Participating in Complementary and Integrative Health Approaches Is Associated With Veterans' Patient-reported Outcomes Over Time
Author: A Rani Elwy1,2, Stephanie L Taylor3,4, Shibei Zhao1, Michael McGowan3, Dorothy N Plumb1, Wendy Westleigh5, Lauren Gaj1, Grace W Yan6, Barbara G Bokhour1,7
Affiliation:
1 VA Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA.
2 Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI.
3 HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Health Care System.
4 Department of Health Policy and Management, University of California, Los Angeles, Los Angeles, CA.
5 Veterans Affairs New Jersey Healthcare System, East Orange.
6 VA National Office of Patient Centered Care & Cultural Transformation, New Jersey VA Health Care System, Lyons, NJ.
7 Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA.
Conference/Journal: Med Care
Date published: 2020 Sep 1
Other:
Volume ID: 58 Suppl 2 9S , Pages: S125-S132 , Special Notes: doi: 10.1097/MLR.0000000000001357. , Word Count: 260
Background:
Veterans Affairs is dedicated to providing a Whole Health approach to care, including offering complementary and integrative health (CIH) approaches to Veterans.
Objective:
The objective of this study was to examine the association of CIH participation with Veterans' patient-reported outcomes over time.
Research design:
A survey of patient-reported outcomes at 5 timepoints: baseline, 2, 4, 6, and 12 months.
Subjects:
Veterans participating in any type of CIH approach at 2 Veterans Affairs medical centers.
Measures:
Mixed hierarchical models with repeated variables were used to test the hypothesis that participating in any CIH approach would be associated with Veterans' overall physical/mental health [Patient-Reported Outcomes Measurement Information System 28 (PROMIS 28)], pain intensity, perceived stress (Perceived Stress Scale-4), and engagement in their care (Patient Activation Measure-13), controlling for age, male sex, site, participation in other CIH approaches, and surveys completed.
Results:
We received 401 surveys from 119 Veterans (72% male, age range: 29-85 y) across all timepoints. Yoga participation was related to decreases in perceived stress (P<0.001), while tai chi participation was associated with improvements in overall PROMIS 28 physical and mental health functioning (P<0.02). Specific types of CIH were associated with significant improvements in PROMIS 28 subscales: meditation participation with physical functioning at 2, 6, and 12 months; tai chi participation with anxiety at 2 and 6 months, and ability to participate in social role activities at 2 months. No CIH approach was associated with Veterans' pain or engagement in their care.
Conclusion:
As specific CIH approaches are associated with improvements in patient-reported outcomes, clinicians, Veterans, and family members may use this information in discussions of nonpharmacological options to address health and well-being.
PMID: 32826782 DOI: 10.1097/MLR.0000000000001357
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