Complementary and integrative health (CIH) therapies, such as yoga, meditation and tai chi may help improve overall physical and mental health and reduce perceived stress among veterans receiving care in the Veterans Health Administration (VA) system, according to a new study published in a special September supplement to Medical Care.
The study reports progress toward implementing CIH therapies throughout the VA system, part of an effort to promote a “Whole Health” approach in VA care. As required by the 2016 Comprehensive Addiction and Recovery Act (CARA), the VA has expanded research and education on its CIH therapies, focusing on the impact on pain, mental health, and chronic illness.
The study was led by Dr. A. Rani Elwy of the VA Center for Healthcare Organization and Implementation Research at the Edith Nourse Rogers Memorial Veterans Hospital in Bedford, Mass, and Associate Professor in the Warren Alpert Medical School of Brown University.
For the study, Elwy and team administered a 12-month survey to analyze the impact of CIH therapies on 119 veterans who self-reported on their health and well-being. The Veterans completed 401 surveys at more than five different time points during the study. The surveys focused on patient-reported outcomes (PROs), an important target for efforts to improve healthcare. They focused on the most important problems and outcomes identified by the patients themselves.
Veterans in the study reported using 14 different CIH therapies. Yoga was the most popular, with nearly half of veterans participating. This was followed by meditation, acupuncture and tai chi. Three CIH therapies were linked to significant improvements in PROs:
- yoga was related to decreases in perceived stress;
- tai chi was linked to improvements in overall physical and mental health functioning, anxiety levels, and ability to participate in social role activities;
- meditation was also associated with improvements in physical functioning.
“[O]ur study showed that meditation, tai chi, and yoga appear to improve overall physical and mental health and reduced perceived stress,” write the authors.
None of the CIH therapies were linked to improvements in veterans’ pain intensity or level of engagement in their health care. Larger studies with longer follow-up times may be needed to show significant effects on these outcomes, according to the authors.
“It is time to focus on health and well-being, as defined by Veterans, and reaching these goals must include participation in CIH treatment approaches,” concluded the authors.
The paper presents 11 original research papers and commentaries on the VA’s progress in implementing and evaluating the impact of CIH therapies on Veterans’ health outcomes.
The special issue addresses strategies to build support for and implement CIH programs, to evaluate their effectiveness, and to promote their long-term sustainability.
“We already know that CIH therapies are effective for the treatment of Veterans’ chronic pain, posttraumatic stress, depression, and other chronic conditions,” write Elwy and Dr. Stephanie L. Taylor of the HSR&D Center for the Study of Healthcare Innovation, Implementation, and Policy, Greater Los Angeles VA Medical Center. “Now we need to develop, test, and use effective strategies to increase CIH use and sustainment.”
In a commentary, Alison Whitehead and Dr. Benjamin Kligler of the VA Office of Patient-Centered Care and Cultural Transformation said, “As the VA continues to develop new and better ways of making CIH approaches available to all Veterans, and to collect data on the outcomes of this expanded access for Veterans and employees, we hope to demonstrate to the rest of the U.S. healthcare system how an emphasis on whole person care and self-management skills should become the new standard across the industry.”
Source: Wolters Kluwer Health
Source: PsychCentral Study: Veterans May Benefit From Yoga, Tai Chi, Meditation