Journal of Integrative and Complementary Medicine最新文献

{"title":"Provider Identified Access Barriers to Delivering Acupuncture to Persons with Traumatic Brain Injury and Chronic Pain: A Cross-Sectional Self-Report Survey.","authors":"Jolie N Haun, Risa Nakase-Richardson, Jeanne M Hoffman, Mitch Sevigny, Mark D Sodders, Flora M Hammond, Bridget A Cotner, Amanda Tweed, Robin Hanks, Aaron M Martin","doi":"10.1089/jicm.2024.0486","DOIUrl":"10.1089/jicm.2024.0486","url":null,"abstract":"<p><p><b><i>Objective:</i></b> Traumatic brain injury (TBI) clinical practice guidelines for pain management and rehabilitation support the use of nonpharmacologic complementary and integrative health (CIH) modalities, such as acupuncture for remediating pain. Barriers to delivering CIH modalities, such as acupuncture warrant examination. The objective of this study is to explore provider perspectives on challenges to accessing acupuncture treatment for chronic pain in persons with TBI and describe differences across health care settings. <b><i>Setting:</i></b> Civilian, Veterans Affairs (VA), and Department of Defense health care systems. <b><i>Participants:</i></b> Health care providers (<i>n</i> = 145) were recruited from November 2022 to March 2023 via email through professional organizations and health care systems. <b><i>Design:</i></b> Descriptive cross-sectional self-report online survey. <b><i>Main Measures:</i></b> A survey assessed barriers using a 5-point Likert scale (<i>always a barrier</i> to <i>never a barrier</i>) using the Levesque Access to Care framework. <b><i>Results:</i></b> Of the 137 participants who provided information on setting, 86 (63%) worked in civilian health care; 47 (34%) worked in the Department of VA; and 4 (2.6%) in the Department of Defense (8 were missing data). Overall, providers endorsed all ten items as being barriers to accessing acupuncture treatment. However, these barriers were more statistically more frequently reported for civilian providers compared with VA providers for six of the 10 items, including lack of caregiver support (<i>p</i> < 0.0001); own knowledge and understanding of the treatment (<i>p</i> = 0.0025); health care setting culture discourages the treatment (<i>p</i> = 0.0181); lack of qualified providers (<i>p</i> = 0.0467); insurance does not cover (<i>p</i> < 0.0001), and patient cannot afford (<i>p</i> < 0.0001). VA provider respondents were more likely to answer all six items, as \"Rarely/Never a Barrier,\" while providers in a civilian setting were more likely to respond \"Always/Frequently\" or \"Sometimes\" a barrier. <b><i>Conclusion:</i></b> Results reflect the cultural, organizational, and structural differences that make acupuncture more accessible within the VA. understanding barriers to delivering care is critical to inform implementation strategy mapping efforts, to tailor strategies that are aimed to increase access and engagement with acupuncture treatment in civilian health care settings.</p>","PeriodicalId":29734,"journal":{"name":"Journal of Integrative and Complementary Medicine","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Randomized Feasibility Study of Rehabilitation Targeting Upper Extremity Function and Participation Using Hippotherapy and the Equine Environment for Children with Cerebral Palsy and Autism Spectrum Disorder.","authors":"Julia Mazzarella, Jill C Heathcock","doi":"10.1089/jicm.2024.0292","DOIUrl":"https://doi.org/10.1089/jicm.2024.0292","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Children with upper extremity neuromotor impairments often have decreased participation in life activities. Hippotherapy and rehabilitation in the equine environment might be effective in targeting participation, given the community context and natural activity involvement. This randomized controlled feasibility trial assessed recruitment, retention, treatment fidelity, and acceptability of rehabilitation using hippotherapy and the equine environment, targeting upper extremity function and participation for children with neuromotor impairments to inform a larger trial. <b><i>Methods:</i></b> This 6-month trial occurred in Ohio, June-December 2021. Participants were 6-17 years old with upper extremity neuromotor impairment (and primary