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Many VA Patients Use and are Interested in Learning More about Complementary and Integrated Health Options


BACKGROUND:
Non-pharmacological treatment options for common conditions such as chronic pain, anxiety, and depression are being given increased consideration in healthcare. For example, the Department of Health and Human Services' National Pain Strategy and the American College of Physicians' chronic low back pain clinical practice guidelines recommend complementary and integrative health (CIH) approaches, such as tai chi, yoga, and acupuncture, among suggested non-pharmacological treatment options. In part to guide the expansion of evidence-based CIH, VA leaders sought current information on Veterans' interest in and use of various CIH approaches, both inside and outside the VA healthcare system. Thus, investigators in this study analyzed survey results from a large sample of Veterans on their interest in, use of, and satisfactions with 26 CIH approaches. From July 17 through July 25, 2017, 1,230 members of the national VHA Veteran Insights Panel (VIP) completed the survey. The VIP is a national online group of Veterans who regularly use VA care; VIP enables them to provide feedback on VA programs and services. The 26 CIH approaches included in the survey were those being provided at some VA medical centers (i.e., acupuncture, biofeedback, massage therapy, meditation/mindfulness, reflexology, yoga, and tai chi), although the evidence base for some is stronger than for others.

FINDINGS:

  • In the past year, 52% of Veterans in this study used any CIH approach, with 44% using massage therapy, 37% using chiropractic, 34% using mindfulness, 24% using other meditation, and 25% using yoga. Pain, stress reduction/relaxation, and improving overall health and well-being were the top three reasons for using 9 of the 26 CIH approaches.
  • Overall, 84% of Veterans in this study stated an interest in trying/learning more about at least one CIH approach, with about half being interested in six individual approaches (massage therapy, chiropractic, acupuncture, acupressure, reflexology, and progressive relaxation).
  • Veterans appeared to be much more likely to use each CIH approach outside vs. within VA.

IMPLICATIONS:

  • To address the gap between patients' level of interest in and use of CIH approaches, primary care providers should consider discussing evidence-based CIH options with their patients for relevant health conditions, given that most CIH approaches are safe.

LIMITATIONS:

  • The study did not use a random sample of Veterans, so it might be that Veterans who were interested in CIH approaches were more likely than others to complete the survey. As such, the rates of use and interest among the wider Veteran population could be lower.

AUTHOR/FUNDING INFORMATION:
This study was funded through VA HSR&D's Quality Enhancement Research Initiative (QUERI). Dr. Taylor leads QUERI's Complementary and Integrative Health Evaluation Center and is with HSR&D's Center for the Study of Healthcare Innovation, Implementation and Policy (CSHIIP) in Los Angeles, CA. Dr. Hoggatt is with HSR&D's Center for Innovation to Implementation (Ci2i) in Palo Alto, CA.


PubMed Logo Taylor S, Hoggatt K, and Kligler B. Complementary and Integrated Health Approaches: What Do Veterans Use and Want? Journal of General Internal Medicine. April 22, 2019; E-pub 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.