Patient Reports on How Well Combining Provider-Delivered and Self-Directed Complementary and Integrative Health Therapies Help Their Health and Well-Being.

Medich M, Shin MH, McGowan MG, Kasom DR, Lott B, Zeliadt SB, Taylor SL. Patient Reports on How Well Combining Provider-Delivered and Self-Directed Complementary and Integrative Health Therapies Help Their Health and Well-Being. Global advances in integrative medicine and health. 2025 Dec 13; 14:27536130251390862, DOI: 10.1177/27536130251390862.

Related HSR&D Project(s)

• RCS 23-082 – HSR&D Research Career Scientist Award
• SDR 17-306 – Complementary and Integrative Health for Pain in the VA: A National Demonstration Project (NIH-VA-DOD Joint Initiative)

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Abstract:

BACKGROUND: Some practitioner-delivered (eg, acupuncture) and self-directed (eg, yoga) complementary and integrative health (CIH) therapies are evidence-based for chronic pain management. Providers often follow recommendations to encourage patients to take active roles in their health care by using self-directed therapies in addition to CIH therapies they deliver. Doing so might be more effective than using practitioner-delivered CIH therapies alone, however we are unaware of studies qualitatively examining this issue. OBJECTIVE: As part of our VA pragmatic study APPROACH (Assessing Pain, Patient-Reported Outcomes and Complementary and Integrative Health) among 6453 veterans with chronic musculoskeletal pain, we qualitatively examined patients' narrative reports of CIH therapy use to explore how using practitioner-delivered CIH therapies with and without self-directed CIH therapies affected their health and well-being. METHODS: We conducted qualitative telephone interviews with 125 patients at six VA medical centers from March 2022 March 2023, asking if their use of CIH therapies affected several health conditions: depression, anxiety, pain, fatigue, sleep, quality of life, and self-empowerment to take care of one's own health. We used deductive and inductive thematic analysis. RESULTS: Half or more of reported CIH therapies helped their pain, quality of life, depression, sleep, and self-empowerment to take care of their own health, but few reported the therapies affected fatigue. Using a combination of practitioner-delivered and self-directed CIH therapies appeared more helpful than using only practitioner-delivered therapies for depression, anxiety, quality of life, fatigue, and self-empowerment. However, for pain or sleep, similar percentages of patients reported using a combination or only practitioner-delivered CIH therapies helped. CONCLUSIONS: Using a combination of practitioner-delivered CIH therapies appear more helpful than using only practitioner-delivered therapies for most examined health conditions, except they appeared similarly helpful for pain and sleep. Chiropractors, acupuncturists and massage therapists might want to encourage patients to participate in self-directed therapies.