diagnosis of cerebral palsy and/or autism). Participants were randomized into treatment or waitlist control using REDCap. Treatment was 16 h (4 h/week/4 weeks) of rehabilitation using hippotherapy and the equine environment. Control participants completed a 4-week waiting period, then received the treatment. Recruitment, screening, enrollment, attendance, and retention were tracked. Nonblinded assessments of body structures and functions, activity, and participation were administered pre- and postcontrol and treatment. Assessment measure completion, treatment fidelity, and acceptability were recorded. <b><i>Results:</i></b> Twenty-six participants were screened between July and October 2021; 77% (20/26) met inclusion criteria; 70% (14/20) enrolled and randomized: 6 control and 8 treatment. Two withdrew after randomization and one was excluded for fear of horses. In total, <i>n</i> = 5 control and <i>n</i> = 6 treatment completed initial assessment. Retention was 80% (4/5) control and 83% (5/6) treatment, just below the <i>a priori</i> criteria (85%). Assessment measure completion was variable (77%-100%) and replacement of some should be considered before advancing to a clinical trial. Treatment fidelity and acceptability were moderate to high. There were no adverse events from study participation. <b><i>Conclusions:</i></b> Results demonstrated preliminary evidence of fidelity and acceptability of rehabilitation using hippotherapy and the equine environment for children with upper extremity neuromotor impairments. Some changes should be made to improve enrollment, retention, and outcome measure completion before advancing to a definitive trial. <b><i>Trial registration:</i></b> ClinicalTrials.gov identifier: NCT0653068. <b><i>Trial funding:</i></b> Eunice Kennedy Shriver National Institute of Child Health and Human Development, Foundation for Physical Therapy Research, American Academy of Cerebral Palsy and Developmental Medicine, and Pedal With Pete Foundation.</p>","PeriodicalId":29734,"journal":{"name":"Journal of Integrative and Complementary Medicine","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"It Has Improved My Practice to Be Able to Offer Alternative Treatments\": A Longitudinal Qualitative Study of Oregon Medicaid Back Pain Providers.","authors":"Mary Gray, Alexis Cooke, Catherine J Livingston, Kate LaForge, Diana P Flores, Esther K Choo","doi":"10.1089/jicm.2023.0743","DOIUrl":"10.1089/jicm.2023.0743","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> This study aimed to understand health care providers' experiences implementing the Oregon Back Pain Policy (OBPP) over time. The Medicaid OBPP expanded coverage of evidence-based nonpharmacological therapy (NPT) for back pain and restricted access to opioid therapy and interventional approaches. <b><i>Methods:</i></b> The study included six online, asynchronous focus groups with providers in February 2020 (Time 1) and August 2022 (Time 2). Analysis was conducted with a longitudinal, recurrent cross-sectional approach. Analysis occurred in three stages: (1) An immersion/crystallization approach was used to analyze Time 1 focus group data, (2) reflexive thematic analysis was used to analyze Time 2 data, and (3) longitudinal analysis was used to integrate the findings across time points. <b><i>Results:</i></b> At Time 1, 48 clinicians and 44 NPT providers participated in the study. Time 2 included 63 clinicians and 59 NPT providers. The longitudinal analysis of the focus group data resulted in four themes: (1) general awareness of the policy, (2) providers support the policy and perceive a benefit to their patients, (3) barriers to NPT accessibility, and (4) barriers to referring patients to NPT. <b><i>Conclusion:</i></b> The goal of the OBPP was to improve back pain care for Oregon Medicaid members by increasing access to evidence-based NPT and decreasing reliance on opioid medications. This study revealed that, although clinicians and NPT providers supported the policy, they faced persistent implementation challenges related to referrals, prior authorizations, coverage limitations, low reimbursement rates, and a reduced workforce for NPT providers. In some cases, implementation barriers were removed during the COVID-19 pandemic, but other challenges were more prominent during the pandemic.