Secondary Topic: State of the science/evidence base for integrative modalities
Tertiary Topic: Health Services Research/Cost Effectiveness
The Pain Management Inventory: Patterns of conventional and complementary non-pharmacological therapy use in Minnesota National Guard Veterans
Late Breaker: Yes
There is a growing body of research regarding complementary and integrative health approaches (CIH) in pain management but the heterogeneity of techniques included in prior studies challenges the external validity of findings. We therefore developed and piloted the Pain Management Inventory (PMI)—a checklist of 20 common conventional and complementary non-pharmacological health approaches. The long-term goal of the present study is to facilitate standardized reporting of non-pharmacologic pain management in research.
National Guard Veterans from a longitudinal cohort (N=3,843) were invited to participate in a follow-up mailed survey that included the PMI and 1,850 (48.1%) responded. Respondents indicated whether they used each approach in the past year. We classified each PMI approach into complementary versus conventional and active/self versus practitioner-delivered. We used latent class analysis to identify distinct latent classes of users of non-pharmacological health approaches. Probability of membership in each class was calculated and respondents were assigned to the maximum-likelihood class based on their PMI responses.
Among all respondents, 74% endorsed use of any PMI approach, 43% any practitioner-delivered CIH (P-CIH), 26% any active/self CIH (A-CIH), and 15% both P-CIH and A-CIH (A&P-CIH). Forty-one percent reported chronic pain. The best fit model had 6 classes: low PMI use (51% of respondents; class mean different CIH modalities endorsed = 0.4), exercise users (23%; 1.1), psychotherapy users (5%; 2.2), multi-modal P-CIH users (12%; 2.6), multi-modal A-CIH users (6%; 3.2), and high-use mixed A&P-CIH (5%; 5.4).
These findings suggest the existence of six subgroups of veterans characterized by their use of mixing multiple non-pharmacological health approaches. Over one-fourth of respondents reported using multiple CIH modalities over the previous year. We will discuss implications for patients with chronic pain. Future studies will examine the generalizability of the latent classes identified with the PMI in other patient populations.