OA11.05 LB
Purpose: Integrative medicine (IM) reduces pain in hospitalized patients. However, a barrier to expanding IM to additional hospitals is the difficulty of identifying clinical populations that best respond to integrative therapies. Overcoming this barrier is challenging, given the paucity of large-scale IM inpatient programs capable of this research. In this retrospective study, we assessed the overall effectiveness of IM provided by the Penny George Institute (PGI) for pain management and then analyzed by clinical populations.
Methods: Data were collected from 7/1/09–12/31/12 and include 12,899 admissions where pre-IM intervention pain >0 and both pre- and post-intervention pain scores (0–10 verbal scale) were available. Dataset also included EPIC-based EMR variables (demographics, diagnoses). CMS major diagnostic categories (MDCs) were calculated by dividing ICD-9CM principal diagnoses into mutually exclusive clinical populations.
Results: Pre-IM intervention pain scores averaged 4.84 (SE=.03) and pain change averaged −2.07 points (SE=.02). Identification of MDCs with large samples resulted in the following MDCs suitable for analysis: “Musculoskeletal System and Connective Tissue” (n=4,058), pre-IM intervention pain of 4.98 (SE=.04) and −1.90 (SD=.03) pain change, “Factors Influencing Health Status” (n=1,796), pre-IM intervention pain of 4.78 (SE=.09) and −2.21 (SE=.05) pain change, “Pregnancy, Childbirth and Puerperium” (n=1,467), pre-IM intervention pain of 3.78 (SE=.07), and −2.33 (SE=.05) pain change, “Circulatory System” (n=1,101), pre-IM intervention pain of 4.88 (SE.09) and −2.23 (SE=0.06) pain change, and “Digestive System” (n=1,030), pre-IM intervention pain of 5.02 (SE .09) and −2.05 (SE=.06) change. Compared with “Pregnancy, Childbirth and Puerperium”, all MDCs had statistically higher pre-IM intervention pain scores (p<.001). Compared with “Musculoskeletal System and Connective Tissue”, 4/5 MDCs had statistically larger post-IM pain decreases (p<.001).
Conclusion: Widespread provision of IM across an entire hospital by the PGI offers a unique opportunity to identify differential patterns of responsiveness by clinical populations. Future PGI research will examine the pattern of responsiveness over the hospital stay.
Contact: Jeffery A. Dusek, jeffery.dusek@allina.com
