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2015 HSR&D/QUERI National Conference Abstract

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3171 — Use of Complementary Alternative Medicine and Conventional Therapies for PTSD in a Veterans Administration Population:

Cohen BE, San Francisco VA Medical Center; Chesney MA, Osher Center for Integrative Medicine/University of California, San Francisco; Whooley MA, San Francisco VA Medical Center; Neylan TC, San Francisco VA Medical Center;

Objectives:
Many complementary alternative medicine (CAM) therapies are being studied for use in PTSD. If efficacious, these could expand therapeutic options for patients, including Veterans who decline conventional therapy. However, little is known about CAM use in Veterans with PTSD. Our goal was to examine self-reported use of CAM and traditional therapies for PTSD, the types of therapies used, and the patient characteristics associated with CAM use in a Veteran population.

Methods:
Patients from two San Francisco area VA medical centers (n = 683) completed an interview asking about their use of therapies for PTSD, including conventional medications, individual counseling, group counseling, or CAM therapies, with participants asked to specify the type of therapy. CAM therapies were classified according to definitions from the National Center for CAM. Standardized questionnaires were used to assess demographics, PTSD (the Clinician Administered PTSD Scale), depressive symptoms, combat exposure, self-rated overall health and quality of life, and health behaviors. Logistic regression models were used to examine patient characteristics associated with CAM use.

Results:
Of 292 participants who reported using any therapy for PTSD, 69 (24%) used CAM, and the majority of these participants (61%) used CAM in conjunction with conventional therapies. Among those using CAM, the most common types were meditation (49%), yoga (38%) and acupuncture (15%). Participants who used CAM were significantly more likely to have a higher level of education (p = .002), report less lifetime tobacco use (p = .008), be more physically active (p = .006), and report lower combat exposure (p = .02) than those who did not use CAM. Those who used CAM versus conventional therapies alone did not differ by age, race, sex, income, level of alcohol use, level of PTSD or depressive symptoms, overall health, or quality of life.

Implications:
These data indicate a substantial number of Veterans may use CAM to treat PTSD, often in conjunction with conventional therapies. CAM use may also be associated with other healthy behaviors, such as greater exercise and lower tobacco use.

Impacts:
Given the large number of patients who decline conventional therapies, further study of the efficacy of CAM therapies and patient preferences for use may increase treatment options for Veterans with PTSD.