Benjamin Kligler's research while affiliated with Icahn School of Medicine at Mount Sinai and other places

Publications (111)

Article
The Veterans Health Administration is undergoing a system-wide transformation to a Whole Person/Whole Health approach to care. The Whole Health model of care is described including early outcome data on utilization and effectiveness. The paper describes the first 10 years of this transformation and provides lessons learned during that process regar...
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The Whole Health System being developed and implemented at the Veterans Health Administration is an approach to care which aims to shift the discussion from "What's the Matter With You?" to "What Matters to You?" This article describes some of the progress and future challenges in the implementation of this approach across the VHA.
Article
Objective: To describe how a partnered evaluation of the Whole Health (WH) system of care-comprised of the WH pathway, clinical care, and well-being programs-produced patient outcomes findings, which informed Veterans Health Administration (VA) policy and system change. Data sources: Electronic health records (EHR)-based cohort of 1,368,413 pati...
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This column continues the JACM commentary series from the Society for Acupuncture Research (SAR). This is a first in the 5 years of this column partnership, a review of top developments in acupuncture research, with an eye to the way cultural contexts are compelling heightened or new foci for the field. The present commentary began with a survey pr...
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Background: We tested the capacity of the 60-site VA Women's Health Practice-Based Research Network (WH-PBRN), embedded within VA, to employ a multisite card study to collect women Veterans' perspectives about Complementary and Integrative Health (CIH) and to rapidly return findings to participating sites and partnered national policy-makers in su...
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Background Between 2013 and 2018 Pacific College of Health and Science (formerly Pacific College of Oriental Medicine) trained faculty and developed curriculum in evidence informed practice (EIP), with support from a grant from the National Institutes of Health (NIH). A three-credit (45 h) Foundations of EIP course, and online EIP learning modules...
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Objective: To identify factors associated with implementing bundled group acupuncture and yoga therapy (YT) to treat underserved patients with chronic pain in community health center (CHC) settings. This is not an implementation science study, but rather an organized approach for identification of barriers and facilitators to implementing these the...
Article
Importance: Quality measures of palliative and end-of-life care relevant to patients with advanced cancer have been developed, but few are in routine use. It is unclear which of these measures are most important for providing patient- and family-centered care and have high potential for improving quality of care. Objective: To prioritize process q...
Preprint
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Background Between 2013-2018 Pacific College of Health and Science (formerly Pacific College of Oriental Medicine) trained faculty and developed curriculum in evidence informed practice (EIP), with support from a grant from the National Institutes of Health (NIH). A three-credit (45 hour) Foundations of EIP course, and online EIP learning modules (...
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Chronic pain is prevalent in the United States, with impact on physical and psychological functioning as well as lost work productivity. Minority and lower socioeconomic populations have increased prevalence of chronic pain with less access to pain care, poorer outcomes, and higher risk of fatal opioid overdose. Acupuncture therapy is effective in...
Article
Objectives: Nonpharmacological options to treat pain are in demand, in part to address the opioid crisis. One such option is acupuncture. Battlefield acupuncture (BFA) is an auricular needling protocol currently used to treat pain in the Veterans Health Administration. We aimed to identify the advantages and disadvantages of BFA from providers' pe...
Article
Objectives: Veterans Health Administration encourages auricular acupuncture (Battlefield Acupuncture/BFA) as a nonpharmacologic approach to pain management. Qualitative reports highlighted a "gateway hypothesis": providing BFA can lead to additional nonpharmacologic treatments. This analysis examines subsequent use of traditional acupuncture. Res...
Article
Objectives: Veterans Health Administration (VHA) launched a national initiative to train providers in a specific, protocolized auricular acupuncture treatment (also called Battlefield Acupuncture or BFA) as a nonpharmacological approach to pain management. This evaluation assessed the real-world effectiveness of BFA on immediate pain relief and id...
