P02.02. Quality Improvement Study Suggesting the Value of Point-of-Care Documentation of Quality of Life Vital Signs in an Academic Integrative Health Center

Focus Area: Supporting Behavioral Change Rigorous quality improvement and outcome reporting within interdisciplinary academic integrative health centers (IHCs) is a realm requiring significant focus in an era of skyrocketing healthcare costs, especially in management of complex chronic illness. In one southeastern US academic IHC seeing primarily (>80%) patients with chronic pain, treatment modalities include yoga, physical therapy (PT), cognitive-based therapy (CBT), acupuncture, and group therapy. A random sample of returning patients at this IHC completed a paper survey querying the following: treatment length and modalities used as a patient at this IHC; current pain, fatigue, and anxiety levels (0–10); change in pain, fatigue, anxiety, and quality of life (−5, “much worse,” to 5, “much better”) since first visit to this IHC. Seventy-seven responses were collected. Mean and median scores were calculated for current pain (m=3.9, SD=2.6, M=4), fatigue (m=4.7, SD=3.0, M=4), anxiety (m=3.5, SD=2.7, M=3), as well as changes in QOL (m=2.8, SD=1.7, M=3), pain (m=2.4, SD=1.9, M=3), anxiety (m=2.4, SD=1.7, M=3), and fatigue (m=1.8, SD=1.7, M=3). Increasing time following treatment was associated with improved QOL (P=.045, r=0.232) as was an increasing number of services utilized (P=.021, r=0.263). Associated with these QOL changes were improved pain (P<.01, r=0.561), fatigue (P<.01, r=0.604), and anxiety (P<0.01, r=0.495) while more severe current pain (P=.002, r=−.347) and fatigue (P=.015, r=−0.277) upon survey completion inversely predicted QOL change. A two-tailed t-test revealed that patients finding PT useful reported improved QOL (P=.008), anxiety (P=.008), fatigue (P=.006), and pain (P=.003) compared to those not. Patients reporting acupuncture useful enjoyed lower anxiety (P=.016) and improved pain (P=.037) while those finding yoga useful reported improved anxiety (P=.005). Together, these data suggest the potential value of implementing a more robust, EMR-based, and consistent evaluation of different treatment modalities and QOL improvement housed within this interdisciplinary academic IHC for quality improvement of personalized, internally coordinated care.