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Patient Feedback on the Effectiveness of Auricular Acupuncture on Pain in Routine Clinical Care

Authors
  • Zeliadt, Steven B.1, 2
  • Thomas, Eva R.1
  • Olson, Juli3
  • Coggeshall, Scott1
  • Giannitrapani, Karleen4
  • Ackland, Princess E.5, 6
  • Reddy, Kavitha P.7, 8
  • Federman, Daniel G.9, 10
  • Drake, David F.11, 12, 13
  • Kligler, Benjamin12, 14
  • Taylor, Stephanie L.15, 16
  • 1 Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound Health Care System
  • 2 Department of Health Services, School of Public Health, University of Washington, Seattle, WA
  • 3 VA Central Iowa Health Care System, Des Moines, IA
  • 4 Center for Innovation to Implementation, Palo Alto VA Health Care System, Palo Alto, CA
  • 5 Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System
  • 6 Department of Medicine, University of Minnesota, Minneapolis, MN
  • 7 John Cochran Veterans Hospital, VA St. Louis Health Care System
  • 8 Department of Emergency Medicine, Washington University School of Medicine, St. Louis, MO
  • 9 VA Connecticut Health Care System
  • 10 Yale University School of Medicine, New Haven, CT
  • 11 Department of Physical Medicine and Rehabilitation, Hunter Holmes McGuire VA Medical Center, Richmond, VA
  • 12 Integrative Health Coordinating Center, Veterans Health Administration, Washington, DC
  • 13 Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA
  • 14 Office of Patient-Centered Care and Cultural Transformation, Veterans Health Administration, Washington, DC
  • 15 Center for the Study of Healthcare Innovation, Implementation and Policy, Greater Los Angeles VA Health Care System
  • 16 Department of Health Policy and Management, UCLA School of Public Health, Los Angeles, CA
Type
Published Article
Journal
Medical Care
Publisher
Lippincott Williams & Wilkins
Publication Date
Aug 13, 2020
Volume
58
Issue
2 9 Suppl
Identifiers
DOI: 10.1097/MLR.0000000000001368
PMID: 32826779
PMCID: PMC7497594
Source
PubMed Central
Keywords
License
Green

Abstract

Veterans Health Administration (VHA) launched a national initiative to train providers in a specific, protocolized auricular acupuncture treatment (also called Battlefield Acupuncture or BFA) as a nonpharmacological approach to pain management. This evaluation assessed the real-world effectiveness of BFA on immediate pain relief and identified subgroups of patients for whom BFA is most effective. Research Design: In a cross-sectional cohort study, electronic medical record data for 11,406 Veterans treated with BFA at 57 VHA medical centers between October 2016 and September 2018 was analyzed. The multivariate analysis incorporated data on pain history, change in pain level on an 11-point scale, complications, and demographic information. Methods: A total of 11,406 Veterans were treated with BFA at 57 VHA medical centers between October 2016 and September 2018 and had effectiveness data recorded in their electronic medical record. Results: More than 3 quarters experienced immediate decreases in pain following administration of BFA, with nearly 60% reported experiencing a minimal clinically important difference in pain intensity. The average decrease in pain intensity was −2.5 points (SD=2.2) at the initial BFA treatment, and −2.2 points (SD=2.0) at subsequent treatments. BFA was effective across a wide range of Veterans with many having preexisting chronic pain, or physical, or psychological comorbid conditions. Veterans with opioid use in the year before BFA experienced less improvement, with pain intensity scores improving more among Veterans who had not recently used opioids. Conclusion: VHA’s rapid expansion of training providers to offer BFA as a nonpharmacological approach to pain management has benefited many Veterans.

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