by Malaika Karriem, VA Office of Patient Centered Care and Cultural Transformation
In a pilot study of Veterans with chronic pain engaged in Whole Health services across 18 “flagship” VA Medical Centers, more than 100,000 Veterans experienced a meaningful reduction of opioid pain medications.
The Whole Health approach to care features conventional clinical care (such as medicines or counseling) and complementary and integrative care (such as acupuncture or yoga) working together as part of an overall treatment plan.
Pictured above, a provider shows where acupuncture is performed on a model ear.
Data from the VA Center for the Evaluation of Patient Centered Care (EPCC): Whole Health Flagship Site Evaluation report demonstrated that, between January 2018 and October 2019, Veterans with chronic pain who used Whole Health services experienced a threefold reduction in prescribed opioid use compared to those who did not.
Opioid use among Veterans engaged in Whole Health decreased 38%. That compares with an 11% decrease among those with no Whole Health use. Additionally, Veterans who used Whole Health services to manage their chronic pain used opioid medications three times less compared to those who did not.
Veterans connected to Whole Health increased by 193%
Prior to the pilot study, 10.5% of Veterans with chronic pain were being connected to Whole Health services. By 2019, this figure increased by 193% with over 30.7% of Veterans with chronic pain connected to the Whole Health System across the 18 pilot flagship sites.
The integration of Whole Health into VA health care was advanced by the passage of the Comprehensive Addiction and Recovery Act (CARA) in 2016. CARA aims to address opioid addiction and chronic pain management among Veterans.
In response to the passage of CARA, VA formalized its cutting-edge Whole Health approach to care that supports Veterans’ health and well-being.
Improved Veteran experiences
Veterans who used Whole Health services reported being able to manage stress better and noted the care they received as being more patient centered. These results indicate improvements in Veterans’ overall well-being.
Improving Veterans’ experiences with care may in turn improve Veteran engagement and foster better self-management of chronic illnesses. Self-management is critical to better health and well-being over time.
Implementation of a Whole Health approach is complex and takes time.
Yet, early findings suggest that when Veterans engage in Whole Health services, improvements in perceptions of care, engagement in care, and well-being are possible.
Demand for Whole Health services is high
Over 97% of Veterans responded that they were either somewhat interested, very interested or already using at least one Whole Health service. During interviews for the report, Whole Health leads shared several stories of the impact of Whole Health approaches on Veterans. These included reductions in the use of opioids and other pain medications, weight loss, smoking cessation, and improvements in mental health.
Whole Health leaders attributed these changes, in part, to a radical shift in approach to health care. Care shifted from one that fosters dependence on medical professionals to one that empowers Veterans and promotes their active partnership with a medical team as they figure out what health and well-being looks like for them.
“These are early findings. Even so, the opioid outcomes are striking and we’re seeing this is good for employees and the system,” said Barbara Bokhour, the principal investigator for the study and director of VA’s Health Services Research & Development Center for Healthcare Organization and Implementation Research at the Bedford and Boston VA medical centers.
“This may take as many as 7-10 years to adopt a Whole Health approach across VA,” she added. “We have to ask, is this the way VA should go? Early findings are saying yes.”
For more information on Whole Health and access to Whole Health service, visit www.va.gov/WHOLEHEALTH/.
Malaika Karriem provides contract support for the VA Office of Patient Centered Care and Cultural Transformation.