title: The effectiveness of integrative medicine interventions on pain and anxiety in cardiovascular inpatients: a practice-based research evaluation.
abstract: BACKGROUND
  Pain and anxiety occurring from cardiovascular disease are associated with long-term health risks. Integrative medicine (IM) therapies reduce pain and anxiety in small samples of hospitalized cardiovascular patients within randomized controlled trials; however, practice-based effectiveness research has been limited. The goal of the study is to evaluate the effectiveness of IM interventions (i.e., bodywork, mind-body and energy therapies, and traditional Chinese medicine) on pain and anxiety measures across a cardiovascular population.
  
  
  METHODS
  Retrospective data obtained from medical records identified patients with a cardiovascular ICD-9 code admitted to a large Midwestern hospital between 7/1/2009 and 12/31/2012. Outcomes were changes in patient-reported pain and anxiety, rated before and after IM treatments based on a numeric scale (0-10).
  
  
  RESULTS
  Of 57,295 hospital cardiovascular admissions, 6,589 (11.5%) included IM. After receiving IM therapy, patients averaged a 46.5% (p-value < 0.001) decrease in pain and a 54.8% (p-value < 0.001) decrease in anxiety. There was no difference between treatment modalities on pain reduction; however, mind-body and energy therapies (p-value < 0.01), traditional Chinese medicine (p-value < 0.05), and combination therapies (p-value < 0.01) were more effective at reducing anxiety than bodywork therapies. Each additional year of age reduced the odds of receiving any IM therapy by two percent (OR: 0.98, p-value < 0.01) and females had 96% (OR: 1.96, p-value < 0.01) higher odds of receiving any IM therapy compared to males.
  
  
  CONCLUSIONS
  Cardiovascular inpatients reported statistically significant decreases in pain and anxiety following care with adjunctive IM interventions. This study underscores the potential for future practice-based research to investigate the best approach for incorporating these therapies into an acute care setting such that IM therapies are most appropriately provided to patient populations.
authors.affiliation: Penny George Institute for Health and Healing, Allina Health, 800 East 28th Street, MR 33540, Minneapolis, MN 55407-3799, USA. Jill.Johnson3@allina.com.
authors.forename: Jill R
authors.initials: JR
authors.lastname: Johnson
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Crespin
authors.forename: Kristen H
authors.initials: KH
authors.lastname: Griffin
authors.forename: Michael D
authors.initials: MD
authors.lastname: Finch
authors.forename: Rachael L
authors.initials: RL
authors.lastname: Rivard
authors.forename: Courtney J
authors.initials: CJ
authors.lastname: Baechler
authors.forename: Jeffery A
authors.initials: JA
authors.lastname: Dusek
mesh_terms: D015670:Acupuncture Therapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000209:etiology / Q000628:therapy*; D002318:Cardiovascular Diseases / Q000150:complications* / Q000523:psychology; D003131:Combined Modality Therapy; D005260:Female; D006760:Hospitalization; D006801:Humans; D007297:Inpatients; D055048:Integrative Medicine; D008297:Male; D008405:Massage; D008516:Medicine, Chinese Traditional; D008875:Middle Aged; D015146:Midwestern United States; D026441:Mind-Body Therapies; D010146:Pain / Q000209:etiology; D059408:Pain Management / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome