Evidence map›Paper›PMID 39384145›Full record

ArticleThe journal of pain2025

Impact of complementary health approaches on opioid prescriptions among veterans with musculoskeletal disorders - A retrospective cohort study.

Ling Han, Joseph L Goulet, Melissa Skanderson, Doug Redd, Cynthia Brandt, Qing Zeng-Treitler

Abstract read
In one paragraph

Article in The journal of pain, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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.

Ling HanYale School of Medicine Department of Internal Medicine, New Haven, CT 06511, United States; VA Connecticut Healthcare System, West Haven, CT, United States. Electronic address: ling.han@yale.edu.
Joseph L GouletVA Connecticut Healthcare System, West Haven, CT, United States; Yale School of Medicine Department of Emergency Medicine, New Haven, CT, United States.
Melissa SkandersonVA Connecticut Healthcare System, West Haven, CT, United States.
Doug ReddWashington DC VA Medical Center, Washington, DC, United States; Biomedical Center, George Washington University, Washington, DC, United States.
Cynthia BrandtVA Connecticut Healthcare System, West Haven, CT, United States; Yale School of Medicine Department of Emergency Medicine, New Haven, CT, United States; Yale School of Public Health Department of Bioinformatics & Data Sciences, New Haven, CT, United States.
Qing Zeng-TreitlerWashington DC VA Medical Center, Washington, DC, United States; Biomedical Center, George Washington University, Washington, DC, United States.

Funding

Yale Study Support Suite (YES3): Dashboard and Web Portal Software Supporting Research Workflow through integrated, customizable REDCap External ModulesP30AG021342 · NIA · YALE UNIVERSITY · PI Lauren Ferrante · 2002 to 2026
$37.9M
NIA NIH HHS P30 AG021342
6 · The paper itself

Abstract

To examine whether complementary and integrative health approaches mitigate opioid prescriptions for pain and whether the relationship differs by post-dramatic stress disorder (PTSD) diagnosis, we followed 1,993,455 Veterans with musculoskeletal disorders during 2005-2017 using Veterans Healthcare Administration electronic health records. Complementary and integrative health (CIH) approaches were defined as ≥ 1 primary care visits for meditation, Yoga, and acupuncture etc using natural language processing. Opioid prescriptions were ascertained from pharmacy dispensing records. A propensity score was estimated and used to match one control Veteran to each CIH recipient. Over the 2-year follow-up period after the index diagnosis, 140,902 (7.1 %) Veterans received ≥ 1 modalities. Among the matched analytic sample (272,296 Veterans), the likelihood of dispensing opioid prescriptions was significantly lower for Veterans in the CIH group than their controls [adjusted hazard ratio (aHR), 0.45 (95 % Confidence Intervals (CI): 0.44-0.46)]. The association did not differ between Veterans with [aHR: 0.46 (95 % CI: 0.45-0.47)] and without [aHR: 0.44 (95 % CI: 0.43-0.45)] PTSD. In sensitivity analyses, the exposure group had 3.82 (95 % CI: 3.76-3.87) months longer restricted mean survival time to opioid initiation, 2 % (95 % CI: 4 %-1 %) lower morphine equivalent and 17 % lower total days' supply (95 % CI: 18 %-16 %). The relationship remains significant but was attenuated after eliminating waiting time for the exposure group (aHR, 0.63 (95 % CI: 0.62-0.64)). These observations suggest that CIH approaches may help reduce opioid prescriptions for Veterans with musculoskeletal disorders and related pain. The impact of the timing of receiving such approaches warrants further investigation. PERSPECTIVE: This article presents a quasi-experimental investigation into potential benefit of complementary and integrative health approaches (CIH) on de-prescribing opioids. The findings may potentially help clinicians who are seeking non-pharmacological alternative options to manage patient pain and opioid dependence".

Indexed as

Analgesics, OpioidComplementary TherapiesDrug PrescriptionsMusculoskeletal DiseasesVeteransAdultAgedFemaleHumansMaleMiddle AgedRetrospective StudiesStress Disorders, Post-TraumaticUnited StatesUnited States Department of Veterans AffairsAnalgesics, OpioidComplementary and integrative health (CIH)Musculoskeletal disorders (MSD)Opioids prescriptionsPost traumatic stress disorder (PTSD)Propensity score (PS)

Identifiers

PMID39384145
PMCPMC11781976

What OpenQuestion holds

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Registered trials

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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.