Whole Health Use and Interest Across Veterans With Co-Occurring Chronic Pain and PTSD: An Examination of the 18 VA Medical Center Flagship Sites

Abstract

Objective Veterans Healthcare Administration (VHA) conducted a large demonstration project of a holistic Whole Health approach to care in 18 medical centers, which included making complementary and integrative health (CIH) therapies more widely available. This evaluation examines patterns of service use among Veterans with chronic pain, comparing those with and without PTSD. Methods We assessed the use of Whole Health services in a cohort of Veterans with co-occurring chronic pain and PTSD (n = 1698; 28.9%), comparing them to Veterans with chronic musculoskeletal pain only (n = 4170; 71.1%). Data was gathered from VA electronic medical records and survey self-report. Whole Health services were divided into Core Whole Health services (e.g., Whole Health coaching) and CIH services (e.g., yoga). Logistic regression was used to determine whether Veterans with co-occurring chronic pain and PTSD utilized more Whole Health services compared to Veterans with chronic pain but without PTSD. Results A total of 40.1% of Veterans with chronic pain and PTSD utilized Core Whole Health services and 53.2% utilized CIH therapies, compared to 28.3% and 40.0%, respectively, for Veterans with only chronic pain. Adjusting for demographics and additional comorbidities, Veterans with comorbid chronic pain and PTSD were 1.24 ( 95% CI: 1.12, 1.35, P ≤ .001) times more likely than Veterans with chronic pain only to use Core Whole Health services, and 1.23 ( 95% CI: 1.14, 1.31, P ≤ .001) times more likely to use CIH therapies. Survey results also showed high interest levels in Core Whole Health services and CIH therapies among Veterans who were not already using these services. Conclusion Early implementation efforts in VHA led to high rates of use of Core Whole Health and CIH therapy use among Veterans with co-occurring chronic pain and PTSD. Future assessments should examine how well these additional services are meeting the needs of Veterans in both groups.

Examining the Veterans Health Administration whole health model of care within the context of posttraumatic stress disorder.

“…Nevertheless, determining whether VA’s Whole Health approach to care improves important patient-centered outcomes is critical. Prior research has shown that veterans, including those with PTSD, are generally interested in Whole Health and CIH services (Reed et al, 2022; Taylor et al, 2019). Our research extends this work on interest in Whole Health and CIH services by showing that veterans with PTSD are also using these services.…”

Meeting the Needs of Rural Veterans: A Qualitative Evaluation of Whole Health Coaches’ Expanded Services and Support during COVID-19

“…Whole Health is a VA wide initiative; there are no particular inclusions or exclusions for Veterans participating in WH coaching aside from being enrolled for healthcare at the VHA. Some common health conditions of WH Veteran users may include chronic musculoskeletal pain and psychiatric conditions such as depressive disorder, anxiety disorders, and PTSD [ 39 , 40 , 41 ].…”

Holistic frailty prevention: The promise of movement‐based mind–body therapies

“…of Veterans with chronic pain and 10.3% with both chronic pain and PTSD reported tai chi use (Reed II et al, 2022). While U.S. older adults can access movement-based mind-body therapies for reduced or no cost through senior centers, rates of yoga and tai chi use through these access points are unknown.…”