Three popular complementary and integrative health (CIH) therapies -- Yoga, Tai Chi, and meditation -- are showing physical and mental health improvement among veterans.
The therapies lead to significant improvements in key outcomes perceived by veterans receiving care in the Veterans Health Administration (VA) system, suggests a new study, published in the Lippincott portfolio by Wolters Kluwer.
"Our study showed that meditation, tai chi, and yoga appear to improve overall physical and mental health and reduced perceived stress," according to the new research, led by Dr A. Rani Elwy of the VA Center for Healthcare Organization and Implementation Research at the Edith Nourse Rogers Memorial Veterans Hospital in Bedford, Mass, and an Associate Professor in the Warren Alpert Medical School of Brown University.
The special issue of Medical Care documents progress in implementing CIH therapies throughout the VA system-- part of efforts to promote a "Whole Health" approach in VA care. As required by the 2016 Comprehensive Addiction and Recovery Act (CARA), the VA has expanded research and education on CIH programs, focusing on the impact on pain, mental health, and chronic illness.
Improvements in patient-reported outcomes with CIH therapies Dr Elwy and colleagues performed a 12-month survey study to examine the impact on CIH therapies on 119 veteran's self-reported health and well-being.
These veterans completed 401 surveys over five different time points during the study. The surveys focused on patient-reported outcomes (PROs)-- an important target for efforts to improve healthcare, focusing on the most important problems and outcomes identified by patients themselves.
Improvements to stress levels
Overall, veterans in the study reported using 14 different CIH therapies. Yoga was the most popular, with nearly half of the veterans participating. This was followed by meditation, acupuncture, and tai chi. Three CIH therapies were associated with significant improvements in PROs:
- Yoga was related to decreases in perceived stress.
- Tai chi was linked to improvements in overall physical and mental health functioning, anxiety levels, and the ability to participate in social role activities.
- Meditation was also associated with improvements in physical functioning.
None of the CIH therapies resulted in improvement in veterans' pain intensity or level of engagement in their health care. Larger studies with longer follow-up times may be needed to show significant effects on these outcomes, according to Dr. Elwy and coauthors.
They conclude: "It is time to focus on health and well-being, as defined by Veterans, and reaching these goals must include participation in CIH treatment approaches."
The special issue papers address strategies to build support for and implement CIH programs, to evaluate their effectiveness, and to promote their long-term sustainability.
"We already know that CIH therapies are effective for the treatment of Veterans' chronic pain, posttraumatic stress, depression, and other chronic conditions. Now we need to develop, test, and use effective strategies to increase CIH use and sustainment," Drs Elwy and Taylor write.
In a commentary, Alison Whitehead and Dr Benjamin Kligler of the VA Office of Patient-Centered Care and Cultural Transformation state: "As the VA continues to develop new and better ways of making CIH approaches available to all Veterans, and to collect data on the outcomes of this expanded access for veterans and employees, we hope to demonstrate to the rest of the U.S. healthcare system how an emphasis on whole-person care and self-management skills should become the new standard across the industry."
