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Research Suggests Battlefield Acupuncture is Immediate but Short-Term Pain Management Tool


BACKGROUND:
Given the prevalence of pain among the military and Veteran populations, VA and the DoD are committed to offering safe and practical non-pharmacologic options for pain management. One potentially effective therapy offered in DoD and VA settings for immediate, short-term pain relief is Battlefield Acupuncture (BFA) – a form of auricular acupuncture. This commentary summarizes work the authors have conducted to examine BFA’s implementation and effectiveness within the VA healthcare system. For example, their research team very recently conducted two examinations of BFA effectiveness for pain using a national sample of 11,406 patients receiving 28,438 procedures from 808 VA providers, using the self-reported Defense and Veterans Pain Rating Scale to assess pain pre- and immediately post-BFA delivery. In another study of a high-volume VA BFA clinic, they examined BFA’s effectiveness for self-reported pain when delivered in group versus individual settings and when delivered repeatedly over time. In addition to examining the effectiveness of BFA, they conducted two studies of BFA implementation in the VA healthcare system by conducting telephone interviews with 23 BFA providers across the nation from June 2017 to January 2018. These implementation studies examined barriers, facilitators, and successful strategies to implementing BFA, as well as VA providers’ perspectives on the advantages/disadvantages of BFA.

FINDINGS:

  • There is some evidence that BFA is a potentially effective, immediate, but short-term pain management tool that can be used in adjunct with other pain therapies.
  • BFA produced a minimal clinically important improvement in pain for over half of Veterans receiving it, including patients who recently filled opioid prescriptions or had significant psychological and physical comorbidities.
  • Both individual and group BFA sessions were effective.
  • BFA providers perceived BFA as having many benefits; they also reported that it was low risk and easy to deliver.

IMPLICATIONS:

  • Given its effectiveness in providing immediate, short-term pain relief, from the perspective of both providers and patients, BFA is one potentially important tool to address pain. BFA also may provide a “window” to allow some patients to engage in more long-term self-management approaches (i.e., yoga and Tai Chi) to address their chronic pain.

LIMITATIONS:

  • The pre-post study designs may not have controlled for historical trends, and differences in outcomes may also be attributed to variation in provider delivery.

AUTHOR/FUNDING INFORMATION:
This study was funded by HSR&D’s Quality Enhancement Research Initiative (QUERI) and VA’s Office of Patient Centered Care and Cultural Transformation. Dr. Taylor is part of HSR&D’s Center for the Study of Healthcare Innovation, Implementation and Policy (CSHIIP); Dr. Giannitrapani is with HSR&D’s Center for Innovation to Implementation (Ci2i); and Dr. Ackland is part of HSR&D’s Center for Care Delivery and Outcomes Research (CCDOR).


Taylor S, Giannitrapani K, Ackland P, et al. The Implementation and Effectiveness of Battlefield Auricular Acupuncture for Pain. Pain Medicine. March 26, 2021. Online ahead of print.

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What are HSR&D Publication Briefs?

HSR&D requires notification by HSR&D-funded investigators about all articles accepted for publication. These journal articles are reviewed by HSR&D and publication briefs or summaries are written for a select number of articles that are then forwarded to VHA Central Office leadership to keep them informed about important findings or information. Articles to be summarized are selected by HSR&D based on timeliness of the findings, interest of leadership, or potential impact on the organization. Publication briefs are written for only a small number of HSR&D published articles. Visit the HSR&D citations database for a complete listing of HSR&D articles and presentations.


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