</p>","PeriodicalId":29734,"journal":{"name":"Journal of Integrative and Complementary Medicine","volume":" ","pages":"1092-1101"},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11631795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141559946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Timing and Dose Effect of Acupuncture on Pregnancy Outcomes for Infertile Women Undergoing <i>In Vitro</i> Fertilization and Embryo Transfer: A Systematic Review and Meta-Analysis.","authors":"Xia Wang, Hong-Mei Xu, Qiao-Ling Wang, Xin-Yun Zhu, Ya-Min Zeng, Li Huang, Xin Feng, Shuai Chen","doi":"10.1089/jicm.2023.0478","DOIUrl":"10.1089/jicm.2023.0478","url":null,"abstract":"<p><p><b><i>Background:</i></b> Women undergoing <i>in vitro</i> fertilization and embryo transfer (IVF-ET) often utilize acupuncture to enhance pregnancy outcomes. Yet, the optimal timing for acupuncture sessions and the relationship between dosage and effect remain uncertain. <b><i>Objectives:</i></b> To investigate the impact of the timing and dosage of acupuncture on pregnancy outcomes, drawing on existing research. <b><i>Methods:</i></b> A comprehensive search of eight databases was conducted from their inception to January 14th, 2023, without restrictions on language. Only randomized controlled trials comparing acupuncture with either sham acupuncture or no adjuvant treatment were selected for inclusion. This meta-analysis assessed the efficacy of acupuncture in IVF-ET, analyzing the influence of varied timing and dosage on pregnancy outcomes. Subgroup analyses were undertaken to address any heterogeneity across the studies. <b><i>Results:</i></b> A total of 38 RCTs involving 5,991 participants were analyzed. In infertile women undergoing IVF fresh cycles, acupuncture performed during controlled ovarian hyperstimulation (COH) significantly increased the clinical pregnancy rate (CPR) (relative risk [RR] = 1.33, 95% confidence interval [CI]: 1.07-1.65, <i>p</i> = 0.01), whereas acupuncture administered either before COH or on the day of ET did not demonstrate reproductive benefits. Regarding frozen cycles, acupuncture before freeze-thaw embryo transfer (FET) significantly enhanced the CPR (RR = 1.71, 95% CI: 1.36-2.16, <i>p</i> < 0.00001) and live birth rate (LBR) (RR = 2.40, 95% CI: 1.20-4.79, <i>p</i> = 0.01). Improvements in CPR were observed across all dosage groups, but only the high-dosage group showed a significant increase in LBR (RR = 1.75, 95% CI: 1.05-2.92, <i>p</i> = 0.03). <b><i>Conclusions:</i></b> Timing and dosage of acupuncture are crucial factors affecting pregnancy outcomes in IVF-ET. For women undergoing IVF fresh cycles, acupuncture during COH yielded more significant reproductive benefits. In addition, acupuncture before freeze-thaw embryo transfer (FET) was associated with improved pregnancy outcomes in frozen cycles. Furthermore, higher dosages of acupuncture were linked to more favorable outcomes.</p>","PeriodicalId":29734,"journal":{"name":"Journal of Integrative and Complementary Medicine","volume":" ","pages":"1031-1046"},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141162479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ginger for Pain Management in Primary Dysmenorrhea: A Systematic Review and Meta-Analysis.","authors":"Reza Moshfeghinia, Nastaran Salmanpour, Hamed Ghoshouni, Hossein Gharedaghi, Roghayeh Zare, Holger Cramer, Ghazaleh Heydarirad, Mehdi Pasalar","doi":"10.1089/jicm.2023.0799","DOIUrl":"10.1089/jicm.2023.0799","url":null,"abstract":"<p><p><b><i>Background:</i></b> Primary dysmenorrhea is a common gynecological disorder that affects many women of reproductive age. Ginger, a widely used spice with anti-inflammatory properties, has been suggested as a potential treatment for the painful cramps associated with this condition. <b><i>Objective:</i></b> The aim of this systematic review and meta-analysis was to evaluate the efficacy of ginger for pain management in primary dysmenorrhea. <b><i>Methods:</i></b> Our systematic review was registered in Prospero (CRD42023418001). Six English (PubMed, Scopus, Web of Science, PsycINFO, CINAHL complete, and Cochrane) and one Persian electric database (SID) was searched up to May 2023 for