ArticlePloS one2019
The use of complementary and integrative health approaches for chronic musculoskeletal pain in younger US Veterans: An economic evaluation.
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed.
- Age differences in demographic and clinical characteristics among veterans with chronic low back pain: a cross-sectional study of baseline findings from the Veteran Response to Dosage in Chiropractic Therapy (VERDICT) trial.Chiropractic & manual therapies · 2025Trial
- Article
- The Problem of Pain in Rheumatology: Variations in Case Definitions Derived From Chronic Pain Phenotyping Algorithms Using Electronic Health Records.The Journal of rheumatology · 2024Article
- Complementary/integrative healthcare utilization in US Gulf-War era veterans: Descriptive analyses based on deployment history, combat exposure, and Gulf War Illness.Complementary therapies in clinical practice · 2022Article
- Non-pharmacological Treatment for Chronic Pain in US Veterans Treated Within the Veterans Health Administration: Implications for Expansion in US Healthcare Systems.Journal of general internal medicine · 2022Article
- From patient outcomes to system change: Evaluating the impact of VHA's implementation of the Whole Health System of Care.Health services research · 2022Article
- Integrating Massage Therapy Into the Health Care of Female Veterans.Federal practitioner : for the health care professionals of the VA, DoD, and PHS · 2022Article
- Care Outcomes for Chiropractic Outpatient Veterans (COCOV): a qualitative study with veteran stakeholders from a pilot trial of multimodal chiropractic care.Pilot and feasibility studies · 2022Article
- Exploring the application of the Charlson Comorbidity Index to assess the patient population seen in a Veterans Affairs chiropractic residency program.The Journal of chiropractic education · 2021Article
- Initial Management of Acute and Chronic Low Back Pain: Responses from Brief Interviews of Primary Care Providers.Journal of alternative and complementary medicine (New York, N.Y.) · 2021Article
- Opioid Prescribing and Opioid Risk Mitigation Strategies in the Veterans Health Administration.Journal of general internal medicine · 2020Article
- Exploring supervised machine learning approaches to predicting Veterans Health Administration chiropractic service utilization.Chiropractic & manual therapies · 2020Article
- Review
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
objectivesTo estimate the cost-effectiveness to the US Veterans Health Administration (VA) of the use of complementary and integrative health (CIH) approaches by younger Veterans with chronic musculoskeletal disorder (MSD) pain. PERSPECTIVE: VA healthcare system.
methodsWe used a propensity score-adjusted hierarchical linear modeling (HLM), and 2010-2013 VA administrative data to estimate differences in VA healthcare costs, pain intensity (0-10 numerical rating scale), and opioid use between CIH users and nonusers. We identified CIH use in Veterans' medical records through Current Procedural Terminology, VA workload tracking, and provider-type codes.
resultsWe identified 30,634 younger Veterans with chronic MSD pain as using CIH and 195,424 with no CIH use. CIH users differed from nonusers across all baseline covariates except the Charlson comorbidity index. They also differed on annual pre-CIH-start healthcare costs ($10,729 versus $5,818), pain (4.33 versus 3.76), and opioid use (66.6% versus 54.0%). The HLM results indicated lower annual healthcare costs (-$637; 95% CI: -$1,023, -$247), lower pain (-0.34; -0.40, -0.27), and slightly higher (less than a percentage point) opioid use (0.8; 0.6, 0.9) for CIH users in the year after CIH start. Sensitivity analyses indicated similar results for three most-used CIH approaches (acupuncture, chiropractic care, and massage), but higher costs for those with eight or more CIH visits.
conclusionsOn average CIH use appears associated with lower healthcare costs and pain and slightly higher opioid use in this population of younger Veterans with chronic musculoskeletal pain. Given the VA's growing interest in the use of CIH, further, more detailed analyses of its impacts are warranted.
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