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Published on: January 8, 2020
Dry Needling in the Military Health System: A Retrospective Observational Study
Megan O'Connell1,2,3, Mitchell Haddad4, Nicholas Koreerat5
1Department of Anesthesiology, Defense and Veterans Consortium for Integrative Pain Management, Uniformed Services University, Bethesda, MD, 20814, United States.
Introduction:
Dry needling (DN) is a commonly performed treatment used by physical therapists. Despite the popularity of DN and the large number of randomized controlled trials evaluating efficacy, few studies have leveraged real world data to determine patient-, care- and system-level variables associated with DN receipt and follow-up after an initial DN visit.
Materials And Methods:
The present retrospective observational study utilized medical records from patients who received an index DN visit at a military treatment facility (MTF) between July 2020 and June 2024. A piecewise exponential additive model was used to identify multilevel characteristics associated with time-to a follow-up DN visit.
Results:
A total of 152,312 patients received DN, with approximately 45.4% (n = 69,810) receiving a follow-up DN visit within 90 days of index DN visit across 429 MTFs. Of patients receiving a follow-up DN visit, patients received a median of 3 DN visits over 6 months [IQR 2,4]. DN follow-up visit receipt varied by MTF volume, with small MTFs (AHR 0.79, CI 0.76-0.82), medium MTFs (AHR 0.86, CI 0.83-0.89), and large MTFs (AHR 0.92, CI 0.89-0.95) having lower hazards relative to very large MTFs. Time-to-follow-up DN visit varied across other patient- and care-level variables as well.
Conclusions:
The present study helps identify the need for tracking clinical functional outcome measures to aid in informing future pragmatic research. Qualitative studies investigating loss of follow-up may also aid in assessing barriers to care.