English or Persian studies that measure the effect of ginger on pain in dysmenorrhea. The Cochrane tool was used to assess the risk of bias of the included studies. Random effects meta-analyses were performed to obtain standardized mean differences (SMD) and 95% confidence intervals (CI). <b><i>Results:</i></b> Out of the 804 articles initially identified from the search, 24 were included for qualitative analysis and 12 for quantitative analysis after a full-text evaluation. The combined results of the studies indicate that ginger is notably more effective than placebo in reducing both the intensity (SMD = -1.13; 95% CI = -1.59 to -0.68, <i>I</i>² = 81.05%) and duration of pain (SMD = -0.29; 95% CI = -0.46 to -0.12). There were no differences between ginger and nonsteroidal anti-inflammatory drugs (NSAIDs) (SMD = 0.01; 95% CI = -0.24 to 0.25), or exercise (SMD = 0.06; 95% CI = -0.66 to 0.78) for pain intensity. Safety-related data were infrequently reported. <b><i>Conclusions:</i></b> The results of this meta-analysis suggest that ginger can effectively reduce pain associated with dysmenorrhea. The findings are limited due to risk of bias in the included studies and the unclear risk-benefit ratio.</p>","PeriodicalId":29734,"journal":{"name":"Journal of Integrative and Complementary Medicine","volume":" ","pages":"1016-1030"},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141071146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Potential for Digital Phenotyping in Understanding Mindfulness App Engagement Patterns: A Pilot Study.","authors":"Lucy Gray, Natalia Marcynikola, Ian Barnett, John Torous","doi":"10.1089/jicm.2023.0698","DOIUrl":"10.1089/jicm.2023.0698","url":null,"abstract":"<p><p><b><i>Background:</i></b> Low app engagement is a central barrier to digital mental health efficacy. With mindfulness-based mental health apps growing in popularity, there is a need for new understanding of factors influencing engagement. This study utilized digital phenotyping to understand real-time patterns of engagement around app-based mindfulness. Different engagement metrics are presented that measure both the total number of app-based activities participants completed each week, as well as the proportion of days that participants engaged with the app each week. <b><i>Method:</i></b> Data were derived from two iterations of a four-week study exploring app engagement in college students (<i>n</i> = 169). This secondary analysis investigated the relationships between general and mindfulness-based app engagement with passive data metrics (sleep duration, home time, and screen duration) at a weekly level, as well as the relationship between demographics and engagement. Additional clinically focused analysis was performed on three case studies of participants with high mindfulness activity completion. <b><i>Results:</i></b> Demographic variables such as gender, race/ethnicity, and age lacked a significant association with mindfulness app-based engagement. Passive data variables such as sleep and screen duration were significant predictors for different metrics of general and mindfulness-based app engagement at a weekly level. There was a significant interaction effect for screen duration between the number of mindfulness activities completed and whether or not the participant received a mindfulness notification. K-means clusters analyses using passive data features to predict mindfulness activity completion had low performance. <b><i>Conclusions:</i></b> While there are no simple solutions to predicting engagement with mindfulness apps, utilizing digital phenotyping approaches at a population and personal level offers new potential. The signal from digital phenotyping warrants more investigation; even small increases in engagement with mindfulness apps may have a tremendous impact given their already high prevalence of engagement, availability, and potential to engage patients across demographics.