Mindfulness-based stress reduction in an integrated care delivery system: one-year impacts on patient-centered outcomes and health care utilization.
Tracy Mccubbin, Sona Dimidjian, Karin Kempe, Melissa S Glassey, Colleen Ross, Arne Beck
The Permanente Journal 2014 DOI: 10.7812/tpp/14-014 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Prospective single cohort study Peer reviewed |
|---|---|
| Sample size | 38 |
| Population | Kaiser Permanente Colorado members with chronic pain, chronic illness, or stress-related problems; mostly white (74%), female (79%), employed part-time (92%), average age 52.6 years, with multiple comorbidities (averaging 16.4 unique diagnoses) |
| Intervention | Mindfulness-Based Stress Reduction (MBSR) |
| Duration | 8-week program with assessments at baseline, 8 weeks, and 1 year; health services utilization compared from 6 months before MBSR to 6 months following the 1-year anniversary |
| Topics | Meditation |
| Keywords | Humans Prospective studies Stress, psychological Middle aged Health services Patient-centered care Female Surveys and questionnaires |
| Key findings | The eight-week MBSR program was associated with significant improvements in self-reported mental and physical function, pain, psychological symptoms, and self-efficacy at 8 weeks and 1 year, but not work productivity. Health services utilization decreased significantly at 1 year: primary care visits by 50%, specialty care visits by 38%, emergency department visits by 50%, and hospital admissions by 80%. |
Abstract
Background: Mindfulness-based stress reduction (MBSR) programs have demonstrated clinical effectiveness for both mental and physical health conditions. Less research exists on health services utilization, self-efficacy, or work productivity outcomes.
Objective: To assess one-year outcomes of MBSR in patients with chronic pain, chronic illness, or stress-related problems, measuring functional status, pain, self-efficacy, depression, anxiety, somatization, psychological distress, work productivity, and changes in health services utilization.
Methods: A prospective single cohort design evaluated an eight-week MBSR program for Kaiser Permanente Colorado members. Patient-reported measures were collected at baseline, eight weeks, and one year following MBSR. Differences in health services utilization were compared from six months before MBSR to six months following the one-year anniversary of MBSR.
Results: Most of the 38 participants were white (28; 74%), female (30; 79%), employed part-time (35; 92%), and average age 52.6 years, with multiple comorbidities (averaging 16.4 unique diagnoses), the most common being joint or back pain (28; 74%) and psychological disorder (20; 53%). Repeated measures analyses at 8 weeks (n = 26) and at 1 year (n = 24) showed significant improvements in self-reported mental and physical function, pain, psychological symptoms, and self-efficacy, but not work productivity. Significant decreases at 1 year were observed for visits in primary care (-50%, p < 0.0001), specialty care (-38%, p = 0.0004), and the Emergency Department (-50%, p = 0.04), and for hospital admissions (-80%, p = 0.02).
Conclusion: The MBSR program was associated with improvements in several patient-centered outcomes over 1 year and reductions in health services utilization up to 18 months.
Comparable studies
Other observational and cohort studies on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Using Self-Report Assessment Methods to Explore Facets of Mindfulness Undergraduate students | 2006 | Observational cohort | |
| Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders Patients with generalized anxiety disorder or panic disorder with or without agoraphobia | 1992 | Observational cohort | n = 22 |
| Meditation experience is associated with increased cortical thickness Participants with extensive Insight meditation experience and matched controls | 2005 | Observational cohort | n = 20 |
| Meditation experience is associated with differences in default mode network activity and connectivity Experienced meditators and matched meditation-naive controls | 2011 | Observational cohort | |
| Long-term meditators self-induce high-amplitude gamma synchrony during mental practice Long-term Buddhist practitioners and controls | 2004 | Observational cohort |
Citations in the library
Cited by 7
- Impact of warm mindfulness on emotion regulation: A randomized controlled effectiveness trial. Health Psychology July 6, 2023
- Enhanced mindfulness-based stress reduction in episodic migraine-effects on sleep quality, anxiety, stress, and depression: a secondary analysis of a randomized clinical trial. Pain March 1, 2022
- Characterizing Interprofessional Collaboration and Referral to Mindfulness-Based Stress Reduction Programs. Global Advances in Health and Medicine 2022
- Mindfulness and Behavior Change Harvard Review of Psychiatry November 1, 2020
- Treatment Engagement and Outcomes of Mindfulness-Based Cognitive Therapy for Veterans with Psychiatric Disorders. The Journal of Alternative and Complementary Medicine September 1, 2019
and 2 more in the library
Cites 13
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- Four-Year Follow-Up of a Meditation-Based Program for the Self-Regulation of Chronic Pain Clinical Journal of Pain 1986
- Association of participation in a mindfulness programme with bowel symptoms, gastrointestinal symptom‐specific anxiety and quality of life Alimentary Pharmacology & Therapeutics June 9, 2011
- Mindfulness therapy for somatization disorder and functional somatic syndromes: randomized trial with one-year follow-up. Journal of Psychosomatic Research January 2013
- Treating fibromyalgia with mindfulness-based stress reduction: results from a 3-armed randomized controlled trial. Pain February 2011
and 8 more in the library