OA10.01
Purpose: The goal of this study is to evaluate an integrative medicine group visits (IMGV) program for patients with chronic pain and other chronic conditions at an inner city outpatient clinic. The objectives of the IMGV are to combine patient-centered non-pharmacologic strategies, based on the principles of Mindfulness-Based Stress Reduction (MBSR), with a conventional group medical visit to reduce pain and improve related comorbidities.
Methods: This prospective observational cohort study enrolled 65 participants between April 2012–2013. All participants receive their primary care in an urban hospital; most are low-income minorities. Patients completed questionnaires at baseline, 8 weeks, 6, and 12 months after the program. We recorded feasibility outcomes including referrals to the program, total enrollment, loss to follow-up, and attendance. Average pain in the previous week was assessed using an 11-point (0–10) scale. Exploratory outcomes including depression (PHQ-8), blood pressure, sleep quality (PSQI), stress (PSS), and anxiety (GAD-7) were assessed.
Results: Sixty-five patients in 7 cohorts enrolled in IMGV between April 2012–2013. The attendance rate across cohorts was 64%, with 68% of participants attending ≥5 weekly sessions. Preliminary analyses of baseline and 8 week data show that for those participants with baseline pain >4, mean reduction in pain score was 0.8 (p=0.002). Average improvement in PHQ-8 score for patients with a baseline PHQ-8 >5 was 2.7 (p<0.001). Of the 16 participants with hypertension, there was a 14 point decrease in mean systolic pressure from baseline to 8 weeks. While other exploratory outcomes showed trends towards improvement, changes were not statistically significant.
Conclusion: An 8-week IMGV program for an underserved patient population with chronic pain and associated conditions is feasible. Preliminary data are promising. IMGV is a model of care for complex patients with multiple chronic conditions that should be studied further.
Contact: Katherine Gergen Barnett, danielle.dresner@bmc.org