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Objectives: To train faculty and develop curricula in evidence-informed practice (EIP) within a Chinese medicine degree program. Setting: Pacific College of Oriental Medicine (New York). Design: Faculty EIP training was undertaken through utilization of online EIP modules, and development and completion of a 3-credit (45 h) online Foundations of...
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Background Acupuncture has been shown to be effective for the treatment of chronic musculoskeletal back, neck, and osteoarthritis pain. However, access to acupuncture treatment has been limited in medically underserved and low-income populations.Objective Acupuncture therapy delivered in groups could reduce cost and expand access. We compared the e...
Article
Background Although there is mounting clinical and cost-effectiveness evidence supporting integrative healthcare (IH), a significant knowledge gap hinders widespread adoption by health professionals. Intervention Foundations in Integrative Health (FIH), a 32-hour online competency-based interprofessional course to address this knowledge gap. Meth...
Article
Background: Although there is mounting clinical and cost-effectiveness evidence supporting integrative healthcare (IH), a significant knowledge gap hinders widespread adoption by primary care professionals. Intervention: Based on IH competencies developed by an interprofessional team and a needs assessment, a 32-h online interprofessional IH cou...
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Objectives Non-pharmacological treatment options for common conditions such as chronic pain, anxiety, and depression are being given increased consideration in healthcare, especially given the recent emphasis to address the opioid crisis. One set of non-pharmacological treatment options are evidence-based complementary and integrative health (CIH)...
Article
Objective: The aim of this article is to describe the process used to develop an acupuncture therapy manual for a large effectiveness trial comparing individual care against group care for chronic pain in an underserved population. The design needed to not only ensure research consistency and replicability but also be 'responsive' to real world he...
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Objectives: Health care systems are increasingly interested in becoming whole health systems that include complementary and integrative health (CIH) approaches. The nation's largest health care system, the Veterans Health Administration (VA), has been transforming to such a system. However, anecdotal evidence suggested that many VA medical centers...
Article
Objectives: The combination of biomedicine and traditional and complementary medicine (T&CM) is often referred to as integrative medicine. However, the degree to which the medical disciplines are integrated varies between medical settings, and it is believed by some to be impossible due to epistemological and paradigmatic differences. Clinicians'...
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The purpose of the present study was to identify the factors that are the strongest predictors of intentions and use of integrative medicine approaches in clinical practice. Ajzen’s theory of planned behavior was used to guide our examination of these questions. Health care professionals exposed to a Veterans Health Administration program (N = 288)...
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Objective: Battlefield Acupuncture (BFA) is an auricular needling protocol for pain. More than 1300 Veterans Health Administration (VHA) clinicians have been trained in BFA delivery. However, little is known about how well BFA has been implemented at the VHA. The aim of this research was to identify the challenges providers experience in implementi...
Article
Objective: The widespread use of opioid analgesics to treat chronic nonmalignant pain has contributed to the ongoing epidemic of opioid-related morbidity and mortality. Previous studies have also demonstrated a relationship between opioid analgesic use and unemployment due to disability. These studies have been limited to mainly white European and...
Article
Introduction: Irritable bowel syndrome (IBS) is a chronic debilitating functional gastrointestinal disorder that affects a large proportion of the general population. Dietary and mind-body approaches have shown some effectiveness in reducing IBS symptoms. Objectives: The purpose of this project was to test the feasibility of a low cost, group-or...
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As a large national healthcare system, Veterans Health Administration (VHA) is ideally suited to build on its work to date and develop a safe, evidence-based, and comprehensive approach to the care of chronic musculoskeletal pain conditions that de-emphasizes opioid use and emphasizes non-pharmacological strategies. The VHA Office of Health Service...
Article
Objectives: Chronic pain is prevalent, burdensome, and costly, and there are ethnic and racial disparities in treatment. Acupuncture is effective and safe, but access is limited. Group acupuncture can decrease cost and increase capacity by decreasing clinic space needs and increasing patient volume per acupuncturist; however, the effectiveness and...
