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The majority of individuals infected with SARS-CoV-2 have mild-to-moderate COVID-19 disease. Convalescence from mild-to-moderate (MtoM) COVID-19 disease may be supported by integrative medicine strategies. Integrative Medicine (IM) is defined as healing-oriented medicine that takes account of the whole person, including all aspects of lifestyle. Integrative medicine strategies that may support recovery from MtoM COVID-19 are proposed given their clinically studied effects in related conditions. Adoption of an anti-inflammatory diet, supplementation with vitamin D, glutathione, melatonin, Cordyceps, Astragalus and garlic have potential utility. Osteopathic manipulation, Qigong, breathing exercises and aerobic exercise may support pulmonary recovery. Stress reduction, environmental optimization, creative expression and aromatherapy can provide healing support and minimize enduring trauma. These modalities would benefit from clinical trials in people recovering from COVID-19 infection.

This study was performed to investigate the effect of live, spontaneous harp music on individual patients in an intensive care unit (ICU), either pre- or postoperatively. The purpose was to determine whether this intervention would serve as a relaxation or healing modality, as evidenced by the effect on patient's pain, heart rate, respiratory rate, blood pressure, oxygen saturation, and heart rate variability. Each consenting patient was randomly assigned to receive either a live 10-minute concert of spontaneous music played by an expert harpist or a 10-minute rest period. Spontaneous harp music significantly decreased patient perception of pain by 27% but did not significantly affect heart rate, respiratory rate, oxygen saturation, blood pressure, or heart rate variability. Trends emerged, although being not statistically significant, that systolic blood pressure increased while heart rate variability decreased. These findings may invoke patient engagement, as opposed to relaxation, as the underlying mechanism of the decrease in the patients' pain and of the healing benefit that arises from the relationship between healer, healing modality, and patient.

Background and Objectives: Opioid misuse is at an all-time crisis level, and nationally enhanced resident and clinician education on chronic pain management is in demand. To date, broad-reaching, scalable, integrative pain management educational interventions have not been evaluated for effectiveness on learner knowledge or attitudes toward chronic pain management. Methods: An 11-hour integrative pain management (IPM) online course was evaluated for effect on resident and faculty attitudes toward and knowledge about chronic pain. Participants were recruited from family medicine residencies participating in the integrative medicine in residency program. Twenty-two residencies participated, with 11 receiving the course and 11 serving as a control group. Evaluation included pre/post medical knowledge and validated measures of attitude toward pain patients, self-efficacy for nondrug therapies, burnout, and compassion. Results: Forty-three participants (34.4%) completed the course. The intervention group (n=50), who received the course, improved significantly (P<.05) in medical knowledge, attitude toward pain patients, and self-efficacy to prescribe nondrug therapies while the control group (n=54) showed no improvement. There was no effect on burnout or compassion for either group. The course was positively evaluated, with 83%-94% rating the course content and delivery very high. All participants responded that they would incorporate course information into practice, and almost all thought what they learned in the course would improve patient care (98%). Conclusions: Our findings demonstrate the feasibility of an online IPM course as an effective and scalable intervention for residents and primary care providers in response to the current opioid crisis and need for better management of chronic pain. Future directions include testing scalability in formats that lead to improved completion rates, implementation in nonacademic settings, and evaluation of clinical outcomes such as decreased opioid prescribing.

Energy medicine (EM) refers to a range of techniques and healing modalities that alter the underlying energy field of the body. Energy is stimulated or moved within the body to restore an energy balance through a variety of modalities that include hands-on healing or vibration applied to the body and through movement or sound. Sleep is impaired when the body’s energy is imbalanced and an excess of energy is activated or carried too high in the body. The evidence specifically examining the effect of energy techniques on sleep is limited, with small studies demonstrating benefit with hands-on healing techniques for intensive-care patients and those with cancer and/or chronic pain. There is moderate evidence that energy medicine significantly decreases many types of chronic pain, and it is most utilized in patients with chronic pain syndromes. In addition, weak evidence exists for energy medicine and decreased anxiety. It is extrapolated by many practitioners that the effect on pain and anxiety will result in better sleep. In addition, most energy medicine modalities have techniques specific for improving for sleep that can be done by a practitioner or can be taught to a patient for self-healing. Finding a skilled practitioner or learning self-healing energy techniques for sleep can be valuable additions to a patient’s plan of care.

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alternative, data-driven proactive patient identification (aka ''trigger programs'') for palliative care services have been credited with strong improvements in quality, satisfaction, and utilization. In fact, there is a growing industry of vendors creating proprietary data-driven algorithms to identify different subsets of patients, including those most likely to benefit from palliative care. While some organizations report huge successes with trigger programs, others find that triggers are underutilized, ineffective in achieving targeted outcomes, or generate patient volumes beyond the capacity of the palliative care team. Still others struggle with implementing trigger programs in the first place, due to concerns about HIPAA compliance or objections from other departments and specialties. This session will walk attendees through the details of implementing a data-driven patient identification program. The session first covers the common core data elements in identification algorithms and how they vary from an inpatient to a community-based setting. Next, the session will review the key steps in the process of implementing a proactive patient identification program. Lastly, triggers create a very different relationship with treating clinicians, and will likely identify patients that some may not think to refer. Thus, the session ends with an exploration of how successful trigger programs incorporate treating clinicians, securing buy-in and sustaining those relationships over time.

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