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Plotnikoff G.A.,Penny George Institute for Health and Healing
Minnesota medicine | Year: 2012

Not all who adhere to vegetarian, vegan or other special diets have nutritionally sound eating habits. The clinical consequences of an insufficiently mindful vegetarian or vegan diet include many common symptoms such as anxiety, brain fog, depression, fatigue, insomnia, neuropathies and other neurologic dysfunction. Patients with such symptoms who report having a vegetarian or vegan diet, or a diet that severely restricts meat consumption, require a slightly expanded differential diagnosis. The challenge is to identify which patients require closer attention. This article lists questions to use to quickly assess for potential dietary drivers of clinical symptoms. In many cases, simple nutritional interventions, through diet and/or supplementation, can resolve or minimize problematic symptoms. Source


Johnson P.J.,Center for Healthcare Innovation | Ward A.,University of Minnesota | Knutson L.,Penny George Institute for Health and Healing | Sendelbach S.,Abbott Laboratories
Health Services Research | Year: 2012

Objective To examine personal use of complementary and alternative medicine (CAM) among U.S. health care workers. Data Data are from the 2007 Alternative Health Supplement of the National Health Interview Survey. We examined a nationally representative sample of employed adults (n = 14,329), including a subsample employed in hospitals or ambulatory care settings (n = 1,280). Study Design We used multivariate logistic regression to estimate the odds of past year CAM use. Principal Findings Health care workers are more likely than the general population to use CAM. Among health care workers, health care providers are more likely to use CAM than other occupations. Conclusions Personal CAM use by health care workers may influence the integration of CAM with conventional health care delivery. Future research on the effects of personal CAM use by health care workers is therefore warranted. © Health Research and Educational Trust. Source


Abrams D.I.,University of California at San Francisco | Dolor R.,Duke University | Roberts R.,Duke University | Pechura C.,Bravewell Collaborative | And 10 more authors.
BMC Complementary and Alternative Medicine | Year: 2013

Background: Chronic pain affects nearly 116 million American adults at an estimated cost of up to $635 billion annually and is the No. 1 condition for which patients seek care at integrative medicine clinics. In our Study on Integrative Medicine Treatment Approaches for Pain (SIMTAP), we observed the impact of an integrative approach on chronic pain and a number of other related patient-reported outcome measures.Methods: Our prospective, non-randomized, open-label observational evaluation was conducted over six months, at nine clinical sites. Participants received a non-standardized, personalized, multimodal approach to chronic pain. Validated instruments for pain (severity and interference levels), quality of life, mood, stress, sleep, fatigue, sense of control, overall well-being, and work productivity were completed at baseline and at six, 12, and 24 weeks. Blood was collected at baseline and week 12 for analysis of high-sensitivity C-reactive protein and 25-hydroxyvitamin D levels. Repeated-measures analysis was performed on data to assess change from baseline at 24 weeks.Results: Of 409 participants initially enrolled, 252 completed all follow-up visits during the 6 month evaluation. Participants were predominantly white (81%) and female (73%), with a mean age of 49.1 years (15.44) and an average of 8.0 (9.26) years of chronic pain. At baseline, 52% of patients reported symptoms consistent with depression. At 24 weeks, significantly decreased pain severity (-23%) and interference (-28%) were seen. Significant improvements in mood, stress, quality of life, fatigue, sleep and well-being were also observed. Mean 25-hydroxyvitamin D levels increased from 33.4 (17.05) ng/mL at baseline to 39.6 (16.68) ng/mL at week 12.Conclusions: Among participants completing an integrative medicine program for chronic pain, significant improvements were seen in pain as well as other relevant patient-reported outcome measures.Trial Registration: ClinicalTrials.gov, NCT01186341. © 2013 Abrams et al.; licensee BioMed Central Ltd. Source


Wolever R.Q.,Duke University | Roberts R.S.,Duke University | Caldwell K.,Appalachian State University | Kligler B.,Mount Sinai Beth Israel Medical Center | And 4 more authors.
Explore: The Journal of Science and Healing | Year: 2015

Context Integrative medicine (IM) is a rapidly growing field whose providers report clinical success in treating significant stress, chronic pain, and depressive and anxiety symptoms. While IM therapies have demonstrated efficacy for numerous medical conditions, IM for psychological symptoms has been slower to gain recognition in the medical community. Objective and Design This large, cross-sectional study is the first of its kind to document the psychosocial profiles of 4182 patients at 9 IM clinics that form the BraveNet Practice-Based Research Network (PBRN). Results IM patients reported higher levels of perceived stress, pain, and depressive symptoms, and lower levels of quality of life compared with national norms. Per provider reports, 60% of patients had at least one of the following: stress (9.3%), fatigue (10.2%), anxiety (7.7%), depression (7.2%), and/or sleep disorders (4.8%). Pain, having both physiological and psychological components, was also included and is the most common condition treated at IM clinics. Those with high stress, psychological conditions, and pain were most frequently treated with acupuncture, IM physician consultation, exercise, chiropractic services, diet/nutrition counseling, and massage. Conclusion With baseline information on clinical presentation and service utilization, future PBRN studies can examine promising interventions delivered at the clinic to treat stress and psychological conditions. © 2015 Elsevier Inc. All rights reserved. Source


Nate K.C.,Penny George Institute for Health and Healing | Griffin K.H.,Penny George Institute for Health and Healing | Christianson J.B.,University of Minnesota | Dusek J.A.,Penny George Institute for Health and Healing
Evidence-based Complementary and Alternative Medicine | Year: 2015

Background. We describe the process and challenges of delivering integrative medicine (IM) at a large, acute care hospital, from the perspectives of IM practitioners. To date, minimal literature that addresses the delivery of IM care in an inpatient setting from this perspective exists. Methods. Fifteen IM practitioners were interviewed about their experience delivering IM services at Abbott Northwestern Hospital (ANW), a 630-bed tertiary care hospital. Themes were drawn from codes developed through analysis of the data. Results. Analysis of interview transcripts highlighted challenges of ensuring efficient use of IM practitioner resources across a large hospital, the IM practitioner role in affecting patient experiences, and the ways practitioners navigated differences in IM and conventional medicine cultures in an inpatient setting. Conclusions. IM practitioners favorably viewed their role in patient care, but this work existed within the context of challenges related to balancing supply and demand for services and to integrating an IM program into the established culture of a large hospital. Hospitals planning IM programs should carefully assess the supply and demand dynamics of offering IM in a hospital, advocate for the unique IM practitioner role in patient care, and actively support integration of conventional and complementary approaches. © 2015 Kent C. Nate et al. Source

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