Outcome evaluation of the Veterans Affairs Salt Lake City Integrative Health Clinic for Chronic Nonmalignant Pain.
OBJECTIVE
the purpose of this longitudinal outcome study was to investigate the effectiveness of the Integrative Health Clinic and Program, an innovative outpatient clinical service that provides nonpharmacologic, biopsychosocial interventions using research based mind-body skills and complementary and alternative therapies. The study assessed improvement in chronic nonmalignant pain and related depression, anxiety, and health-related quality of life.


METHODS
the study was a retrospective post-hoc quasi-experimental design with a group analysis comparing chronic nonspinal-related pain (CNSP) (eg, joint pain, headache, and fibromyalgia) (n=53) to chronic spinal-related pain (CSP) (eg, back pain and neck pain) (n=88). Data were collected at intake and up to 4 follow-up visits. Hierarchical Linear Modeling was used for statistical analysis. Outcome measures included: Quality of Life (Short Form-36), the Beck Depression Inventory, and Beck Anxiety Inventory.


RESULTS
there were statistically significant differences within and between the CNSP and CSP groups across all follow-up visits. For the CNSP group, depression, anxiety, and bodily pain significantly improved with moderate-to-large effect sizes at 6 months (Cohen's d=0.74, 0.53, and 0.66, respectively) and these benefits persisted across all follow-up visits. The CSP group showed an improvement trend in bodily pain (Cohen's d=0.26).


CONCLUSIONS
significant study findings revealed that the greatest improvement after participation in Integrative Health Clinic and Program were seen in the CNSP group with benefits persisting to 24 months in mood and in some health-related quality of life subcategories.
Smeeding
Sandra J W
SJ
Departments of Anesthesia, Integrative Health, University of Utah, Salt Lake City, UT 84148, USA. Sandra.Smeeding@va.gov
Bradshaw
David H
DH
Kumpfer
Karol L
KL
Trevithick
Susan
S
Stoddard
Gregory J
GJ
D000328:Adult; D000368:Aged; D002908:Chronic Disease; D019033:Delivery of Health Care, Integrated / Q000706:statistics & numerical data*; D006787:Hospitals, Veterans / Q000706:statistics & numerical data*; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D009369:Neoplasms; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D010146:Pain / Q000453:epidemiology*; D059408:Pain Management; D015995:Prevalence; D015397:Program Evaluation; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome; D014589:Utah / Q000453:epidemiology