Author: Taona P Haderlein1,2, Steven B Zeliadt3,4, Alexander T Kloehn3,4, Briana D Lott5, Joy Toyama1, Adam Resnick5, A Rani Elwy6,7, Claudia Der-Martirosian1,2, Stephanie L Taylor1,8
Affiliation: <sup>1</sup> VHA HSR&D Center for the Study of Health Care Innovation, Implementation, and Policy, Greater Los Angeles VA Medical Center, Los Angeles, California, USA.
<sup>2</sup> Veterans Emergency Management Evaluation Center, U.S. Department of Veterans Affairs, North Hills, California, USA.
<sup>3</sup> VA Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound Healthcare System, Seattle, Washington, USA.
<sup>4</sup> Department of Health Systems and Population Health, School of Public Health, University of Washington, Seattle, Washington, USA.
<sup>5</sup> VA Greater Los Angeles Healthcare System, West Los Angeles, California, USA.
<sup>6</sup> Center for Healthcare Organization and Implementation Research, Edith Bourse Rogers Memorial Veterans Hospital, Bedford, Massachusetts, USA.
<sup>7</sup> Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA.
<sup>8</sup> Department of Medicine and Department of Health Policy and Management, University of California Los Angeles, Los Angeles, California, USA.
Conference/Journal: Telemed J E Health
Date published: 2024 Sep 11
Other:
Special Notes: doi: 10.1089/tmj.2024.0060. , Word Count: 260
Background: Virtual complementary and integrative health (CIH) therapy availability increased during the COVID-19 pandemic, but little is known about effectiveness. We examined the perceived effectiveness of in-person and virtual CIH therapies for patients with chronic musculoskeletal pain who recently started using CIH therapies. Methods: The sample included Veterans (n = 1,091) with chronic musculoskeletal pain, identified in the Veterans Health Administration's electronic health record based on initiation of CIH therapy use, who responded to VA's Patient Complementary and Integrative Health Therapy Experience Survey during March, 2021, to August, 2022. Using multivariable models with self-guided virtual (apps or videos) delivery as the reference, we compared patient-reported outcomes (pain, mental health, fatigue, and general well-being) associated with any yoga, Tai Chi/Qigong, or meditation use delivered: (1) only in-person, (2) only virtually with a live provider, (3) only virtually self-guided, (4) virtually self-guided + virtually provider-guided, or (5) hybrid in-person + virtual (self-or provider-guided). Results: Under 10% of Veterans reported only in-person use; 54% used only virtual formats and 36% a hybrid of in-person and virtual. Forty-one percent reported improvement in general well-being, 40.6% in mental health, 37.1% in pain, and 22.7% in fatigue. Compared with Veterans using only self-guided virtual CIH therapies, Veterans using only in-person therapies were more likely to report improvement in fatigue (odds ratio [OR]: 1.8, confidence interval [CI]: 1.1-3.1) and general well-being (OR: 1.7, CI: 1.0-2.6). Conclusions: Many patients perceived health improvements from CIH therapies, with in-person users reporting more improvement in fatigue and well-being than those using virtual sessions and similar improvements in pain and mental health for in-person and hybrid users.
Keywords: COVID-19; Veterans; complementary and integrative therapies; musculoskeletal pain; telemedicine.
PMID: 39258762 DOI: 10.1089/tmj.2024.0060