Inpatient integrative medicine program can have significant impact on pain: Study

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Non-traditional therapies relieve pain among a wide range of hospitalized patients as much as 50 percent, according to a first-of-a-kind study in the Journal of Patient Safety.

The study shows that an inpatient integrative medicine program can have a significant impact on pain in an environment where pain management continues to be a major challenge, and traditional medications can have negative consequences.

"Roughly 80 percent of patients report moderate to severe pain levels after surgery," says Gregory Plotnikoff, M.D., one of the study's authors and medical director of the Penny George Institute for Health and Healing at Abbott Northwestern Hospital.

"We struggle to provide effective pain control while trying to avoid the adverse effects of opioid medications, such as respiratory depression, nausea, constipation, dizziness and falls."

The study included 1,837 cardiovascular, medical, surgical, orthopedics, spine, rehabilitation, oncology, and women's health patients at Abbott Northwestern between January 1, 2008, and June 30, 2009. They scored their pain verbally on a zero-to-ten scale before and after treatments.

The treatments included non-pharmaceutical services: mind body therapies to elicit the relaxation response, acupuncture, acupressure, massage therapy, healing touch, music therapy, aromatherapy, and reflexology.

The study, "The Impact of Integrative Medicine on Pain Management in a Tertiary Care Hospital" was published March 5 in the Journal of Patient Safety.

"Earlier studies narrowly focused on whether specific integrative therapies manage pain in either cancer or surgical patients," says Jeffery A. Dusek, Ph.D., research director for the George Institute.

"Our real-world study broadly shows that these therapies effectively reduce pain by over 50 percent across numerous patient populations. Furthermore, they can be clinically implemented in real time, across, and under the operational and financial constraints within an acute care hospital."

Dusek says future research will focus on defining appropriate intervention doses, duration of pain relief, and developing profiles of which patients are most likely to respond to nonpharmacologic treatments. Reductions in total hospitalization costs, medication use and adverse events will be quantified in future prospective research using the electronic medical record.

"I think we will find that integrative approaches to pain management during the hospital stay will improve patient satisfaction and outcomes, and we will see cost savings from patients using fewer drugs and experiencing fewer adverse events," said Lori Knutson, RN, BSN, HN-BC, executive director of the George Institute.

The George Institute's inpatient program employs 21 integrative medicine practitioners, including six registered nurses, board-certified in their specialty areas such as oncology and cardiovascular, and also board-certified in holistic nursing; six licensed Asian medicine practitioners; eight certified massage therapists, with an emphasis on acute care massage, and one certified music therapist.

Inpatient integrative services provided to patients are based on physician and nursing referrals, are supported by philanthropy and provided at no additional cost to the patient.

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