Author: Stephanie L Taylor1,2, Hannah M Gelman3, Rian DeFaccio3, Jamie Douglas3, Matthew J Hawrilenko3, Nathan K McGinty3, Adam Resnick4, Nathan C Tomlanovich3, Joy Toyama4, Alison M Whitehead5, Benjamin Kligler5, Steven B Zeliadt3,6
Affiliation: <sup>1</sup> Center for the Study of Healthcare Innovation, Implementation and Policy, Health Services Research & Development, Greater Los Angeles VA Healthcare System, MC 151, 11301 Wilshire, Bldg. 206, 2nd Floor, Los Angeles, CA, 90073, USA. Stephanie.Taylor8@va.gov. <sup>2</sup> Department of Medicine and Department of Health Policy and Management, UCLA, Los Angeles, CA, USA. Stephanie.Taylor8@va.gov. <sup>3</sup> Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound Healthcare System, Seattle, WA, USA. <sup>4</sup> Center for the Study of Healthcare Innovation, Implementation and Policy, Health Services Research & Development, Greater Los Angeles VA Healthcare System, MC 151, 11301 Wilshire, Bldg. 206, 2nd Floor, Los Angeles, CA, 90073, USA. <sup>5</sup> Integrative Health Coordinating Center, Office of Patient-Centered Care and Cultural Transformation, Veterans Health Administration, Washington, DC, USA. <sup>6</sup> Department of Health Services, School of Public Health, University of Washington, Seattle, WA, USA.
Conference/Journal: J Gen Intern Med
Date published: 2022 Nov 30
Other: Special Notes: doi: 10.1007/s11606-022-07889-4. , Word Count: 307
Interest in complementary and integrative health (CIH) approaches, such as meditation, yoga, and acupuncture, continues to grow. The evidence of effectiveness for some CIH approaches has increased in the last decade, especially for pain, with many being recommended in varying degrees in national guidelines. To offer nonpharmacological health management options and meet patient demand, the nation's largest integrated healthcare system, the Veterans Health Administration (VA), greatly expanded their provision of CIH approaches recently.
This paper addressed the questions of how many VA patients might use CIH approaches and chiropractic care if they were available at modest to no fee, and would patients with some health conditions or characteristics be more likely than others to use these therapies.
Using electronic medical records, we conducted a national, three-year, retrospective analysis of VA patients' use of eleven VA-covered therapies: chiropractic care, acupuncture, Battlefield Acupuncture, biofeedback, clinical hypnosis, guided imagery, massage therapy, meditation, Tai Chi/Qigong, and yoga.
We created a national cohort of veterans using VA healthcare from October 2016-September 2019.
Veterans' use of these approaches increased 70% in three years. By 2019, use was 5.7% among all VA patients, but highest among patients with chronic musculoskeletal pain (13.9%), post-traumatic stress disorder (PTSD; 10.6%), depression (10.4%), anxiety (10.2%), or obesity (7.8%). The approach used varied by age and race/ethnicity, with women being uniformly more likely than men to use each approach. Patients having chronic musculoskeletal pain, obesity, anxiety, depression, or PTSD were more likely than others to use each of the approaches.
Veterans' use of some approaches rapidly grew recently and was robust, especially among patients most in need. This information might help shape federal/state health policy on the provision of evidence-based CIH approaches and guide other healthcare institutions considering providing them.
Keywords: complementary and alternative medicine; complementary and integrative health; meditation; veteran; yoga.
PMID: 36451011 DOI: 10.1007/s11606-022-07889-4