We Built it, But Did They Come: Veterans’ Use of VA Healthcare System-Provided Complementary and Integrative Health Approaches

Background Interest in complementary and integrative health (CIH) approaches, such as meditation, yoga, and acupuncture, continues to grow. The evidence of effectiveness for some CIH approaches has increased in the last decade, especially for pain, with many being recommended in varying degrees in n...

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Published in:	Journal of general internal medicine : JGIM Vol. 38; no. 4; pp. 905 - 912
Main Authors:	Taylor, Stephanie L., Gelman, Hannah M., DeFaccio, Rian, Douglas, Jamie, Hawrilenko, Matthew J., McGinty, Nathan K., Resnick, Adam, Tomlanovich, Nathan C., Toyama, Joy, Whitehead, Alison M., Kligler, Benjamin, Zeliadt, Steven B.
Format:	Journal Article
Language:	English
Published:	Cham Springer International Publishing 01-03-2023 Springer Nature B.V
Subjects:	Acupuncture Alternative medicine Anxiety Battlefields Biofeedback Chiropractic medicine Chronic pain Chronic Pain - epidemiology Chronic Pain - therapy Complementary Therapies Delivery of Health Care, Integrated Electronic health records Electronic medical records Feedback Female Health care Health care policy Health policy Humans Hypnosis Internal Medicine Male Medicine Medicine & Public Health Meditation Mental depression Mental disorders Minority & ethnic groups Musculoskeletal Pain - therapy Obesity Original Research Pain Patients Post traumatic stress disorder Psychological stress Retrospective Studies United States - epidemiology United States Department of Veterans Affairs Veterans Veterans Health United States yoga veteran complementary and integrative health complementary and alternative medicine meditation
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Summary:	Background Interest in complementary and integrative health (CIH) approaches, such as meditation, yoga, and acupuncture, continues to grow. The evidence of effectiveness for some CIH approaches has increased in the last decade, especially for pain, with many being recommended in varying degrees in national guidelines. To offer nonpharmacological health management options and meet patient demand, the nation’s largest integrated healthcare system, the Veterans Health Administration (VA), greatly expanded their provision of CIH approaches recently. Objective This paper addressed the questions of how many VA patients might use CIH approaches and chiropractic care if they were available at modest to no fee, and would patients with some health conditions or characteristics be more likely than others to use these therapies. Design Using electronic medical records, we conducted a national, three-year, retrospective analysis of VA patients’ use of eleven VA-covered therapies: chiropractic care, acupuncture, Battlefield Acupuncture, biofeedback, clinical hypnosis, guided imagery, massage therapy, meditation, Tai Chi/Qigong, and yoga. Participants We created a national cohort of veterans using VA healthcare from October 2016–September 2019. Key Results Veterans’ use of these approaches increased 70% in three years. By 2019, use was 5.7% among all VA patients, but highest among patients with chronic musculoskeletal pain (13.9%), post-traumatic stress disorder (PTSD; 10.6%), depression (10.4%), anxiety (10.2%), or obesity (7.8%). The approach used varied by age and race/ethnicity, with women being uniformly more likely than men to use each approach. Patients having chronic musculoskeletal pain, obesity, anxiety, depression, or PTSD were more likely than others to use each of the approaches. Conclusions Veterans’ use of some approaches rapidly grew recently and was robust, especially among patients most in need. This information might help shape federal/state health policy on the provision of evidence-based CIH approaches and guide other healthcare institutions considering providing them.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0884-8734 1525-1497
DOI:	10.1007/s11606-022-07889-4