. 2024 Apr 6:13:27536130241241259.

doi: 10.1177/27536130241241259. eCollection 2024 Jan-Dec.

Measuring Patient-Reported Use and Outcomes From Complementary and Integrative Health Therapies: Development of the Complementary and Integrative Health Therapy Patient Experience Survey

Stephanie L Taylor^{1

2}, A Rani Elwy^{3

4}, Barbara G Bokhour^{3

5}, Scott S Coggeshall^{6

7}, Amy Cohen⁸, Claudia Der-Martirosian^{1

9}, Taona Haderlein^{1

9}, Jolie Haun^{10

11}, Benjamin Kligler¹², Alex T Kloehn⁶, Karl A Lorenz^{13

14}, Briana Lott¹, Marlena H Shin³, Tammy Schult¹², Joy Toyama¹, Alison M Whitehead¹², Xiaoyi Zhang¹⁵, Steven B Zeliadt^{6

7}

Affiliations

¹ Center for the Study of Healthcare Innovation, Implementation and Policy, Greater Los Angeles VA Healthcare System, Los Angeles, CA, USA.
² Department of Medicine and Department of Health Policy and Management, UCLA, Los Angeles, CA, USA.
³ Center for Healthcare Organization and Implementation Research, VA Bedford, Bedford, MA, USA and VA Boston Healthcare Systems, Boston, MA, USA.
⁴ Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA.
⁵ Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA.
⁶ Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound Healthcare System, Seattle, WA, USA.
⁷ Department of Health Services, School of Public Health, University of Washington, Seattle, WA, USA.
⁸ Division of Education, American Psychiatric Association, Washington, DC, USA.
⁹ Veterans Emergency Management Evaluation Center, Office of Patient Care Services, North Hills, CA, USA.
¹⁰ James A. Haley Veterans Hospital, Tampa, FL, USA.
¹¹ College of Public Health at University of South Florida, Tampa, FL, USA.
¹² Office of Patient Centered Care and Cultural Transformation, Veterans Health Administration, Washington, DC, USA.
¹³ Center for Innovation to Implementation, VA Palo Alto Healthcare System, Palo Alto, CA, USA.
¹⁴ Division of Primary Care and Population Health, Stanford School of Medicine, Stanford, CA, USA.
¹⁵ Department of Biomedical Informatics and Medical Education, School of Medicine, University of Washington, Seattle, WA, USA.

PMID: 38585239
PMCID: PMC10998493
DOI: 10.1177/27536130241241259

Measuring Patient-Reported Use and Outcomes From Complementary and Integrative Health Therapies: Development of the Complementary and Integrative Health Therapy Patient Experience Survey

Stephanie L Taylor et al. Glob Adv Integr Med Health. 2024.

. 2024 Apr 6:13:27536130241241259.

doi: 10.1177/27536130241241259. eCollection 2024 Jan-Dec.

Authors

Affiliations

¹ Center for the Study of Healthcare Innovation, Implementation and Policy, Greater Los Angeles VA Healthcare System, Los Angeles, CA, USA.
² Department of Medicine and Department of Health Policy and Management, UCLA, Los Angeles, CA, USA.
³ Center for Healthcare Organization and Implementation Research, VA Bedford, Bedford, MA, USA and VA Boston Healthcare Systems, Boston, MA, USA.
⁴ Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA.
⁵ Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA.
⁶ Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound Healthcare System, Seattle, WA, USA.
⁷ Department of Health Services, School of Public Health, University of Washington, Seattle, WA, USA.
⁸ Division of Education, American Psychiatric Association, Washington, DC, USA.
⁹ Veterans Emergency Management Evaluation Center, Office of Patient Care Services, North Hills, CA, USA.
¹⁰ James A. Haley Veterans Hospital, Tampa, FL, USA.
¹¹ College of Public Health at University of South Florida, Tampa, FL, USA.
¹² Office of Patient Centered Care and Cultural Transformation, Veterans Health Administration, Washington, DC, USA.
¹³ Center for Innovation to Implementation, VA Palo Alto Healthcare System, Palo Alto, CA, USA.
¹⁴ Division of Primary Care and Population Health, Stanford School of Medicine, Stanford, CA, USA.
¹⁵ Department of Biomedical Informatics and Medical Education, School of Medicine, University of Washington, Seattle, WA, USA.

PMID: 38585239
PMCID: PMC10998493
DOI: 10.1177/27536130241241259

Abstract

Background: Assessing the use and effectiveness of complementary and integrative health (CIH) therapies via survey can be complicated given CIH therapies are used in various locations and formats, the dosing required to have an effect is unclear, the potential health and well-being outcomes are many, and describing CIH therapies can be challenging. Few surveys assessing CIH therapy use and effectiveness exist, and none sufficiently reflect these complexities.

Objective: In a large-scale Veterans Health Administration (VA) quality improvement effort, we developed the "Complementary and Integrative Health Therapy Patient Experience Survey", a longitudinal, electronic patient self-administered survey to comprehensively assess CIH therapy use and outcomes.

Methods: We obtained guidance from the literature, subject matter experts, and Veteran patients who used CIH therapies in designing the survey. As a validity check, we completed cognitive testing and interviews with those patients. We conducted the survey (March 2021-April 2023), inviting 15,608 Veterans with chronic musculoskeletal pain with a recent CIH appointment or referral identified in VA electronic medical records (EMR) to participate. As a second validity check, we compared VA EMR data and patient self-reports of CIH therapy utilization a month after survey initiation and again at survey conclusion.

Results: The 64-item, electronic survey assesses CIH dosing (amount and timing), delivery format and location, provider location, and payor. It also assesses 7 patient-reported outcomes (pain, global mental health, global physical health, depression, quality of life, stress, and meaning/purpose in life), and 3 potential mediators (perceived health competency, healthcare engagement, and self-efficacy for managing diseases). The survey took 17 minutes on average to complete and had a baseline response rate of 45.3%. We found high degrees of concordance between self-reported and EMR data for all therapies except meditation.

Conclusions: Validly assessing patient-reported CIH therapy use and outcomes is complex, but possible.

Keywords: acupuncture; integrative medicine; meditation; veterans; yoga.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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Measuring Patient-Reported Use and Outcomes From Complementary and Integrative Health Therapies: Development of the Complementary and Integrative Health Therapy Patient Experience Survey

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Measuring Patient-Reported Use and Outcomes From Complementary and Integrative Health Therapies: Development of the Complementary and Integrative Health Therapy Patient Experience Survey

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