Barriers to recommendation of integrative oncology modalities in supportive care: a MASCC/SIO survey

Purpose: Integrative oncology (IO) modalities aim to improve the quality of life of persons with cancer, including strategies to manage treatment and disease-related symptoms. As evidence increases to include IO in supportive care, interest grows globally. Understanding barriers to IO recommendation is key to facilitating its uptake. Methods: Members of the Multinational Association of Supportive Care in Cancer (MASCC) and the Society for Integrative Oncology (SIO) were invited to complete an online survey in Fall 2023 assessing barriers to IO recommendation on a 5-point scale. Descriptive statistics assessed demographic data and general counts of scaled agreement, while logistic regression analysis evaluated perceived barriers in relation to relevant covariates. Results: Over 80% of respondents believed that healthcare professionals’ (HCP) lack of knowledge with IO and lack of insurance/out-of-pocket costs were barriers to recommending IO. Approximately 80% agreed that lack of referral pathways was a logistical barrier and 85% reported lack of confidence in IO as an individual-level barrier. Respondents from Europe were 2.2 times more likely to agree with the perceived barrier of HCP knowledge, compared to respondents from North America (OR 2.22, 95% CI 1.05–4.67, p = 0.036). Lastly, compared to general physicians, integrative professionals were more likely to report perceptions that IO would delay conventional care delivery (OR 3.62, 95% CI 1.56–8.43, p = 0.0003). Conclusions: Results of this study highlight important barriers and facilitators of IO integration into standard supportive care globally. These findings represent perspectives from an international sample of MASCC and SIO members and may not apply to all oncology professionals. Further research is necessary to understand the global roadblocks that exist among practitioners interested in IO use.