</p>","PeriodicalId":29734,"journal":{"name":"Journal of Integrative and Complementary Medicine","volume":" ","pages":"1108-1115"},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141248826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping the Research Landscape: The Rise of Bibliometric Analysis in Integrative Medicine.","authors":"Thomas Ostermann, Jeremy Y Ng","doi":"10.1089/jicm.2024.0855","DOIUrl":"10.1089/jicm.2024.0855","url":null,"abstract":"","PeriodicalId":29734,"journal":{"name":"Journal of Integrative and Complementary Medicine","volume":" ","pages":"1013-1015"},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142547970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Chinese Medicine Facing a Potential Workforce Crisis in Australia? Demographic Changes in the Profession over the Last Decade.","authors":"Qin Li, Jing Liang, Demin Xue, Keith M Kendrick, Christopher Zaslawski, Ji Chen","doi":"10.1089/jicm.2024.0094","DOIUrl":"10.1089/jicm.2024.0094","url":null,"abstract":"<p><p><b><i>Background:</i></b> As a prominent part of complementary and alternative medicine, Chinese Medicine (CM) has proved its strengths in treating a diverse range of acute and chronic medical conditions and is at present recognized in 196 countries and territories worldwide. In 2012, Australia regulated the CM profession under the National Regulation and Accreditation Scheme (NRAS) by legislation and reports quarterly demographic information about individual CM practitioners so to ensure public interest, although research examining the change of CM workforce in Australia has been scarce. <b><i>Objective:</i></b> This study aims to investigate the construction of the CM workforce in Australia and more importantly, evaluated its development in the last decade to capture the trajectory and trend in the present period and future potential changes. <b><i>Methods:</i></b> Data were sourced from the Australian Health Practitioner Regulation Agency (AHPRA) annual reports and the Chinese Medicine Board of Australia (CMBA) registration statistics from 2012 to 2023. A descriptive analysis was conducted with demographic variables, including profession, age, and gender, and chi-square tests and linear regression modeling were carried out to assess the variations between regions and across years. <b><i>Results:</i></b> The population of CM practitioners in 2022/2023 stagnated with slight decrease to 4,823, in contrast to the increase rate of 2.9% in the whole health care community. The number of young CM registrants (<35 y) shrank by 37.5% from 691 in 2012 to 432 in 2023. In comparison with other health care professions, CM comprises the smallest proportion of the population aged younger than 25 (0.2%) and the largest proportion aged older than 65 years (16.2%), advancing into an aging era. <b><i>Conclusions:</i></b> This study indicates a worrying potential decline in CM workforce in Australia, which is likely to be further exacerbated by the lack of new graduates and rise of median age among practitioners. Meanwhile, continued advancement in Western medicine technology and standards requires substantial efforts to increase both a better understanding of CM and demonstration of its efficacy. Furthermore, greater effort is needed to recruit and educate new young CM practitioners in Australia and to broaden the international training pipeline for a sustainable development of CM practice.</p>","PeriodicalId":29734,"journal":{"name":"Journal of Integrative and Complementary Medicine","volume":" ","pages":"1072-1081"},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141071138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mindfulness in the Clinic Waiting Room May Decrease Pain: Results from Three Pilot Randomized Controlled Trials.","authors":"Adam W Hanley, Rebecca Wilson Zingg, Benjamin Smith, Melissa Zappa, Shelley White, Allison Davis, Phillip R Worts, Carli Culjat, Geraldine Martorella","doi":"10.1089/jicm.2024.0020","DOIUrl":"10.1089/jicm.2024.0020","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Mindfulness interventions can improve a broad range of patient outcomes, but traditional mindfulness-based interventions are time and resource intensive. Emerging evidence indicates brief, single-session mindfulness interventions can also improve patient outcomes, and brief mindfulness interventions can be embedded into medical care pathways with minimal disruption. However, the direct impact of a brief mindfulness intervention on patients' pain while waiting in the clinic waiting room remains unexamined. <b><i>Objective:</i></b> A