Complementary and Integrative Medicine in Pain Management
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Yoga is a steady guide, returning patients to their own agency even in the midst of difficult times. In this workshop we will take yoga from mat to clinic, surveying cutting-edge yoga research across all cancer types while focusing on the 30 million people worldwide who are living with a cancer diagnosis, giving a human face to the disease. This is a special opportunity for healthcare providers, patient advocates, and yoga professionals to collaborate to share the evidence-based, hands-on skills necessary to work safely with this unique cohort at all stages of care to improve quality of life.
Together we can enhance whole person health care for patients, families, and healthcare providers - in clinic and in community. Yoga is an effective, low cost intervention accessible to everyone. Extended auricular therapy incorporates techniques and devices that provide ongoing ear point stimulation after a clinical session.
For extended auricular point acupressure APA , non-penetrating spheres are used: seeds, usually botanical Semen Vaccaria, magnetic pellets, or tiny stainless-steel metal balls.
These are pre-fixed with tape to secure their placement on the ear at a point. Latex-free taped products are available. Extended auricular therapy in general and extended auricular acupressure has been shown to benefit acute and chronic pain, anxiety, and other conditions with cost-effective access enhanced when given in a group setting. Auriculotherapy is used extensively in acupuncture practice; adaptations are used by other health professionals, particularly auricular acupressure, allowing for wider access of this safe and effective intervention.
This workshop will review the evidence for auricular acupressure and teach participants how to apply the technique in clinical practice.
Management of chronic pain using complementary and integrative medicine | The BMJ
Participants will learn how to identify known ear points, become familiar with protocols for pain and anxiety and interact with points to assess sensitivity. Participants will also be given information on how to communicate with patients about auricular acupressure. This pre-congress workshop incorporates expertise, practice and research from multiple Consortium member institutions. This workshop is geared toward clinical psychologists and medical professionals interested in learning about the early stages of behavioral health intervention development and adaptation.
The course will discuss the stages of intervention development up to an efficacy trial, including the role of qualitative data focus groups, dyadic interviews, individual interviews and exit interviews with patients and stakeholders e. We will present information on how to design a qualitative interview and use the information for mind-body intervention development, adaptation, and refinement.
We will use specific examples on how to decide between intervention development or adaptation, how to set a priori evidence based benchmarks, and how to revise the intervention e. This course will not provide qualitative data analyses skills. Participants are encouraged to bring questions, or specific examples of mind-body interventions that they are interested in developing.
Chronic Pain: Study of Complementary and Alternative Treatments
An integrated care model combines evidence based conventional medical approach with holistic modalities to address not just the physical symptoms but also the psychological, social, spiritual and environmental influences on health and wellbeing. Four years ago we created the Integrative Health and Wellbeing program to bring evidence based holistic modalities into academic healthcare setting. This program offers services such as physician consultation, nutrition, psychotherapy, Ayurveda, functional medicine, acupuncture, meditation, yoga, reiki and pilates.
Our goal was to create a program that is affordable, accessible, fiscally responsible and sustainable. Today our program has expanded to include 25 team members providing 10, visits a year. Along with visiting programs across the country and learning from their experience, we thought it equally important to understand our own institution and the patients we serve. Through our process of discovery, we applied what we had learned into a new model, and launched The Integrative Health and Wellbeing Program at New York Presbytarian Hospital in There are several elements that have been integral to our early success: stakeholder engagement, strategic planning, organizational structure and operations, marketing and communications, building performance metrics, and building our team.
We would like to share some of these lessons we have learned along the way. We hope this knowledge can help other clinicians and healthcare institutions create successful and sustainable programs by embracing a more holistic care approach to care. Health outcomes in our country are poor; the US is ranked 64th in life expectancy despite spending far more on healthcare. These financial and human costs are not sustainable, necessitating a radical re-envisioning and redesign of the health care system.
Key to this is expanding our understanding of what defines health and healthcare and developing a process that begins with what matters most to the patient and enables them to reach their personal goals. The VA, the largest integrated health system in the US, is transforming to a system that empowers and equips people to connect with their purpose in life, to take charge of their health and well-being, and to live their life to the fullest.
Clinical care is centered on what matters most to the Veteran, not just "what's the matter". Importantly, during this era of health care provider burnout, this transformation encourages employees to connect with their own Whole Health, self-care and resilience. During this workshop, attendees will learn how about Whole Health transformation and implementation at individual, facility, and system levels.
Participants will explore their own Whole Health through experiential activities that are currently helping VA health care team members reignite their connection to their work and their whole selves, and supporting Veterans living their fullest lives. Participants will come away with concrete tools and strategies for facilitating health care transformation at their own sites.
There will be time to discuss implementation strategies and answer questions. Integrative health cannot happen without collaboration between a number of groups including health policy makers, healthcare systems, providers of different types, third-party payers including self-insured employers and patients and their families.
