A recent study from researchers at University Hospitals (UH) Connor Whole Health examined variables associated with engagement in (1) integrative health and medicine (IHM) and (2) nonpharmacologic modalities rather than opioids among United States adults with chronic pain. The study, published in the Journal of Pain Research, uncovered disparities in access to these modalities, particularly among older adults, Black/African American individuals, and those with higher depressive symptoms and lower education and income levels, who are more likely to have chronic pain.
The researchers used data from the 2019 National Health Interview Survey, which captured data on whether participants (1) had chronic pain, (2) engaged in IHM modalities including chiropractic care, yoga, Tai Chi, massage, meditation, guided imagery, or other relaxation techniques; or (3) engaged in other nonpharmacologic pain management modalities including chronic pain self-management programs, support groups, or physical, rehabilitative, occupational, or talk therapy.
The analysis examined over 7,000 U.S. adults reporting pain on most days or every day during the past three months. The authors found that metropolitan residence, higher income, and higher education levels were linked to greater use of IHM for chronic pain. Having more pain locations and reporting an increased frequency of pain limiting life or work activities was also associated with higher IHM use. In contrast, older age, male sex, daily opioid use, and non-Hispanic Black/African American race/ethnicity were associated with lower IHM engagement.
Additionally, metropolitan residence, higher income, and more education increased the likelihood of using nonpharmacologic therapies exclusively instead of opioids. However, older individuals and those with more pain-related limitations were less likely to engage solely in nonpharmacologic modalities.
“Despite guidelines from major institutions like the Centers for Disease Control and American College of Physicians, which recommend evidence-based integrative and nonpharmacologic approaches, our findings reveal gaps in utilization among vulnerable patient groups,” said Robert J. Trager, DC, Chiropractic researcher and co-author of the study.
The findings reveal disparities between populations more affected by chronic pain and factors associated with accessing IHM and nonpharmacologic therapies. This highlights the importance of addressing barriers to these therapies, especially among vulnerable subgroups like older adults, Black individuals, rural residents, and those with less education and income.
“Understanding which populations face barriers to accessing integrative modalities helps us develop solutions. At Connor Whole Health, we are proud to lead multiple efforts to expand access to our services through advocating for improved insurance coverage, partnering with community wellness centers, and engaging in research with minority health populations such as individuals with sickle cell disease,” said Francoise Adan, MD, Chief Whole Health and Well-being Officer at UH and Director of UH Connor Whole Health.
Sam Rodgers-Melnick, the lead author, added “Given these findings, the prevalence and burden of chronic pain in the U.S., and the persistence of the opioid epidemic, our findings point to the need for policy changes to promote equitable access to these evidence-based integrative pain management modalities.”
You can read the article by clicking here.
Rodgers-Melnick SN, Trager RJ, Love TE, Dusek JA. Engagement in Integrative and Nonpharmacologic Pain Management Modalities Among Adults with Chronic Pain: Analysis of the 2019 National Health Interview Survey. J Pain Res. 2024 Jan 16;17:253–64.
About University Hospitals / Cleveland, Ohio
Founded in 1866, University Hospitals serves the needs of patients through an integrated network of 21 hospitals (including five joint ventures), more than 50 health centers and outpatient facilities, and over 200 physician offices in 16 counties throughout northern Ohio. The system’s flagship quaternary care, academic medical center, University Hospitals Cleveland Medical Center, is affiliated with Case Western Reserve University School of Medicine, Northeast Ohio Medical University, Oxford University, the Technion Israel Institute of Technology and . National Taiwan University College of Medicine. The main campus also includes the UH Rainbow Babies & Children’s Hospital, ranked among the top children’s hospitals in the nation; UH MacDonald Women’s Hospital, Ohio’s only hospital for women; and UH Seidman Cancer Center, part of the NCI-designated Case Comprehensive Cancer Center. UH is home to some of the most prestigious clinical and research programs in the nation, with more than 3,000 active clinical trials and research studies underway. UH Cleveland Medical Center is perennially among the highest performers in national ranking surveys, including “America’s Best Hospitals” from U.S. News & World Report. UH is also home to 19 Clinical Care Delivery and Research Institutes. UH is one of the largest employers in Northeast Ohio with more than 30,000 employees. Follow UH on LinkedIn, Facebook and Twitter. For more information, visit UHhospitals.org.
Journal of Pain Research