The use of integrative medicine interventions leads to significant improvements in patient activation and patient-reported outcomes in the treatment of chronic pain, depression, and stress, according to a new report released by The Bravewell Collaborative. The findings are based on data collected by the Patients Receiving Integrative Medicine Interventions Effectiveness Registry (PRIMIER), the first-ever patient registry on integrative medicine.
“We are encouraged by these early results, and we see tremendous potential for PRIMIER to provide evidence-based research that will improve healthcare quality by pinpointing the most effective practices in integrative medicine,” said Donald I. Abrams, M.D., lead author and integrative oncologist at the Osher Center for Integrative Medicine at the University of California San Francisco.
Using data from PRIMIER, researchers found that the use of integrative medicine yielded an increase in the Patient Activation Measure (PAM), which assesses to what degree patients believe they have the knowledge, skill, and confidence to take action to improve their health, and whether they are likely to maintain positive self-care actions over time. Over six months, the percentage of patients with low levels of patient activation decreased from 29 percent to 17 percent, while those with higher levels of activation increased from 71 percent to 83 percent. Previous research has found that higher scores on the PAM are strongly related to improvements in clinical outcomes such as less pain, an increase in utilization of prevention screenings, and a reduction in emergency room visits.
After reviewing the prospective data from 369 patients over six months, researchers also found significant reductions in patients’ perception of depression and stress. In 179 of these patients who were being treated for chronic pain, researchers also found statistically significant decreases in pain severity and a 28 percent decrease in the degree to which pain interfered with quality of life.
PRIMIER is the first nationwide database of its kind, and is able to evaluate patient-reported outcomes over time – such as quality of life, pain, mood, and stress – for patients who supplement conventional medical care with therapies such as acupuncture, yoga, chiropractic, biofeedback, nutrition, massage, and mindfulness. The registry combines de-identified patient-reported data with information from the Electronic Health Records (EHR) from each participating center, documenting patient visit details, procedures offered, diagnosis and patient pain-assessment score. Developed and managed by BraveNet, a practice-based research network comprised of 14 integrative medicine centers based at some of the nation’s leading hospitals and medical centers, the registry has enrolled more than 1,600 patients to date.
With its growing database, PRIMIER will evaluate whether patient-reported outcomes differ with the frequency and duration of each particular intervention, while also tracking variables based on multiple characteristics of the participants, such as age, gender, ethnicity, race, clinical condition, and PAM level. Data is based on patient response to questionnaires comparing their baseline with results at 2, 4, and 6 months, and up to two years.
“PRIMIER is a cost-effective tool to accelerate research on integrative medicine,” said Benjamin Kligler, M.D., M.P.H., associate professor of clinical family and social medicine at Albert Einstein College of Medicine and chair of BraveNet. “The registry offers us the unique opportunity to assess the effectiveness of integrative medicine interventions in a wide variety of clinical conditions in real-world settings.”
About the Bravewell Collaborative
Formed in 2002, The Bravewell Collaborative is a community of philanthropists in the United States dedicated to bringing about optimal health and healing for individuals and society. An operating foundation, Bravewell develops and manages strategic initiatives that support integrative approaches to health care. Embracing rigorous research and scientific approaches in the entirety of its work, The Bravewell Collaborative’ s key initiatives include programs to educate the general public, change the way physicians are educated, develop leading clinical centers as models for change, acknowledge and support leaders in the field, and promote translational and outcomes-based research. Most recently, The Bravewell Collaborative established the first practice-based research network in integrative medicine and worked with the Institute of Medicine at the National Academies of Science to produce a National Summit on Integrative Medicine.
About Albert Einstein College of Medicine of Yeshiva University
Albert Einstein College of Medicine of Yeshiva University is one of the nation’s premier centers for research, medical education and clinical investigation. The College of Medicine has more than 2,000 full-time faculty members located on the main campus and at its clinical affiliates. In 2014, Einstein faculty received $158 million in awards from the National Institutes of Health, which also funds major research centers at Einstein in aging, intellectual development disorders, diabetes, cancer, clinical and translational research, liver disease and AIDS. Other areas where the College of Medicine is focused include developmental brain research, neuroscience, cardiac disease and initiatives to eliminate or reduce ethnic and racial health disparities. The college’s partnership with Montefiore Medical Center, its University Hospital and academic medical center, advances clinical and translational research to accelerate the pace at which new discoveries become the treatments and therapies that benefit patients. For more information, please visit http://www.einstein.yu.edu, read our blog, follow us on Twitter, like us on Facebook and view us on YouTube.
BraveNet is a practice-based research network focused on integrative medicine. The 14 members clinics are:
Alliance Integrative Medicine, Cincinnati, Ohio
Boston Medical Center, Boston University Boston, Massachusetts
Integrative Medicine at the University of Colorado Denver, Aurora, Colorado
Duke Integrative Medicine, Duke University, Durham, North Carolina
Jefferson-Myrna Brind Center for Integrative Medicine, Philadelphia, Pennsylvania
Center for Integrative Medicine at the University of Maryland School of Medicine, Baltimore, Maryland
Mount Sinai Beth Israel Center for Health and Healing, New York, New York
Osher Center for Integrative Medicine at Northwestern University
Northwestern Physicians Group, Chicago, Illinois
UCSF Osher Center for Integrative Medicine, University of California, San Francisco, California
Penny George Institute for Health and Healing, Allina Health, Minneapolis, Minnesota
University of Pittsburgh Center for Integrative Medicine, Pittsburgh, Pennsylvania
Scripps Center for Integrative Medicine, Scripps Health, La Jolla, California
Simms/Mann Health and Wellness Center at Venice Family Clinic, Los Angeles, California
The Osher Center for Integrative Health at Vanderbilt University, Nashville, Tennessee
Sara Beth Cloar