Efficacy of selected complementary and alternative medicine interventions for chronic pain

Tan, Gabriel; Craine, Michael; Bair, Matthew J.; Garcia, M. Kay; Giordano, James; Jensen, Mark P.; McDonald, Shelley M.; Patterson, David R.; Sherman, Richard A.; Williams, Wright; Tsao, Jennie C.I.

doi:10.1682/jrrd.2006.06.0063

Cited by 50 publications

(24 citation statements)

References 151 publications

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“…However, since CAM treatments typically do not use expensive medical equipment or invasive procedures, the cost is typically lower for CAM treatments than for traditional treatments [50]; Lafferty et al found that median cost of visits to CAM providers was $39.00 versus the median cost of $74.40 for visits to allopathic providers [51]. Importantly, since each of the CAM options studied here has demonstrated effectiveness for chronic pain [27][28][29][30], patient outcomes might be expected to improve as a result of their use. Indeed, one systematic review found evidence to support the cost-effectiveness of CAM modalities, especially for use with migraine and neck pain [52].…”

Section: Discussionmentioning

confidence: 99%

“…We chose these modalities because they have been supported by prior research for use with chronic pain [27][28][29][30] but may not necessarily be offered as a treatment option in VA facilities. The CAM items were embedded in a 15-item measure that assessed various approaches to pain management.…”

Section: Cam Treatment Use and Willingnessmentioning

confidence: 99%

“…As part of the Study of the Effectiveness of a Collaborative Approach to Pain (SEACAP), we surveyed veterans about their prior use of and their willingness to try four CAM treatment modalities previously supported by research for use with chronic pain [27][28][29][30]: massage therapy, chiropractic care, herbal medicines, and acupuncture. Specifically, we were interested in whether veterans with chronic pain reported using CAM at levels previously observed in the general public and which treatment modalities were the most appealing to this population.…”

Section: Introductionmentioning

confidence: 99%

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Complementary and alternative medicine use among veterans with chronic noncancer pain

Denneson

Corson

Dobscha³

2011

JRRD

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Abstract-We describe prior use and willingness to try complementary and alternative medicine (CAM) among 401 veterans experiencing chronic noncancer pain and explore differences between CAM users and nonusers. Participants in a randomized controlled trial of a collaborative intervention for chronic pain from five Department of Veterans Affairs (VA) primary care clinics self-reported prior use and willingness to try chiropractic care, massage therapy, herbal medicines, and acupuncture. Prior CAM users were compared with nonusers on demographic characteristics, pain-related clinical characteristics, disease burden, and treatment satisfaction. A majority of veterans (n = 327, 82%) reported prior use of at least one CAM modality, and nearly all (n = 399, 99%) were willing to try CAM treatment for pain. Chiropractic care was the least preferred option, whereas massage therapy was the most preferred (75% and 96%, respectively). CAM users were less likely to have service-connection disabilities (54% vs 68%; chi square = 4.64, p = 0.03) and reported having spent a larger percentage of their lives in pain (26% vs 20%; Z = 1.40, p = 0.04) than nonusers. We detected few differences between veterans who had tried CAM and those who had not, suggesting that CAM may have broad appeal among veterans with chronic pain. Implications for VA policy and practice and for clinicians treating veterans with chronic pain are discussed.Clinical Trial Registration: ClinicalTrials.gov. NCT00129480, "Improving the Treatment of Chronic Pain in Primary Care"; http://www.clinicaltrials.gov.

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Section: Discussionmentioning

confidence: 99%

Section: Cam Treatment Use and Willingnessmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Complementary and alternative medicine use among veterans with chronic noncancer pain

Denneson

Corson

Dobscha³

2011

JRRD

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“…The Veteran’s goal is to find new approaches to managing and/or rehabilitating from chronic pain, anxiety, post-traumatic stress disorder (PTSD), and other troubling symptoms, which significantly affect health and quality of life. Research on many of these therapies has shown promising results [2–8]. The Department of Veterans Affairs (VA) is exploring ways to meet this demand for access to CIH when combined with conventional medical care.…”

Section: Introductionmentioning

confidence: 99%

Perceptions of other integrative health therapies by Veterans with pain who are receiving massage

