Qigong Institute

Author: Steven B Zeliadt^1,2, Scott Coggeshall¹, Xiaoyi Zhang^1,3, Ethan W Rosser¹, David E Reed Ii^1,2, A Rani Elwy^4,5, Barbara G Bokhour^4,6, Joy A Toyama⁷, Stephanie L Taylor^7,8,9
Affiliation:
¹ Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound Health Care System, Seattle, WA 98108, United States.
² Department of Health Systems and Population Health, School of Public Health, University of Washington, Seattle, WA 98195, United States.
³ Department of Biomedical Informatics and Medical Information, School of Medicine, University of Washington, Seattle, WA 98195, United States.
⁴ Center for Health Optimization and Implementation Research, VA Bedford Health Care System, Bedford, MA 01730, United States.
⁵ Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI 02912, United States.
⁶ Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA 01655, United States.
⁷ Center for the Study of Healthcare Innovation, Implementation and Policy, Greater Los Angeles VA Health Care System, Los Angeles, CA 90073, United States.
⁸ Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA 90095, United States.
⁹ Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, United States.
Conference/Journal: Pain Med
Date published: 2024 Nov 1
Other: Volume ID: 25 , Issue ID: Supplement_1 , Pages: S54-S63 , Special Notes: doi: 10.1093/pm/pnae070. , Word Count: 279

Objective:
Beliefs and perceptions about pain intervention effectiveness when initiating a therapy may influence long-term engagement. This study examines how early perceived effectiveness of complementary and integrative health therapies impacts long-term engagement in a pragmatic trial context.

Participants:
Veterans with chronic musculoskeletal pain participating in a pragmatic trial of provider-delivered complementary and integrative health therapies (acupuncture, chiropractic care, or massage therapy) used alone compared to combining those therapies with self-care therapies (yoga, Tai Chi/Qigong, or meditation). This analysis focuses on 1713 participants using self-care therapies at baseline.

Setting:
18 Veterans Healthcare Administration Medical Facilities.

Design:
Prospective cohort study.

Methods:
Predictors of total self-care complementary and integrative health therapy sessions over a 6-month assessment period were assessed using linear regression to determine how strongly perceptions of initial therapy effectiveness was associated with total utilization. Perception of initial therapy effectiveness was assessed at study entry across four domains (pain, mental health, fatigue, and general well-being).

Results:
In total, 56% (1032/1713) of Veterans reported a positive perceived effectiveness of their recent complementary and integrative health therapy use at study initiation. Older individuals and those using meditation were more likely to report early positive perceptions. Mean number of therapy sessions over the 6-month study was 11 (range 1 to 168). Early positive perceptions had a small effect on overall use, increasing mean sessions by 2.5 (1.3 to 3.6). Other factors such as recent physical therapy use and distance to primary care explained more variation in total utilization.

Conclusions:
Pragmatic pain trials should examine factors associated with engagement across assigned treatment protocols, especially if any of the treatment protocols being tested are sensitive to long-term engagement.

Keywords: chronic pain; complementary therapies; mind-body therapies; musculoskeletal pain veterans health; patient adherence.

PMID: 39514886 DOI: 10.1093/pm/pnae070

Qigong and Energy Medicine Database™

How initial perceptions of the effectiveness of mind and body complementary and integrative health therapies influence long-term adherence in a pragmatic trial