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Publication Briefs

Women Veterans with Pain More Likely to Use Complementary and Integrative Therapies

Women Veterans are prescribed opioids for chronic pain more than men. Research findings underscore a critical need to better understand gender-specific healthcare needs, use, and outcomes among Veterans being treated for chronic pain. VA promotes evidence-based complementary and integrative health (CIH) therapies as non-pharmacological approaches for chronic pain. This study sought to examine CIH therapy use by gender among Veterans with chronic musculoskeletal pain, and variations in gender differences by race/ethnicity and age. Investigators examined electronic health record data from a cohort of Veterans aged 18-54 with chronic musculoskeletal pain who received VA healthcare any time from 2010-2013 (n= 79,537 women and 389,269 men). CIH therapies included meditation, yoga, tai chi, acupuncture, chiropractic care, biofeedback, guided imagery, therapeutic massage, and hypnosis.


  • Of Veterans with chronic musculoskeletal pain, more women than men used CIH therapies (36% vs. 26%).
  • Black women, regardless of age, were least likely to use CIH therapies compared to other women.
  • Among men, White and Black Veterans were less likely to use CIH therapies, irrespective of age, than men of Hispanic or other race/ethnicities.
  • Among both women and men, CIH therapies were least likely to be used by younger Black or White Veterans.

Given the disparities in CIH therapy use, tailoring CIH therapy engagement to gender, race/ethnicity, and age may increase CIH therapy use among Veterans.


  • Investigators relied on administrative medical record data, which are subject to reporting biases.
  • Findings may not be representative of Veterans older than age 54 or treated in other types of healthcare settings, or of how Veterans are being treated currently.
  • Investigators did not examine variation in availability of CIH therapies and association with CIH use.

Drs. Washington, Yuan, Hamilton, and Taylor are with HSR&D's Center for the Study of Healthcare Innovation, Implementation and Policy, Los Angeles, CA. Drs. Lorenz and Marshall are with HSR&D's Center for Innovation to Implementation, Palo Alto, CA.

PubMed Logo Evans E, Herman P, Washington D, Lorenz KA, Yuan A, Upchurch DM, Marshall N, Hamilton AB, Taylor SL. Gender Differences in Use of Complementary and Integrative Health by U.S. Military Veterans with Chronic Musculoskeletal Pain. Women’s Health Issues. September-October 2018;28(5):379-86.

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What are HSR Publication Briefs?

HSR requires notification by HSR-funded investigators about all articles accepted for publication. These journal articles are reviewed by HSR 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 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 published articles. Visit the HSR citations database for a complete listing of HSR articles and presentations.

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