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Use of Non-Pharmacological Pain Treatment Modalities Among Veterans with Chronic Pain: Results from a Cross-Sectional Survey.

Edmond SN, Becker WC, Driscoll MA, Decker SE, Higgins DM, Mattocks KM, Kerns RD, Haskell SG. Use of Non-Pharmacological Pain Treatment Modalities Among Veterans with Chronic Pain: Results from a Cross-Sectional Survey. Journal of general internal medicine. 2018 May 1; 33(Suppl 1):54-60.

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BACKGROUND: Despite strong evidence for the effectiveness of non-pharmacological pain treatment modalities (NPMs), little is known about the prevalence or correlates of NPM use. OBJECTIVE: This study examined rates and correlates of NPM use in a sample of veterans who served during recent conflicts. DESIGN: We examined rates and demographic and clinical correlates of self-reported NPM use (operationalized as psychological/behavioral therapies, exercise/movement therapies, and manual therapies). We calculated descriptive statistics and examined bivariate associations and multivariable associations using logistic regression. PARTICIPANTS: Participants were 460 veterans endorsing pain lasting = 3 months who completed the baseline survey of the Women Veterans Cohort Study (response rate 7.7%. MAIN MEASURES: Outcome was self-reported use of NPMs in the past 12 months. KEY RESULTS: Veterans were 33.76 years old (SD? = 10.72), 56.3% female, and 80.2% White. Regarding NPM use, 22.6% reported using psychological/behavioral, 50.9% used exercise/movement and 51.7% used manual therapies. Veterans with a college degree (vs. no degree; OR? = 2.51, 95% CI? = 1.46, 4.30, p? = 0.001) or those with worse mental health symptoms (OR? = 2.88, 95% CI? = 2.11, 3.93, p? < 0.001) were more likely to use psychological/behavioral therapies. Veterans who were female (OR? = 0.63, 95% CI? = 0.43, 0.93, p? = 0.02) or who used non-opioid pain medications (OR? = 1.82, 95% CI? = 1.146, 2.84, p? = 0.009) were more likely to use exercise/movement therapies. Veterans who were non-White (OR? = 0.57, 95% CI? = 0.5, 0.94, p? = 0.03), with greater educational attainment (OR? = 2.11, 95% CI? = 1.42, 3.15, p? < 0.001), or who used non-opioid pain medication (OR? = 1.71, 95% CI? = 1.09, 2.68, p? = 0.02) were more likely to use manual therapies. CONCLUSIONS: Results identified demographic and clinical characteristics among different NPMs, which may indicate differences in veteran treatment preferences or provider referral patterns. Further study of provider referral patterns and veteran treatment preferences is needed to inform interventions to increase NPM utilization. Research is also need to identify demographic and clinical correlates of clinical outcomes related to NPM use.

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