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- Title
Outcome Evaluation of the Veterans Affairs Salt Lake City Integrative Health Clinic for Chronic Pain and Stress-Related Depression, Anxiety, and Post-Traumatic Stress Disorder.
- Authors
Smeeding, Sandra J. W.; Bradshaw, David H.; Kumpfer, Karol; Trevithick, Susan; Stoddard, Gregory J.
- Abstract
Objectives: The purpose of this longitudinal outcome research study was to determine the effectiveness of the Integrative Health Clinic and Program (IHCP) and to perform a subgroup analysis investigating patient benefit. The IHCP is an innovative clinical service within the Veterans Affairs Health Care System designed for nonpharmacologic biopsychosocial management of chronic nonmalignant pain and stress-related depression, anxiety, and symptoms of post-traumatic stress disorder (PTSD) utilizing complementary and alternative medicine and mind–body skills. Methods: A post-hoc quasi-experimental design was used and combined with subgroup analysis to determine who benefited the most from the program. Data were collected at intake and up to four follow-up visits over a 2-year time period. Hierarchical linear modeling was used for the statistical analysis. The outcome measures included: Health-Related Quality of Life (SF-36), the Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). Subgroup comparisons included low anxiety (BAI < 19, n = 82), low depression (BDI < 19, n = 93), and absence of PTSD ( n = 102) compared to veterans with high anxiety (BAI ≥ 19, n = 77), high depression (BDI > 19, n = 67), and presence of PTSD ( n = 63). Results: All of the comparison groups demonstrated an improvement in depression and anxiety scores, as well as in some SF-36 categories. The subgroups with the greatest improvement, seen at 6 months, were found in the high anxiety group (Cohen's d = 0.52), the high-depression group (Cohen's d = 0.46), and the PTSD group (Cohen's d = 0.41). Conclusions: The results suggest IHCP is an effective program, improving chronic pain and stress-related depression, anxiety, and health-related quality of life. Of particular interest was a significant improvement in anxiety in the PTSD group. The IHCP model offers innovative treatment options that are low risk, low cost, and acceptable to patients and providers.
- Subjects
SALT Lake City (Utah); UTAH; HEALTH outcome assessment; MEDICAL care of veterans; LONGITUDINAL method; THERAPEUTICS; MENTAL depression; TREATMENT of post-traumatic stress disorder; ALTERNATIVE medicine
- Publication
Journal of Alternative & Complementary Medicine, 2010, Vol 16, Issue 8, p823
- ISSN
1075-5535
- Publication type
Article
- DOI
10.1089/acm.2009.0510