Research News

Study Shows Success of Veterans Using VA’s Whole Health Approach to Care

June 9, 2020

A new progress report shows improvement in the lives of Veterans with chronic pain who use VA Whole Health services.

In 2016, Congress passed the Comprehensive Addiction and Recovery Act (CARA) to address the national opioid epidemic. The bill directs VA to address pain management for Veterans – and to conduct research on the implementation and impact of complementary and integrative health (CIH) and other approaches on the health and well-being of Veterans. In response, VA’s Office of Patient-Centered Care and Cultural Transformation formalized an approach to care called the Whole Health System of Care (WHS), incorporating patient-centered care and CIH. In FY2018, each VISN identified and funded a flagship site for a three-year pilot implementation of the WHS. The VA Center for the Evaluation of Patient Centered Care (EPCC): Whole Health Flagship Site Evaluation is a progress report on the implementation of the WHS at 18 flagship sites after two years. Early results show:

• Veterans with chronic pain who used WHS had a threefold reduction in opioid use compared to those who did not.
• Opioid use among comprehensive Whole Health users decreased 38% compared with only an 11% decrease among those with no Whole Health use.
• Veterans who used Whole Health services also reported being able to manage stress better and noted the care they received as being more patient centered.
• Of Veterans with chronic pain, 26% used CIH therapies; although many services were delivered in the community, an increasing proportion are being delivered within VA due to hiring of CIH providers within VA pilot sites.
• WHS use among Veterans with mental health conditions was associated with smaller increases in outpatient pharmacy costs (3.5% annual increase) compared to similar Veterans who did not use WHS (12.5% annual increase).

“These are early findings, but even so the opioid outcomes are striking, and we’re seeing this is good for employees and the system,” said Barbara Bokhour, PhD, Principal Investigator for the study, Co-Director of HSR&D’s Center for Healthcare Organization and Implementation Research (CHOIR), and Principal Investigator for the Evaluating VA’s Patient-Centered Care QUERI Partnered Evaluation Initiative. “This may take as many as 7-10 years to adopt a Whole Health approach across VA, and we have to ask, is this the way VA should go? Early findings are saying yes.”

Funding for this report was provided by VA HSR&D’s Quality Enhancement Research Initiative (QUERI) and the Office of Patient-Centered Care and Cultural Transformation.