Utilization of Complementary and Integrative Healthcare to Treat Pain in Persons with Spinal Cord Injury

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Modular (Joint)
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The goal of this module project is to provide comprehensive information regarding utilization of complementary and integrative healthcare (CIH) to treat pain in people with SCI, and barriers and facilitators to utilization for people with SCI. Specific Aim 1: Characterize utilization of CIH in people with SCI in the SCIMS (i.e., who is using which therapies and why?). Hypothesis 1: A large proportion of people with SCI utilize CIH primarily to manage pain. Specific Aim 2: Compare rates of utilization of CIH in people with SCI to the US population. Hypothesis 2: People with SCI will utilize CIH at greater rates than people in the US general population. Specific Aim 3: Identify barriers to use of CIH for people with SCI (i.e., for those not using CIH, why not?). Hypothesis 3: People with SCI will report financial limitations, including lack of insurance coverage and prohibitive costs, as the primary barrier to access CHI. Specific Aim 4: Determine the relationship between utilization of CIH and functional and psychosocial outcomes collected concurrently at SCIMS NDB Form II follow-up. Hypothesis 4: Utilization of CIH will be associated with improved functional and psychosocial outcomes, including pain • There is an increasing trend towards use of CIH in the adult US population with 32.3% of adults using CIH in 2002 and 38.3% in 2007, but the most recent survey of adults with SCI was done in 2006 and included only 117 participants. • Pain is the most common reason for seeking alternatives to conventional medicine. • Pain is one of the most common secondary conditions after SCI, with prevalence of pain in people with SCI ranging from 11% to 94%, and has been found to be significantly related to a number of psychosocial and functional outcomes. • In a 2015 survey conducted by the MSKTC to identify topics for future SCI factsheets, consumers indicated a desire for a factsheet on access to alternative therapies. Anecdotally, a high number of patients in our outpatient clinics are seeking alternatives to • pain medications and asking how to access CIH to treat their pain. A high proportion of patient-directed self-treatment using alternatives to pharmacologic modalities speaks to an untreated need in a significant area of concern. • Conducting a survey of the utilization of CIH to treat pain will provide practitioners and stakeholders with a current and comprehensive understanding of the needs in this area for people with SCI. The implications of this research range from facilitating new ideas to develop RCTs to demonstrating efficacy for CIH for treatment of pain to policy change regarding access to CIH for people with SCI.