{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T10:28:02Z","timestamp":1787135282800,"version":"build-2736575974"},"reference-count":37,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T00:00:00Z","timestamp":1763078400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000738","name":"U.S. Department of Veterans Affairs","doi-asserted-by":"crossref","award":["I01 HX003412"],"award-info":[{"award-number":["I01 HX003412"]}],"id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Integrative and Complementary Medicine"],"published-print":{"date-parts":[[2026,4,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Use of complementary and integrative health (CIH) therapies has increased over the past two decades. Accumulating evidence supports the effectiveness of CIH therapies for a range of health outcomes and an association between CIH therapy use and reduced use of opioid therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To describe differences in the use of evidence-based CIH therapies among individuals with chronic pain on long-term opioid therapy (LTOT) by sociodemographic and clinical characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>This was an observational study using a national retrospective cohort of patients developed from Veterans Affairs (VA) electronic health record data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Sample:<\/jats:title>\n                    <jats:p>The sample comprised 281,903 patients receiving LTOT upon cohort entry between July 1, 2017, and December 31, 2021, with a health care encounter in one of 54 VA medical centers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Measures:<\/jats:title>\n                    <jats:p>CIH therapy use was defined as chart-documented use of any of eight priority CIH therapies or chiropractic care in the year prior to cohort entry. LTOT was defined as having a prescribed opioid analgesic for \u226590 consecutive days, allowing \u226430 days between fills. Sociodemographic and clinical characteristic variables were assessed as covariates of CIH therapy use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Results:<\/jats:title>\n                    <jats:p>Among the full cohort, the CIH therapy use rate was 9.5%. Use increased with each cohort entry year relative to 2017. In a multivariable model, variables associated with greater odds of CIH therapy use included being female, having a musculoskeletal pain condition, obesity, opioid use disorder, anxiety, depression, post-traumatic stress disorder, and receiving services in a flagship site. Lower odds of use were associated with being older, unmarried, prescribed higher opioid doses, smoking, and rural residence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>CIH therapy use has increased over time, consistent with national trends; however, differential patterns of exposure suggest the need to explore pathways to use. These may elucidate opportunities to broaden access to these evidence-based therapies for patients with chronic pain.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/27683605251396445","type":"journal-article","created":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T14:50:47Z","timestamp":1763736647000},"page":"385-392","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Use of Complementary and Integrative Health Therapies and Chiropractic Care Among Patients Receiving Long-Term Opioid Therapy in the Department of Veterans Affairs"],"prefix":"10.1177","volume":"32","author":[{"given":"Anne C.","family":"Black","sequence":"first","affiliation":[{"name":"VA Connecticut Healthcare System, West Haven, CT, USA."},{"name":"Yale School of Medicine, New Haven, CT, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven B.","family":"Zeliadt","sequence":"additional","affiliation":[{"name":"VA Puget Sound Healthcare System, Seattle, WA, USA."},{"name":"University of Washington School of Public Health, Seattle, WA, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert D.","family":"Kerns","sequence":"additional","affiliation":[{"name":"Yale School of Medicine, New Haven, CT, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamie H.","family":"Douglas","sequence":"additional","affiliation":[{"name":"VA Puget Sound Healthcare System, Seattle, WA, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica A.","family":"Abel","sequence":"additional","affiliation":[{"name":"VA Connecticut Healthcare System, West Haven, CT, USA."},{"name":"Yale School of Medicine, New Haven, CT, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haseena","family":"Rajeevan","sequence":"additional","affiliation":[{"name":"Yale School of Medicine, New Haven, CT, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alicia A.","family":"Heapy","sequence":"additional","affiliation":[{"name":"VA Connecticut Healthcare System, West Haven, CT, USA."},{"name":"Yale School of Medicine, New Haven, CT, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryam","family":"Kazemitabar","sequence":"additional","affiliation":[{"name":"Yale School of Medicine, New Haven, CT, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie L.","family":"Taylor","sequence":"additional","affiliation":[{"name":"VA Greater Los Angeles, Los Angeles, VA, USA."},{"name":"UCLA School of Medicine, School of Public Health, Los Angeles, VA, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William C.","family":"Becker","sequence":"additional","affiliation":[{"name":"VA Connecticut Healthcare System, West Haven, CT, USA."},{"name":"Yale School of Medicine, New Haven, CT, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,11,14]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.26775"},{"key":"e_1_3_3_3_2","unstructured":"National Center for Complementary and Integrative Health. 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