Article
Integrative health care (IH) is an approach to health that utilizes biomedical and social determinants of health to promote health and prevent disease, focusing on primary, secondary, and tertiary prevention, and utilizing not only the clinician–patient relationship but also how the family and community contribute to health promotion and disease. I...
Conference Paper
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Background: High expectations about acupuncture might contribute to larger treatment effects (Prady et al., 2015). However, problems in the assessment are well known: 1) floor or ceiling effects lower variance; 2) expectation measures include general beliefs about complementary medicine; 3) construct validity of expectation measures remains unclear...
Article
Background and objectives: Online curricular interventions in residency have been proposed to address challenges of time, cost, and curriculum consistency. This study is designed to determine the feasibility and effectiveness of a longitudinal, multisite online curriculum in integrative medicine (IMR) for residents. Methods: Residents from eight...
Article
Objective.: This project was designed to test the feasibility and effectiveness of acupuncture therapy given in a group setting for chronic pain. Design.: Nonrandomized, repeated measures quasi-experimental trial. Setting.: Care was delivered in a primary care clinic waiting area after clinic hours. Subjects.: Included were primary care pati...
Article
Significant evidence supports the effectiveness and safety of several complementary or integrative treatment approaches to common primary care problems. Acupuncture is effective in the management of chronic low back pain. Mind-body interventions such as cognitive behavior therapy, yoga, tai chi, qi gong, and music therapy may be helpful for treatin...
Article
Context: Research literacy and the practice of evidence-based medicine (EBM) are important initiatives in complementary and alternative medicine (CAM), which requires cultural change within educational institutions for successful implementation. Objective: To determine the self-assessed research and EBM perspectives of Chinese medicine Masters d...
Article
Purpose: To improve understanding of the facilitators and barriers affecting the integration of mind-body medicine (MBM) into primary care and describe the experiences of mind-body primary care providers. Methods: The authors conducted a qualitative analysis of semi-structured telephone interviews with mind-body primary care providers selected v...
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Background: Integrative medicine (IM) provides patient-centered care and addresses the full range of physical, emotional, mental, social, spiritual, and environmental influences that affect a person's health. IM is a "whole systems" approach that employs multiple modalities as opposed to an isolated complementary therapy. Thus, studying outcomes o...
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In October 2014, the National Center for Integrative Primary Healthcare (NCIPH) was launched as a collaboration between the University of Arizona Center for Integrative Medicine and the Academic Consortium for Integrative Health and Medicine and supported by a grant from the Health Resources and Services Administration. A primary goal of the NCIPH...
Article
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The demands placed on medical trainees pose a challenge to personal wellbeing, leading to burnout and erosion of empathy. However, it is unclear at what point in medical education this decline begins. Although many schools have begun to design and implement wellness programs for their students, the medical education community's experience in evalua...
Article
To examine the experience of patients from a low-income, ethnically diverse medically underserved population receiving acupuncture for chronic pain. Qualitative analysis using inductive thematic analysis of interviews with participants from an acupuncture trial. Four community health centers in the Bronx, New York. Thirty-seven adults with chronic...
Article
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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. Thi...
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Context: Educating healthcare practitioners to understand, critically evaluate, and apply evidence to the clinical practice of complementary and alternative medicine has been an important initiative for the National Institutes of Health National Center for Complementary and Alternative Medicine. Objective: To determine the self-assessed research...
Article
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Acupuncture, a licensed health care profession in the United States, is poorly integrated into the American health care system, despite the evidence of its effectiveness. The purpose of this study was to offer a phenomenological description of the experience of acupuncturists who delivered acupuncture care in a tertiary teaching hospital in New Yor...
