Evidence map›Paper›PMID 38748671›Full record

Observational studyPloS one2024

Patient-reported pain and physical health for acupuncture and chiropractic care delivered by Veterans Affairs versus community providers.

Claire E O'Hanlon, Steven B Zeliadt, Rian DeFaccio, Lauren Gaj, Barbara G Bokhour, Stephanie L Taylor

Abstract readObservational Study
In one paragraph

Observational study in PloS one, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Claire E O'HanlonVeterans Affairs Greater Los Angeles Healthcare System, Center for the Study of Healthcare Innovation, Implementation & Policy (CSHIIP), Los Angeles, California, United States of America.ORCID 0000-0001-6398-5845
Steven B ZeliadtVeterans Affairs Puget Sound Health Care System, VA Center of Innovation for Veteran-Centered and Value-Driven Care, Seattle, Washington, United States of America.
Rian DeFaccioVeterans Affairs Puget Sound Health Care System, VA Center of Innovation for Veteran-Centered and Value-Driven Care, Seattle, Washington, United States of America.
Lauren GajVA Bedford Healthcare System, Center for Healthcare Organization and Implementation Research (CHOIR), Bedford, Massachusetts, United States of America.
Barbara G BokhourVA Bedford Healthcare System, Center for Healthcare Organization and Implementation Research (CHOIR), Bedford, Massachusetts, United States of America.
Stephanie L TaylorVeterans Affairs Greater Los Angeles Healthcare System, Center for the Study of Healthcare Innovation, Implementation & Policy (CSHIIP), Los Angeles, California, United States of America.ORCID 0000-0002-3266-1132

Funding

HSRD VA I50 HX002384HSRD VA IK6 HX003766
6 · The paper itself

Abstract

backgroundAcupuncture and chiropractic care are evidence-based pain management alternatives to opioids. The Veterans Health Administration (VA) provides this care in some VA facilities, but also refers patients to community providers. We aimed to determine if patient-reported outcomes differ for acupuncture and chiropractic care from VA versus community providers. MATERIALS AND

methodsWe conducted an observational study using survey outcome data and electronic medical record utilization data for acupuncture and chiropractic care provided in 18 VA facilities or in community facilities reimbursed by VA. Study participants were users of VA primary care, mental health, pain clinic, complementary and integrative therapies, coaching or education services in 2018-2019. Patients received 1) 4+ acupuncture visits (N = 201) or 4+ chiropractic care visits (N = 178) from a VA or community provider from 60 days prior to baseline to six-months survey and 2) no acupuncture or chiropractic visits from 1 year to 60 days prior to baseline. Outcomes measured included patient-reported pain (PEG) and physical health (PROMIS) at baseline and six-month surveys. Multivariate analyses examined outcomes at six months, adjusting for baseline outcomes and demographics.

resultsIn unadjusted analyses, pain and physical health improved for patients receiving community-based acupuncture, while VA-based acupuncture patients experienced no change. Unadjusted analyses also showed improvements in physical health, but not pain, for patients receiving VA-based chiropractic care, with no changes for community-based chiropractic care patients. Using multivariate models, VA-based acupuncture was no different from community-based acupuncture for pain (-0.258, p = 0.172) or physical health (0.539, p = 0.399). Similarly, there were no differences between VA- and community-based chiropractic care in pain (-0.273, p = 0.154) or physical health (0.793, p = 0.191).

conclusionsAcupuncture and chiropractic care were associated with modest improvements at six months, with no meaningful differences between VA and community providers. The choice to receive care from VA or community providers could be based on factors other than quality, like cost or convenience.

Indexed as

Acupuncture TherapyManipulation, ChiropracticPain ManagementPatient Reported Outcome MeasuresUnited States Department of Veterans AffairsAdultAgedFemaleHumansMaleMiddle AgedUnited StatesVeterans

Identifiers

PMID38748671
PMCPMC11095679

What OpenQuestion holds

Textmetadata
LicenceCC0
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.