Complementary Therapies for Pain
Good collaboration depends on the involved groups all seeing a net benefit - experiencing benefits that outweigh their costs and each group experiences different benefits and costs. The techniques of economic evaluation can help the various parties understand these relationships. Therefore, in addition to efforts to demonstrate the safety, efficacy and effectiveness of integrative health approaches, we must also provide information on costs and net benefits to the collaborators involved.
The overall goals of this workshop are threefold: 1 to introduce participants to the basics of economic evaluation with an emphasis on identifying the appropriate perspectives of the analysis; 2 to enable participants to better interpret the economic evaluation literature; and 3 to prepare those interested in performing an economic evaluation. This workshop will use a combination of lecture and individual and whole and small group exercises to give participants a strong foundation in economic evaluation in general, and the cost-effectiveness, cost-utility, and cost-benefit analysis of collaborative health care specifically.
Participants will also benefit from a list of resources offering additional information on the topics covered. Emmeline Edwards. Ashlee Tipton will describe the review process and highlight key characteristics of strong K-award applications. Current NCCIH grantees at different stages of their careers will lead a panel discussion with tips for successful career transitions Drs.
- Integrative Pain Care: When and How to Prescribe?;
- Management of chronic pain using complementary and integrative medicine?
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Breakout sessions specific to research and clinical care, clinical research, and basic and mechanistic research will be co-led by funded investigators and NCCIH staff to discuss the following topic areas: juggling demands and finding balance, finding mentors for different career stages, and planning NIH grant submissions Drs. Amanda Shallcross and Carol Greco along with panel speakers. Attendees are invited to sign up for one-on-one consultations with Dr.
Mudd later in the day for individualized advice on preparing grant applications. Historically, Anthroposophic Medicine and Holistic Nursing have demonstrated strength in this approach to affect healing, and thus are provided as exemplars of effective interprofessional effort. This workshop will promote understanding of the concepts of interprofessional collaboration to benefit integrative patient care, assist with skill building to develop collaborative integrative teams, explore facilitators, barriers and potential solutions related to interprofessional work, and apply learning to clinical case studies grounded in anthroposophic medicine and nursing.
An overview of interprofessional approaches currently in use and supporting research will be discussed. Fahey reports no financial relationships relevant to this field of study. Millions of people in the United States suffer from chronic pain, and a large percentage suffer disability due to that pain. Chronic pain is a public health issue in the United States, and emotional, psychological, and physical needs for patients with chronic pain need to be addressed. The mechanism of chronic pain begins with a complex stress response that activates multiple systems within the body.
Patients with chronic pain experience neurological, immunological, and emotional symptoms, which also must be examined. Chapman et al described this disruption within the systems of the body as supersystem dysregulation. Chronic pain causes deregulation of this supersystem and is much more than just a neural issue. The interconnectivity and interdependence of these systems and all systems within the body working together is important for understanding how to treat chronic pain.
Managing symptoms in chronic pain is a challenge. According to the NCCIH, symptoms can change over time, and patients may experience multiple symptoms at once. Researchers have discovered that certain interventions, including meditation and acupuncture, may affect central mechanisms of pain perception and processing, regulation of emotion and attention, and placebo responses. This review focuses on acupuncture and massage for treating chronic pain.
Acupuncture has been used to treat several chronic pain conditions ranging from surgical pain to osteoarthritis. In a double-blind, controlled study, Kotani et al tested whether preoperative intradermal acupuncture along the bladder meridian provided reasonable postoperative analgesia. Manheimer et al reviewed 16 randomized, controlled trials comparing needle acupuncture with a sham or other control. Compared to a sham control at the short-term follow-up, patients receiving acupuncture showed improvements in osteoarthritis pain standardized mean difference [SMD], Acupuncture combined with nonnarcotic analgesics may remove the need for opioid therapy and reduce side effects associated with higher dosages of medication.
- Management of chronic pain using complementary and integrative medicine.
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In a recent systematic review of osteoarthritis guidelines, five of the eight guidelines recommended acupuncture as an osteoarthritis treatment modality. Manyanga et al found that the practice of acupuncture is associated with significant reductions in pain intensity, improvement in functional mobility, and improved quality of life.
Acupuncture use was associated with significant reductions in pain intensity SMD, A subgroup analysis of pain intensity by intervention duration suggested pain intensity was reduced when intervention periods were more than four weeks SMD Researchers also have studied acupuncture for fibromyalgia pain.
In , Martin et al conducted a prospective, partially blinded, controlled, randomized trial in which patients received true or simulated acupuncture control. The largest difference in mean FIQ total scores was observed at one month In addition, acupuncture was well-tolerated and adverse effects were minimal. Harris et al studied short- and long-term effects of traditional vs.
Kliger et al published a review and found that acupuncture, compared with sham acupuncture and no treatment, was effective for treating chronic low back pain, with a moderate effect size of 0. The Joint Commission recently added acupuncture as a treatment option for pain management at its accredited hospitals.