August 26, 2020 - ATCQA has been working with many healthcare facilities of Veterans Affairs (VA) across the country to certify their Tai Chi or Qigong instructors. It’s no surprise to us when a study in a special September supplement to Medical Care finds that Tai Chi, as well as Yoga and meditation, leads to significant improvements in key outcomes perceived by Veterans receiving care in the Veterans Health Administration system.
"Our study showed that meditation, Tai Chi, and Yoga appear to improve overall physical and mental health and reduced perceived stress," according to the new research, led by Dr. A. Rani Elwy of the VA Center for Healthcare Organization and Implementation Research at the Edith Nourse Rogers Memorial Veterans Hospital in Bedford, Mass, and an Associate Professor in the Warren Alpert Medical School of Brown University.
Published on August 24, 2020, the special issue of Medical Care documents progress toward implementing complementary and integrative health (CIH) therapies throughout the VA system - part of efforts to promote a "Whole Health" approach in VA care. As required by the 2016 Comprehensive Addiction and Recovery Act (CARA), the VA has expanded research and education on CIH programs, focusing on the impact on pain, mental health, and chronic illness.
Dr. Elwy and colleagues performed a 12-month survey study to examine the impact on CIH therapies on 119 veteran's self-reported health and well-being. These Veterans completed 401 surveys over five different time point during the study. The surveys focused on patient-reported outcomes (PROs) - an important target for efforts to improve healthcare, focusing on the most important problems and outcomes identified by patients themselves.
Overall, Veterans in the study reported using 14 different CIH therapies. Yoga was the most popular, with nearly half of Veterans participating. This was followed by meditation, acupuncture, and Tai Chi. Three CIH therapies were associated with significant improvements in PROs:
- Tai Chi was linked to improvements in overall physical and mental health functioning, anxiety levels, and ability to participate in social role activities.
- Yoga was related to decreases in perceived stress.
- Meditation was also associated with improvements in physical functioning.
None of the CIH therapies resulted in improvement in Veterans' pain intensity or level of engagement in their health care. Larger studies with longer follow-up times may be needed to show significant effects on these outcomes, according to Dr. Elwy and coauthors. They conclude: "It is time to focus on health and well-being, as defined by Veterans, and reaching these goals must include participation in CIH treatment approaches."
Titled The Implementation of Complementary and Integrative Health Therapies in the Veterans Health Administration, the new supplement presents 11 original research papers and commentaries on the VA's progress in implementing and evaluating the impact of CIH therapies on Veterans' health outcomes.
In a commentary, Alison Whitehead and Dr. Benjamin Kligler of the VA Office of Patient-Centered Care and Cultural Transformation state: "As the VA continues to develop new and better ways of making CIH approaches available to all Veterans, and to collect data on the outcomes of this expanded access for Veterans and employees, we hope to demonstrate to the rest of the U.S. healthcare system how an emphasis on whole person care and self-management skills should become the new standard across the industry."
Current evidence indicates that practicing TQ has a physiologic impact on immune system functioning and inflammatory responses. Rigorous studies are needed to guide clinical guidelines and harness the power of TQ to promote health and wellbeing.