The effectiveness of integrative medicine interventions on pain and anxiety in cardiovascular inpatients: a practice-based research evaluation

Abstract

BackgroundPain 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.MethodsRetrospective 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).ResultsOf 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.ConclusionsCardiovascular 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.

Perceptions of other integrative health therapies by Veterans with pain who are receiving massage

“…Both inpatients and outpatients reported a decrease in pain from 1 to 3 points on a 0 to 10 numeric rating scale, which is consistent with the scientific literature of CIH on pain for civilian inpatients [18–19]. Reported pain changes were comparable across groups, with the exception that inpatients reported a shorter duration of pain relief than outpatients.…”

“…The aim of a supplement to the parent study was promotion of a collaboration between a non-VA hospital with an extensive CIH program and a VA hospital for the purpose of promoting CIH at the VA site [18–19]. To better understand how CIH was currently viewed at the VA, our approach included interviews of VA patients, providers, and administrators about the use of CIH.…”

Complementary and integrative healthcare for patients with mechanical low back pain in a U.S. hospital setting

“…CIH recipients were younger and more likely to be female, which is consistent with findings in outpatient settings, 26,32 and in other inpatient populations such as cardiology. 33 It appears that CIH might be appealing to inpatients with certain demographic factors (e.g., middle-aged and female), or it is possible that those patients are more likely to receive CIH referrals from clinical providers. As evidence supporting the effectiveness of some CIH for mechanical LBP emerges, strategies for expanding delivery to broader and more diverse populations may be warranted.…”

Disease Prevention and Health Promotion

“…116 In recent years, a number of whole-practice outcomes studies demonstrate benefit of integrative approaches, particularly in chronic pain, 33, 35, 36, 117-119 Type 2 diabetes, 34 and cardiovascular risk markers. 120 These findings suggest public health benefits as well as possible cost savings.…”