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Provider Perspectives of Battlefield Acupuncture

Authors
  • Giannitrapani, Karleen F.1, 2
  • Ackland, Princess E.3, 4
  • Holliday, Jesse1
  • Zeliadt, Steve5, 6
  • Olson, Juli7
  • Kligler, Benjamin8
  • Taylor, Stephanie L.9, 10
  • 1 Center for Innovation to Implementation, Palo Alto VA Healthcare System
  • 2 Primary Care and Population Health, Stanford University School of Medicine, Palo Alto, CA
  • 3 Center for Chronic Disease and Outcomes Research, Minneapolis VA Health Care System
  • 4 Department of Medicine, University of Minnesota, Minneapolis, MN
  • 5 Seattle-Denver Center of Innovation, VA Puget Sound Health Care System
  • 6 Department of Health Services, University of Washington, Seattle, WA
  • 7 Integrative Health Coordinating Center, VA Central Iowa Health Care System, Des Moines, IA
  • 8 Integrative Health Coordinating Center, Veterans Health Administration Office of Patient Centered Care and Cultural Transformation, Washington, DC
  • 9 Center for the Study of Healthcare Innovation, Implementation and Policy, Greater Los Angeles Healthcare System
  • 10 Department of Health Policy and Management, University of California—Los Angeles 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.0000000000001332
PMID: 32826777
PMCID: PMC7497600
Source
PubMed Central
Keywords
License
Green

Abstract

Nonpharmacological options to treat pain are in demand, in part to address the opioid crisis. One such option is acupuncture. Battlefield acupuncture (BFA) is an auricular needling protocol currently used to treat pain in the Veterans Health Administration. We aimed to identify the advantages and disadvantages of BFA from providers’ perspectives. Methods: We rely on an inductive qualitative approach to explore provider perceptions through thematic analysis of semistructured interviews with 43 BFA providers across the nation. Results: We identified the following themes. Disadvantages included: (1) clinical guidelines are insufficient; (2) patients often request multiple BFA visits from providers; (3) BFA can be uncomfortable; (4) BFA may not be an effective treatment option unless it can be provided “on demand”; and (5) BFA can promote euphoria, which can have deleterious consequences for patient self-care. Perceived advantages included: (1) BFA can simultaneously effectively control pain while reducing opioid use; (2) BFA may alleviate the pain that has been unsuccessfully treated by conventional methods; (3) BFA gives providers a treatment option to offer patients with substance use disorder; (4) BFA helps build a trusting patient-provider relationship; (5) BFA can create the opportunity for hope. Conclusions: Providers perceive BFA to have many benefits, both clinical and relational, including ways in which it may have utility in addressing the current opioid crisis. BFA is easy to deliver and has potential clinical and relational utility. Efforts to better understand effectiveness are warranted.

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