Patient Reports on How Well Combining Provider-Delivered and Self-Directed Complementary and Integrative Health...

Area of Science:

• Complementary and Integrative Health
• Pain Management
• Health Psychology

Background:

• Complementary and Integrative Health (CIH) therapies, including acupuncture and yoga, are evidence-based for chronic pain.
• Healthcare providers often encourage patients to actively participate in their health through self-directed therapies.
• The combined effect of practitioner-delivered and self-directed CIH therapies on health outcomes requires further qualitative examination.

Purpose of the Study:

• To qualitatively explore how using practitioner-delivered CIH therapies with and without self-directed CIH therapies impacts veterans' health and well-being.
• To examine patient narratives regarding the effectiveness of combined CIH therapy approaches in a pragmatic study.

Main Methods:

• Qualitative telephone interviews were conducted with 125 veterans diagnosed with chronic musculoskeletal pain.
• Interviews explored the impact of CIH therapies on depression, anxiety, pain, fatigue, sleep, quality of life, and self-empowerment.
• Deductive and inductive thematic analysis was employed to analyze patient-reported outcomes.

Main Results:

• Over half of reported CIH therapies positively affected pain, quality of life, depression, sleep, and self-empowerment; fatigue was less frequently impacted.
• A combination of practitioner-delivered and self-directed CIH therapies showed greater benefits for depression, anxiety, quality of life, fatigue, and self-empowerment compared to practitioner-delivered therapies alone.
• Similar percentages of patients reported benefits for pain and sleep, regardless of whether they used a combination or only practitioner-delivered CIH therapies.

Conclusions:

• Combining practitioner-delivered and self-directed CIH therapies appears more beneficial for most health conditions than using practitioner-delivered therapies alone.
• For pain and sleep, the benefits of combined versus practitioner-delivered CIH therapies were comparable.
• Clinicians such as chiropractors, acupuncturists, and massage therapists should consider encouraging patients to engage in self-directed CIH therapies to enhance overall well-being.