المؤلفون: Rodgers-Melnick, Samuel, Srinivasan, Roshini, Rivard, Rachael, Adan, Francoise, Dusek, Jeffery

مصطلحات موضوعية: anxiety, electronic health record, integrative medicine, pain, stress

الوصف: BACKGROUND: Patients seeking integrative health and medicine (IHM) modalities often present with multiple physical and psychological concerns. Research supports IHMs effectiveness for addressing symptoms over longer time periods. However, few studies have evaluated immediate outpatient effects. OBJECTIVE: This study describes pre-encounter patient-reported outcome (PRO) clusters and examines the immediate clinical effectiveness of IHM modalities on pain, stress, and anxiety among outpatients with moderate-to-severe symptoms. METHODS: A retrospective review was conducted of encounters among adults presenting to outpatient acupuncture, chiropractic, massage, integrative medicine consultation, or osteopathic manipulation treatment between January 2019 and July 2020. Encounters were included if patients reported pre-encounter pain, stress, or anxiety ≥4 on a numeric rating scale (NRS). Outcome analyses included random effects for patient and provider using a mixed model. RESULTS: Across 7335 clinical encounters among 2530 unique patients (mean age: 49.14 years; 81.0% female; 75.9% White; 15.8% Black/African American), the most common pre-encounter PRO clusters were pain, stress, and anxiety ≥4 (32.4%); pain ≥4 only (31.3%); and stress and anxiety ≥4 (15.6%). Clinically meaningful single-encounter mean [95% CI] changes were observed across all modalities in pain (-2.50 [-2.83, -2.17]), stress (-3.22 [-3.62, -2.82]), and anxiety (-3.05 [-3.37, -2.73]). CONCLUSION: Patients presenting to outpatient IHM with moderate-to-severe symptoms most often presented with pain, stress, and anxiety ≥4 on the NRS. Multiple IHM modalities yielded clinically meaningful (≥2 unit) immediate reductions in these symptoms. Future research measuring immediate and longitudinal effectiveness is needed to optimize the triage and coordination of IHM modalities to meet patients needs.

وصف الملف: application/pdf

URL الوصول: https://escholarship.org/uc/item/2jc2w6tw

المؤلفون: Rodgers-Melnick, Samuel N., Srinivasan, Roshini, Rivard, Rachael L., Adan, Francoise, Dusek, Jeffery A.

المصدر: Global Advances in Integrative Medicine & Health; 5/10/2024, p1-11, 11p

مصطلحات موضوعية: TREATMENT of psychological stress, ANXIETY treatment, TREATMENT of backaches, NECK pain treatment, SHOULDER pain treatment, HEADACHE treatment, INTEGRATIVE medicine, PAIN measurement, STATISTICAL models, OUTPATIENT services in hospitals, STRESS management, ACADEMIC medical centers, MENTAL health, RESEARCH funding, QUESTIONNAIRES, SEVERITY of illness index, SYMPTOMS, RETROSPECTIVE studies, ACUPUNCTURE, MANIPULATION therapy, DESCRIPTIVE statistics, PAIN management, MEDICAL records, ACQUISITION of data, HEALTH outcome assessment, MASSAGE therapy, CONFIDENCE intervals, DATA analysis software, CHIROPRACTIC, MIGRAINE, PREVENTIVE health services, INTEGRATED health care delivery

مصطلحات جغرافية: OHIO

مستخلص: Background: Patients seeking integrative health and medicine (IHM) modalities often present with multiple physical and psychological concerns. Research supports IHM's effectiveness for addressing symptoms over longer time periods. However, few studies have evaluated immediate outpatient effects. Objective: This study describes pre-encounter patient-reported outcome (PRO) clusters and examines the immediate clinical effectiveness of IHM modalities on pain, stress, and anxiety among outpatients with moderate-to-severe symptoms. Methods: A retrospective review was conducted of encounters among adults presenting to outpatient acupuncture, chiropractic, massage, integrative medicine consultation, or osteopathic manipulation treatment between January 2019 and July 2020. Encounters were included if patients reported pre-encounter pain, stress, or anxiety ≥4 on a numeric rating scale (NRS). Outcome analyses included random effects for patient and provider using a mixed model. Results: Across 7335 clinical encounters among 2530 unique patients (mean age: 49.14 years; 81.0% female; 75.9% White; 15.8% Black/African American), the most common pre-encounter PRO clusters were pain, stress, and anxiety ≥4 (32.4%); pain ≥4 only (31.3%); and stress and anxiety ≥4 (15.6%). Clinically meaningful single-encounter mean [95% CI] changes were observed across all modalities in pain (−2.50 [-2.83, −2.17]), stress (−3.22 [-3.62, −2.82]), and anxiety (−3.05 [-3.37, −2.73]). Conclusion: Patients presenting to outpatient IHM with moderate-to-severe symptoms most often presented with pain, stress, and anxiety ≥4 on the NRS. Multiple IHM modalities yielded clinically meaningful (≥2 unit) immediate reductions in these symptoms. Future research measuring immediate and longitudinal effectiveness is needed to optimize the triage and coordination of IHM modalities to meet patients' needs. [ABSTRACT FROM AUTHOR]

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