Fletcher¹,

Mitchinson²,

Trumble³

et al. 2016

J Rehabil Res Dev

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Veterans are increasingly using complementary and integrative health (CIH) therapies to manage chronic pain and other troubling symptoms that significantly impair health and quality of life. The Department of Veterans Affairs (VA) is exploring ways to meet the demand for access to CIH, but little is known about Veterans’ perceptions of the VA’s efforts. To address this knowledge gap, we conducted interviews of 15 inpatients, 8 receiving palliative care, and 15 outpatients receiving CIH in the VA. Pain was the precipitating factor in all participants’ experience. Participants were asked about their experience in the VA and their opinions about which therapies would most benefit other Veterans. Participants reported that massage was well-received and resulted in decreased pain, increased mobility, and decreased opioid use. Major challenges were the high ratio of patients to CIH providers, the difficulty in receiving CIH from fee-based CIH providers outside of the VA, cost issues, and the role of administrative decisions in the uneven deployment of CIH across the VA. If the VA is to meet its goal of offering personalized, proactive, patient-centered care nationwide then it must receive support from Congress while considering Veterans’ goals and concerns to ensure that the expanded provision of CIH improves outcomes.

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“…In line with these recommendations, sustained expansion of specialty pain medicine services over the past 5 years has been documented. Consistent with data on patient preferences [36], VHA is working to build capacity for complementary and alternative medicine services [37], especially acupuncture [38,39]. Models of integrative care are emerging [31,40] and are beginning to be evaluated for their efficacy and, ultimately, their cost-effectiveness.…”

Section: Step 2: Specialty Carementioning

confidence: 99%

Implementation of the Veterans Health Administration National Pain Management Strategy

Kerns

Philip

Lee

et al. 2011

Behav. Med. Pract. Policy Res.

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Since its introduction in 1998, the VHA National Pain Management Strategy has introduced and implemented a series of plans for promoting systems improvements in pain care. We present the milestones of VHA efforts in pain management as reflected by the work of the Strategy. This includes the development of the Strategy and its current structure as well as a review of important initiatives such as "pain as the fifth vital sign" and the stepped care model of pain management. KEYWORDS Pain, Pain management, Primary care, VeteransAccording to the Institute of Medicine's recently published report on the state of pain care in the United States, "Relieving Pain in America: A Blueprint for Transforming Pain Prevention, Care, Education, and Research" [1], as many as one-third of Americans experience persistent pain at a cost of as much as $635 billion. The report noted that military Veterans are a particularly vulnerable group with data documenting a particularly high prevalence of pain and extraordinary rates of complexity associated with multiple medical and mental health comorbidities.Data document that as many as 50% of male Veterans treated at Veterans Health Administration (VHA) primary care clinics report the presence of pain [2], and the prevalence may even be as high as 75% among female Veterans returning from Afghanistan in Operation Enduring Freedom (OEF) or Iraq in Operation Iraqi Freedom (OIF) [3]. Painful musculoskeletal conditions are the most highly prevalent cluster of diagnosed medical conditions among OEF/OIF Veterans surpassing the rates of all diagnosed mental health conditions combined. Published observational data document that pain is one of the most frequent presenting complaints for OEF/OIF Veterans treated in the VHA particularly in patients with polytrauma [4][5][6]. In addition, reports suggest that the prevalence of pain complaints among Veterans is growing steadily with each passing year [7,8].Pain is associated with serious and diverse health problems. The presence of pain among Veterans receiving primary care in VHA facilities, relative to those not reporting pain, is associated with poorer self-rated health, greater utilization of healthcare resources, greater prevalence of health risk behaviors and factors such as tobacco use, excessive alcohol use, weight concerns, decreased social and physical activity, lower social support, and greater ratings of affective distress [9]. Among women Veterans, pain is associated with high rates of military and nonmilitary sexual harassment and trauma [10]. Finally, pain is also among the most costly disorders treated in VHA settings [11].This article describes a comprehensive VHA National Pain Management Strategy and its ambitious agenda for improving pain care for Veterans receiving care in its healthcare facilities. It includes a review of ongoing implementation efforts over the 1 PRIME Center/11ACSLG, VA Connecticut Healthcare System, West Haven, CT 06516, USA Implications Practice: A process including qualitative content evaluation, usabilit...

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Efficacy of selected complementary and alternative medicine interventions for chronic pain

Cited by 50 publications

References 151 publications

Complementary and alternative medicine use among veterans with chronic noncancer pain

Complementary and alternative medicine use among veterans with chronic noncancer pain

Perceptions of other integrative health therapies by Veterans with pain who are receiving massage

Implementation of the Veterans Health Administration National Pain Management Strategy

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