series of three, pilot, randomized controlled trials (RCTs) were conducted to examine the impact of a brief, audio-recorded, mindfulness intervention on patients' pain in the clinic waiting room. <b><i>Method:</i></b> Study 1 examined an 8-min mindfulness recording delivered before a provider visit; Study 2 examined a 5-min mindfulness recording after a provider visit; and Study 3 examined a 4-min mindfulness recording before a provider visit. Time- and attention-matched control conditions were used in each study. Studies 1 and 2 were conducted in an academic cancer hospital. Study 3 was conducted at a walk-in orthopedic clinic. Pain intensity was measured in each of the three studies. Anxiety and depression symptoms were measured in Studies 2 and 3. Pain unpleasantness was measured in Study 3. <b><i>Results:</i></b> A brief (i.e., 4- to 8-min), audio-recorded mindfulness intervention decreased patients' pain intensity in the clinic waiting room, whether delivered before (Study 1 Cohen's d=1.01, Study 3 Cohen's d=0.39) or after (Study 2 Cohen's d=0.89) a provider visit. Mindfulness had a significant effect on anxiety symptoms in both studies in which it was measured. No effect on depression symptoms was observed. <b><i>Conclusions:</i></b> Results from these three pilot RCTs indicate brief, audio-recorded, mindfulness interventions may be capable of quickly decreasing clinical symptoms. As such, embedding brief, audio-recorded, mindfulness interventions in clinic waiting rooms may have the potential to improve patient outcomes. The continued investigation of this intervention approach is needed. <b><i>Clinical Trial Registrations:</i></b> NCT04477278 and NCT06099964.</p>","PeriodicalId":29734,"journal":{"name":"Journal of Integrative and Complementary Medicine","volume":" ","pages":"1082-1091"},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140960027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health Resource Utilization and Cost Impact of Integrative Medicine Services for Newly Diagnosed Chronic Pain Patients.","authors":"Justin Whetten, Laura Medina, Crystal Krabbenhoft, Vanessa Will, Mary Reising, Breanna K Maska, Jennifer K Phillips","doi":"10.1089/jicm.2024.0093","DOIUrl":"10.1089/jicm.2024.0093","url":null,"abstract":"<p><p><b><i>Background:</i></b> Integrative medicine (IM) is the healing-oriented practice of medicine that emphasizes the relationship between practitioner and patient. It considers the whole person, their environment, lifestyle, and social and cultural factors. It is evidence based and makes use of all appropriate therapies, conventional and complimentary. <b><i>Objective:</i></b> To evaluate the impact of IM services on health outcomes and care costs of chronic pain management patients compared with standard care. <b><i>Methods:</i></b> This article uses University of New Mexico hospital billing data from 10/2016 to 09/2019 to identify patients with nervous system or musculoskeletal pain. A total of 1,304 patients were matched using propensity scores into IM services (treatment: 652) and standard care (control: 652) cohorts for difference-in-differences analysis. The patients were matched based on age, sex, race, zip code, insurance type, ICD-10s, prescriptions, health care events, and medical claim costs. <b><i>Results:</i></b> Patients who used IM services had better health outcomes and lower costs at 3-month, 6-month, and 12-month follow-up. At the 12-month follow-up, the IM group showed a 19% decrease in utilization of inpatient care, a 37% decrease in Emergency Department utilization, and an 11.3% reduction in claim costs compared with the control group. <b><i>Conclusion:</i></b> Patients who utilize IM services as part of chronic pain management have overall lower health care costs and better health outcomes. Unfortunately, in the health system studied, less than 3% of patients utilize these services. Promotion of and education about IM services should be aimed at both patients and their providers.</p>","PeriodicalId":29734,"journal":{"name":"Journal of Integrative and Complementary Medicine","volume":" ","pages":"1116-1121"},"PeriodicalIF":1.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141559948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}