Mao Jun J, Bryl Karolina, Gillespie Erin F, Green Angela, Hung Tony K W, Baser Raymond, Panageas Katherine, Postow Michael A, Daly Bobby
Integrative Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA.
Department of Radiation Oncology, University of Washington School of Medicine / Fred Hutchinson Cancer Center, Seattle, WA, 98195, USA.
NPJ Digit Med. 2025 Jan 14;8(1):29. doi: 10.1038/s41746-024-01387-z.
Exercise and mindfulness-based interventions have growing evidence for managing fatigue and comorbid symptoms; however, packaging them in a cohesive digital way for patients undergoing cancer treatment has not been evaluated. We conducted a randomized controlled trial to assess the impact of a 12 week digital integrative medicine program, Integrative Medicine at Home (IM@Home), versus enhanced usual care on fatigue severity (primary outcome), comorbid symptoms and acute healthcare utilization (secondary outcomes), in 200 patients with solid tumors experiencing fatigue during treatment. Fatigue severity decreased more in IM@Home than in the control (1.99 vs. 1.51 points; p = 0.04). IM@Home participants also had reduced symptom distress (p = 0.003), anxiety (p = 0.03), and depression (p = 0.02). Acute healthcare utilization was lower with IM@Home, with fewer emergency department visits (rate ratio 0.49; p = 0.04), hospitalizations (4% vs. 12.9%; p = 0.03), and shorter hospital stays (4.25 vs. 10 days; p < 0.001). These promising findings should be confirmed in phase III clinical trials. "Study registered at clinicaltrials.gov (NCT05053230) on 09-20-2021".
基于运动和正念的干预措施在管理疲劳和共病症状方面的证据越来越多；然而，对于正在接受癌症治疗的患者，以一种连贯的数字化方式整合这些干预措施的效果尚未得到评估。我们进行了一项随机对照试验，以评估一项为期12周的数字化综合医学项目“居家综合医学”（IM@Home）与强化常规护理相比，对200名在治疗期间出现疲劳的实体瘤患者的疲劳严重程度（主要结局）、共病症状和急性医疗服务利用情况（次要结局）的影响。与对照组相比，IM@Home组的疲劳严重程度下降更为明显（分别为1.99分和1.51分；p = 0.04）。IM@Home组的参与者症状困扰（p = 0.003）、焦虑（p = 0.03）和抑郁（p = 0.02）也有所减轻。IM@Home组的急性医疗服务利用情况较低，急诊就诊次数较少（率比为0.49；p = 0.04），住院率较低（4% 对12.9%；p = 0.03），住院时间较短（4.25天对10天；p < 0.001）。这些有前景的发现应在III期临床试验中得到证实。“该研究于2021年9月20日在clinicaltrials.gov上注册（NCT05053230）”
