Complementary, Integrative, and Nondrug Therapy Use for Pain Among US Military Veterans on Long-term Opioids

Elizabeth S Goldsmith; Richard F MacLehose; Agnes C Jensen; Barbara Clothier; Siamak Noorbaloochi; Brian C Martinson; Melvin T Donaldson; Erin E Krebs

doi:10.1097/MLR.0000000000001333

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Complementary, Integrative, and Nondrug Therapy Use for Pain Among US Military Veterans on Long-term Opioids

Journal article

Peer reviewed

Complementary, Integrative, and Nondrug Therapy Use for Pain Among US Military Veterans on Long-term Opioids

Elizabeth S Goldsmith, Richard F MacLehose, Agnes C Jensen, Barbara Clothier, Siamak Noorbaloochi, Brian C Martinson, Melvin T Donaldson and Erin E Krebs

Medical care, Vol.58 Suppl 2 9S(2), pp.S116-S124

09/2020

DOI: 10.1097/MLR.0000000000001333

PMCID: PMC7444474

PMID: 32826781

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https://www.ncbi.nlm.nih.gov/pmc/articles/7444474View

Open Access

Abstract

Long-term opioid therapy for chronic pain arose amid limited availability and awareness of other pain therapies. Although many complementary and integrative health (CIH) and nondrug therapies are effective for chronic pain, little is known about CIH/nondrug therapy use patterns among people prescribed opioid analgesics. The objective of this study was to estimate patterns and predictors of self-reported CIH/nondrug therapy use for chronic pain within a representative national sample of US military veterans prescribed long-term opioids for chronic pain. National two-stage stratified random sample survey combined with electronic medical record data. Data were analyzed using logistic regressions and latent class analysis. US military veterans in Veterans Affairs (VA) primary care who received ≥6 months of opioid analgesics. Self-reported use of each of 10 CIH/nondrug therapies to treat or cope with chronic pain in the past year: meditation/mindfulness, relaxation, psychotherapy, yoga, t'ai chi, aerobic exercise, stretching/strengthening, acupuncture, chiropractic, massage; Brief Pain Inventory-Interference (BPI-I) scale as a measure of pain-related function. In total, 8891 (65%) of 13,660 invitees completed the questionnaire. Eighty percent of veterans reported past-year use of at least 1 nondrug therapy for pain. Younger age and female sex were associated with the use of most nondrug therapies. Higher pain interference was associated with lower use of exercise/movement therapies. Nondrug therapy use patterns reflected functional categories (psychological/behavioral, exercise/movement, manual). Use of CIH/nondrug therapies for pain was common among patients receiving long-term opioids. Future analyses will examine nondrug therapy use in relation to pain and quality of life outcomes over time.

Age Factors

Aged

Aged, 80 and over

Analgesics, Opioid - administration & dosage

Analgesics, Opioid - therapeutic use

Chronic Pain - drug therapy

Chronic Pain - therapy

Complementary Therapies - methods

Complementary Therapies - statistics & numerical data

Female

Health Status

Humans

Integrative Medicine - methods

Integrative Medicine - statistics & numerical data

Male

Middle Aged

Pain Management

Pain Perception

Quality of Life

Sex Factors

Socioeconomic Factors

United States

United States Department of Veterans Affairs

Veterans - statistics & numerical data

Veterans Health

Details

Title: Subtitle: Complementary, Integrative, and Nondrug Therapy Use for Pain Among US Military Veterans on Long-term Opioids
Creators: Elizabeth S Goldsmith - Minneapolis VA Health Care System
Richard F MacLehose - Minnesota Department of Health
Agnes C Jensen - Minneapolis VA Health Care System
Barbara Clothier - Minneapolis VA Health Care System
Siamak Noorbaloochi - Minneapolis VA Health Care System
Brian C Martinson - Minneapolis VA Health Care System
Melvin T Donaldson - University of Minnesota Medical Center
Erin E Krebs - Minneapolis VA Health Care System
Resource Type: Journal article
Publication Details: Medical care, Vol.58 Suppl 2 9S(2), pp.S116-S124
DOI: 10.1097/MLR.0000000000001333
PMID: 32826781
PMCID: PMC7444474
NLM abbreviation: Med Care
ISSN: 0025-7079
eISSN: 1537-1948
Grant note: I01 HX001752 / HSRD VA
Language: English
Date published: 09/2020
Academic Unit: Emergency Medicine
Record Identifier: 9984656604102771

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17 Times Cited - Web of Science