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How Veterans Affairs Used Telehealth for Tai Chi and Qigong During COVID-19

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October 28, 2022 - Complementary and integrative health (CIH) therapies, such as Tai Chi, Qigong, yoga, in-person acupuncture and chiropractic care, are evidence-based nonpharmaceutical treatment options for pain. During COVID-19, the Veterans Health Administration (VA) delivered several CIH therapies virtually. A recently published study by VA, University of Washington, Seattle and University of California Los Angeles explores veterans' utilization, advantages/disadvantages, and delivery issues of three practitioner-delivered CIH therapies (acupuncture, chiropractic care, and massage therapy) and three self-care CIH therapies (Tai Chi, yoga, and mindfulness/meditation).

Use of virtual care was examined quantitatively with VA administrative data for six CIH therapies before and after COVID-19 onset (2019-2021). Advantages/disadvantages and health care delivery issues of these CIH therapies through virtual care were examined qualitatively using interview data (2020-2021).

For CIH self-care therapies, in-person classes rapidly pivoted to telehealth group classes for yoga, Tai Chi (or Qigong), and meditation/mindfulness using VA's Video Connect. At most sites, virtual group classes for CIH self-care therapies were welcomed by many veterans. As such, sites expressed plans to continue offering these classes even when in-person CIH group classes resume.

The study also identified some disadvantages of tele-visits. For example, typically, 20 participants can attend in-person group classes. However, with virtual yoga, Tai Chi, and Qigong classes, sites had to limit the number of attendees (approximately six to eight participants per class) due to safety protocols. This is because yoga, Tai Chi, and Qigong instructors need to see all patients clearly to ensure safety for all patients.

Despite delivery issues or disadvantages of tele-CIH self-care, utilization of CIH self-care therapies increased significantly between 2019 and 2021; another study, conducted by Dana-Farber Cancer Institute in Boston, also found similar results, where tele-visits in yoga, Tai Chi, Qigong, and meditation/mindfulness increased in the first 6 months of the pandemic.

Overall, for tele-visits, the advantages included increased access to self-care, increased patient receptivity to engaging in self-care, and flexibility in staffing online group classes. Disadvantages included patient preference, patient safety, and strain on staffing.




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