC arm. At 24 months, the estimated OS was 69.1% (95% CI, 58.4 to 81.8) for those in the IM@Home arm compared with 52.6% (95% CI, 41.4 to 67.0) for those in the EUC arm ( P = .037). In sensitivity analyses controlling for tumor type and stage, the adjusted HR was 0.59 in IM@Home versus EUC (95% CI, 0.33 to 1.04; P = .070). CONCLUSION IM@Home, a digitally delivered integrative medicine intervention improved OS, in patients receiving systemic cancer therapy, warranting a future adequately powered prospective trial in diverse settings to confirm the promising results.