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Purpose: The purpose of this study was to describe outcomes of the Acupuncture to Decrease Disparities in Outcomes of Pain Treatment (ADDOPT) trial, testing acupuncture as an adjunct to usual treatment for chronic pain in urban health centers. Method: We conducted a quasi-experimental trial. Primary care patients (>21 years old) with chronic pain c...
Article
Purpose: To improve understanding of the impact of the third year on medical student wellness and help educators improve approaches to promoting wellness. Method: The authors used an interpretive description approach to conduct a qualitative analysis of required essays written by 173 third-year medical students as part of a May 2011 final exam a...
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Despite the tremendous growth of integrative medicine (IM) in clinical settings, IM has not been well characterized in the medical literature. To describe characteristics and motivation of patients seeking care at an IM clinic. Patients from a nine-site practice-based research network participated in this cross-sectional survey. Clinicians document...
Article
Objectives: The objectives of this study were to develop a better understanding of which patients with chronic illness tend to respond to integrative medicine interventions, by identifying a set of characteristics or qualities that are associated with a positive outcome in a randomized clinical trial of an integrative medicine approach to asthma t...
Article
Of the 34 million adult Americans (17%) using mind-body medicine therapies, 8 million (24%) have anxiety/depression. The evidence for using mind-body therapies to address varying depressive symptoms in populations with and without other chronic comorbidities is reviewed. Systematic literature searches of PubMed (Medline), Embase, CINAHL, and the se...
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This article describes the feasibility and acceptability of the Acupuncture to Decrease Disparities in Outcomes of Pain Treatment (ADDOPT) trial, which incorporates acupuncture as an adjunct to usual treatment for chronic pain in urban health centers. The study assessed feasibility (ability to carry out in real-world practice; adequacy of resources...
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Purpose This paper aims to systematically compare and contrast the evidence for the use of mind-body therapies to address varying degrees of depressive symptoms in populations with and without other chronic co-morbidities. Systematic literature searches of PubMed (Medline), Embase, CINAHL, and the 7 databases encompassed by Current Contents, Web of...
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Purpose Little is known about the integration of acupuncture for chronic pain in primary care settings, especially in low income and minority communities. The purpose of this ongoing NCCAM-funded study was to explore the feasibility and effectiveness of adding acupuncture to routine management in the primary care setting for diverse, low income chr...
Conference Paper
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We presented preliminary data from our ongoing qualitative reseaarch on the integration of acupuncture care into an in-patient biomedical setting.
Article
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The Integrative Medicine in Residency (IMR) program, a 200-hour Internet-based, collaborative educational initiative was implemented in 8 family medicine residency programs and has shown a potential to serve as a national model for incorporating training in integrative/complementary/alternative medicine in graduate medical education. The curriculum...
Article
The purpose of this study was to test the effectiveness of an integrative medicine approach to the management of asthma compared to standard clinical care on quality of life (QOL) and clinical outcomes. This was a prospective parallel group repeated measurement randomized design. Participants were adults aged 18 to 80 years with asthma. The interve...
Article
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To evaluate the cost impact of an integrative medicine intervention on an inpatient oncology service. This study used nonrandomized, nonequivalent groups. A baseline sample of inpatient oncology patients at Beth Israel Medical Center admitted to the medical oncology unit before implementation of the Urban Zen Initiative were compared with patients...
Article
This is a commentary of a Cochrane review, published in this issue of EBCH, first published as: Bernaola Aponte G, BadaMancilla CA, Carreazo Pariasca NY, Rojas Galarza RA. Probiotics for treating persistent diarrhoea in children. Cochrane Database of Systematic Reviews 2010, Issue 11. Art. No.: CD007401. DOI: 10.1002/14651858.CD007401.pub2. Further...
Article
The purpose of this study was to evaluate the impact of the Urban Zen Initiative, an "optimal healing environment" intervention, at Beth Israel Medical Center on both quantitative and qualitative measures of the experience of patients admitted for inpatient oncology care. A quasi-experimental design was used comparing a baseline sample of patients...