December 2016

In this Issue: Improving Treatment of Pain among Veterans
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Cost-Effectiveness of Complementary and Alternative Treatments to Reduce Pain

Ongoing study

Chronic musculoskeletal disorder (MSD) pain (i.e., head, neck, knee, and back pain), is highly prevalent among Veterans of the wars in Iraq and Afghanistan, with one study showing more half reporting MSD pain. Some complementary and integrative health (CIH) – formerly known as complementary and alternative medicine or CAM – therapies appear effective in treating pain and its comorbidities. This is the first widespread study of the overall impact of CIH use on healthcare utilization and healthcare cost at the VA. Specific aims also include determining the cost-effectiveness of adjunctive CIH use compared to usual care alone, as well as the healthcare cost impact of CIH use with both pain and pain-comorbid conditions.

Study participants include all Veterans of the Iraq and Afghanistan wars with MSD pain who were treated in the VA healthcare system from 2010 to 2013. Investigators are examining the cost of one year of healthcare use for Veterans with MSD pain diagnoses compared to those who have and have not used CIH at the VA. Investigators then will compare patient self-report of pain levels over the same year between those who did and did not use CIH. They also will conduct this analysis among Veterans with MSD pain comorbid conditions, such as traumatic brain injury and mental health conditions (i.e., PTSD, substance abuse disorder, anxiety, and depression).

Impact

The results of this cost-effectiveness study will help VA determine the extent to which types of CIH can be a cost-effective way to reduce MSD pain and address its comorbid conditions given limited resources. Findings also will be used to better facilitate the integration of these results into recommendations for VA delivery of CIH, using an advisory board of key VA stakeholders.

Principal Investigator: Stephanie Taylor, PhD, MPH, is Associate Director of HSR&D's Center for Healthcare Innovation, Implementation and Policy (CSHIIP) in Los Angeles, CA, and Director of the national VA Complementary and Integrative Health Evaluation Center; and Co-PI: Karl Lorenz, MD, MSHS, is part of HSR&D's Center for Innovation to Implementation (Ci2i), and Section Chief, VA Palo Alto - Stanford University Palliative Care Programs.

See HSR&D Project Abstract