Longitudinal Utilization of Invasive Pain Treatment Procedures Among Veterans with Chronic Pain Following Use of Whole Health Services and Complementary and Integrative Health Therapies
Steven B Zeliadt,1,2 Rian DeFaccio,1 Evan P Carey,3 Bella Etingen,4,5 Ethan W Rosser,1 Pradeep Suri,6 Jessica A Chen,1 Barbara G Bokhour,7,8 Scott Coggeshall1 1VA Center of Innovation (COIN) for Veteran-Centered and Value-Driven Care, VA Puget Sound Healthcare System, Seattle, WA, USA; 2Department o...
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Dove Medical Press
2025-02-01
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| Series: | Journal of Pain Research |
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| Online Access: | https://www.dovepress.com/longitudinal-utilization-of-invasive-pain-treatment-procedures-among-v-peer-reviewed-fulltext-article-JPR |
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| author | Zeliadt SB DeFaccio R Carey EP Etingen B Rosser EW Suri P Chen JA Bokhour BG Coggeshall S |
| author_facet | Zeliadt SB DeFaccio R Carey EP Etingen B Rosser EW Suri P Chen JA Bokhour BG Coggeshall S |
| author_sort | Zeliadt SB |
| collection | DOAJ |
| description | Steven B Zeliadt,1,2 Rian DeFaccio,1 Evan P Carey,3 Bella Etingen,4,5 Ethan W Rosser,1 Pradeep Suri,6 Jessica A Chen,1 Barbara G Bokhour,7,8 Scott Coggeshall1 1VA Center of Innovation (COIN) for Veteran-Centered and Value-Driven Care, VA Puget Sound Healthcare System, Seattle, WA, USA; 2Department of Health Systems and Population Health, School of Public Health, University of Washington, Seattle, WA, USA; 3VA Center of Innovation (COIN) for Veteran-Centered and Value-Driven Care, Eastern Colorado Healthcare System, Denver, CO, USA; 4Research and Development Service, Dallas VA Medical Center, Dallas, TX, USA; 5Department of Public Health, Peter O’Donnell Jr. School of Public Health, UT Southwestern Medical Center, Dallas, TX, USA; 6Seattle Epidemiologic Research and Information Center (ERIC), VA Puget Sound Healthcare System, Seattle, WA, USA; 7Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, MA, USA; 8Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USACorrespondence: Steven B Zeliadt, VA Center of Innovation (COIN) for Veteran-Centered and Value-Driven Care, VA Puget Sound Healthcare System, 1660 South Columbian Way, S-15, Seattle, WA, 98108, USA, Tel +1 206 277-4175, Fax +1 206 764-2935, Email steven.zeliadt@va.govObjective: To assess whether Whole Health, a system of care that emphasizes non-pharmacological approaches for chronic pain management, is associated with changes in downstream utilization of invasive pain treatment procedures.Methods: Longitudinal retrospective cohort analysis of VHA administrative data. A total of 53,412 Veterans with chronic pain were identified between April and September 2018, with 584 initiating Whole Health and 3794 initiating a complementary and integrative health (CIH) therapy independent of Whole Health (CIH-only). Whole Health included use of coaching, personal health planning, and other services including CIH referral. CIH therapies included chiropractic care, acupuncture, massage therapy, yoga, Tai Chi/Qigong, and meditation. Propensity score matching was used to estimate expected rates of invasive pain treatment procedures 0– 3, 4– 12, and 13– 18 months after initiating Whole Health or CIH-only compared to similar Veterans who had not engaged in either.Results: Overall, 14% of the population were female, 11% had received prior spine injections, 3.3% had received surgery, and 0.4% had an implantable spinal stimulator. Whole Health use was associated with 42% (− 61% to − 17%) lower utilization of invasive pain procedures at three months compared to matched patients who did not use Whole Health. This reduction was attenuated at 18 months: 22% (− 39% to − 5%). CIH-only was associated with 18% (− 29% to − 4%) lower utilization at three months compared with matched patients, but differences were minimal at 18 months: 1% (− 9% to 9%).Discussion: Whole Health care, including CIH therapies, may help patients interrupt patterns of escalating and invasive pain care.Keywords: chronic pain, complementary and integrative health, invasive spine procedures, whole health, veterans |
| format | Article |
| id | doaj-art-e7ca489a5b044fcaa3ac6e0b1bc708b1 |
| institution | Kabale University |
| issn | 1178-7090 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Journal of Pain Research |
