Abstract
ObjectiveTo evaluate veteran patient and provider perceptions and preferences on complementary and integrative medicine (CIM) for headache management.BackgroundThe Veterans Health Administration (VHA) has spearheaded a Whole Health system of care focusing on CIM-based care for veteran patients. Less is known about patients’ and providers’ CIM perceptions and preferences for chronic headache management.MethodsWe conducted semi-structured interviews with 20 veteran patients diagnosed with headache and 43 clinical providers, across 12 VHA Headache Centers of Excellence (HCoE), from January 2019 to March 2020. We conducted thematic and case comparative analyses.ResultsVeteran patients and VHA clinical providers viewed CIM favorably for the treatment of chronic headache. Specific barriers to CIM approaches included: (1) A lack of personnel specialized in specific CIM approaches for timely access, and (2) variation in patient perceptions and responses to CIM treatment efficacy for headache management.ConclusionVeteran patients and VHA clinical providers in this study viewed CIM favorably as a safe addition to mainstream headache treatments. Advantages to CIM include favorable adverse effect profiles and patient autonomy over the treatment. By adding more CIM providers and resources throughout the VHA, CIM modalities may be recommended more routinely in the management of veterans with headache.
Highlights
The Veterans Health Administration (VHA) has spearheaded a Whole Health system of care focusing on complementary and integrative medicine (CIM)-based care for veteran patients
Specific barriers to CIM approaches included: (1) A lack of personnel specialized in specific CIM approaches for timely access, and (2) variation in patient perceptions and responses to CIM treatment efficacy for headache management
CIM is defined by the National Center for Complementary and Integrative Health (NCCIH) as treatments that are separate from mainstream medicine but may be integrated with it
Summary
The Veterans Health Administration (VHA) has spearheaded a Whole Health system of care focusing on CIM-based care for veteran patients. Migraine affects 1 out of 7 Americans and close to 12% of veteran patients within the Veteran Health Administration (VHA) system [1, 2]. CIM is defined by the National Center for Complementary and Integrative Health (NCCIH) as treatments that are separate from mainstream medicine but may be integrated with it. Examples of CIM are commonly divided into two main categories: Natural products (herbs, vitamins, minerals, and probiotics) and mind-body practices (yoga, chiropractic, meditation, and massage therapy). While there is evidence surrounding the use of integrative approaches such as meditation/mindfulness, acupuncture, and nutraceuticals for the treatment of migraine among the general population, there are limited studies involving headache disorders in the veteran patient population [12]
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