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Updated: Jul 14, 2026

Inverse Probability of Treatment Weighting (Propensity Score) using the Military Health System Data Repository and National Death Index

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Published on: January 8, 2020

Dry Needling in the Military Health System: A Retrospective Observational Study.

Megan O'Connell^1,2,3, Mitchell Haddad⁴, Nicholas Koreerat⁵

¹Department of Anesthesiology, Defense and Veterans Consortium for Integrative Pain Management, Uniformed Services University, Bethesda, MD, 20814, United States.

Military Medicine

|July 7, 2026

Summary

This study analyzed real-world data on dry needling (DN) follow-up visits. Factors influencing patient adherence to DN treatment were identified, highlighting areas for improved care delivery.

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Area of Science:

Physical Therapy
Rehabilitation Medicine
Health Services Research

Background:

Dry needling (DN) is a prevalent physical therapy intervention.
Limited real-world data exists on factors influencing DN follow-up care.
Understanding patient, care, and system variables is crucial for optimizing DN treatment.

Purpose of the Study:

To investigate patient-, care-, and system-level factors associated with follow-up visits after initial dry needling.
To analyze real-world data to identify variables impacting adherence to dry needling protocols.

Main Methods:

Retrospective observational study using medical records from military treatment facilities (MTFs).
Analysis of 152,312 patients receiving an index dry needling visit between July 2020 and June 2024.
Piecewise exponential additive model to assess time-to-follow-up DN visit.

Main Results:

Approximately 45.4% of patients received a follow-up DN visit within 90 days.
Median of 3 DN visits received within 6 months for those with follow-up care.
Lower hazard for follow-up visits observed in smaller MTFs compared to very large ones.

Conclusions:

Identifies the need for tracking clinical functional outcomes in dry needling research.
Suggests qualitative studies to explore barriers to dry needling follow-up care.
Highlights the importance of system-level factors, like MTF volume, in patient adherence.