| spelling | doaj-art-e7ca489a5b044fcaa3ac6e0b1bc708b12025-02-11T17:30:56ZengDove Medical PressJournal of Pain Research1178-70902025-02-01Volume 18647661100047Longitudinal Utilization of Invasive Pain Treatment Procedures Among Veterans with Chronic Pain Following Use of Whole Health Services and Complementary and Integrative Health TherapiesZeliadt SBDeFaccio RCarey EPEtingen BRosser EWSuri PChen JABokhour BGCoggeshall SSteven B Zeliadt,1,2 Rian DeFaccio,1 Evan P Carey,3 Bella Etingen,4,5 Ethan W Rosser,1 Pradeep Suri,6 Jessica A Chen,1 Barbara G Bokhour,7,8 Scott Coggeshall1 1VA Center of Innovation (COIN) for Veteran-Centered and Value-Driven Care, VA Puget Sound Healthcare System, Seattle, WA, USA; 2Department of Health Systems and Population Health, School of Public Health, University of Washington, Seattle, WA, USA; 3VA Center of Innovation (COIN) for Veteran-Centered and Value-Driven Care, Eastern Colorado Healthcare System, Denver, CO, USA; 4Research and Development Service, Dallas VA Medical Center, Dallas, TX, USA; 5Department of Public Health, Peter O’Donnell Jr. School of Public Health, UT Southwestern Medical Center, Dallas, TX, USA; 6Seattle Epidemiologic Research and Information Center (ERIC), VA Puget Sound Healthcare System, Seattle, WA, USA; 7Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, MA, USA; 8Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USACorrespondence: Steven B Zeliadt, VA Center of Innovation (COIN) for Veteran-Centered and Value-Driven Care, VA Puget Sound Healthcare System, 1660 South Columbian Way, S-15, Seattle, WA, 98108, USA, Tel +1 206 277-4175, Fax +1 206 764-2935, Email steven.zeliadt@va.govObjective: To assess whether Whole Health, a system of care that emphasizes non-pharmacological approaches for chronic pain management, is associated with changes in downstream utilization of invasive pain treatment procedures.Methods: Longitudinal retrospective cohort analysis of VHA administrative data. A total of 53,412 Veterans with chronic pain were identified between April and September 2018, with 584 initiating Whole Health and 3794 initiating a complementary and integrative health (CIH) therapy independent of Whole Health (CIH-only). Whole Health included use of coaching, personal health planning, and other services including CIH referral. CIH therapies included chiropractic care, acupuncture, massage therapy, yoga, Tai Chi/Qigong, and meditation. Propensity score matching was used to estimate expected rates of invasive pain treatment procedures 0– 3, 4– 12, and 13– 18 months after initiating Whole Health or CIH-only compared to similar Veterans who had not engaged in either.Results: Overall, 14% of the population were female, 11% had received prior spine injections, 3.3% had received surgery, and 0.4% had an implantable spinal stimulator. Whole Health use was associated with 42% (− 61% to − 17%) lower utilization of invasive pain procedures at three months compared to matched patients who did not use Whole Health. This reduction was attenuated at 18 months: 22% (− 39% to − 5%). CIH-only was associated with 18% (− 29% to − 4%) lower utilization at three months compared with matched patients, but differences were minimal at 18 months: 1% (− 9% to 9%).Discussion: Whole Health care, including CIH therapies, may help patients interrupt patterns of escalating and invasive pain care.Keywords: chronic pain, complementary and integrative health, invasive spine procedures, whole health, veteranshttps://www.dovepress.com/longitudinal-utilization-of-invasive-pain-treatment-procedures-among-v-peer-reviewed-fulltext-article-JPRchronic paincomplementary and integrative healthinvasive spine procedureswhole healthveterans |
| spellingShingle | Zeliadt SB DeFaccio R Carey EP Etingen B Rosser EW Suri P Chen JA Bokhour BG Coggeshall S Longitudinal Utilization of Invasive Pain Treatment Procedures Among Veterans with Chronic Pain Following Use of Whole Health Services and Complementary and Integrative Health Therapies Journal of Pain Research chronic pain complementary and integrative health invasive spine procedures whole health veterans |
| title | Longitudinal Utilization of Invasive Pain Treatment Procedures Among Veterans with Chronic Pain Following Use of Whole Health Services and Complementary and Integrative Health Therapies |
| title_full | Longitudinal Utilization of Invasive Pain Treatment Procedures Among Veterans with Chronic Pain Following Use of Whole Health Services and Complementary and Integrative Health Therapies |
| title_fullStr | Longitudinal Utilization of Invasive Pain Treatment Procedures Among Veterans with Chronic Pain Following Use of Whole Health Services and Complementary and Integrative Health Therapies |
| title_full_unstemmed | Longitudinal Utilization of Invasive Pain Treatment Procedures Among Veterans with Chronic Pain Following Use of Whole Health Services and Complementary and Integrative Health Therapies |
| title_short | Longitudinal Utilization of Invasive Pain Treatment Procedures Among Veterans with Chronic Pain Following Use of Whole Health Services and Complementary and Integrative Health Therapies |
| title_sort | longitudinal utilization of invasive pain treatment procedures among veterans with chronic pain following use of whole health services and complementary and integrative health therapies |
| topic | chronic pain complementary and integrative health invasive spine procedures whole health veterans |
| url | https://www.dovepress.com/longitudinal-utilization-of-invasive-pain-treatment-procedures-among-v-peer-reviewed-fulltext-article-JPR |
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