Integrative Medicine Group Visits: A Patient-Centered Approach to Reducing Chronic Pain and Depression in a Disparate Urban Population
Speaker: Paula Gardiner MD MPH; Katherine Gergen Barnett; Danielle Dresner
Format: Audio & Slides

Objective: This presentation will introduce the audience to a new model of care known as integrative medicine group visits (IMGV). The program rationale, curriculum, and results to date will be discussed. At the end of the presentation, the audience will be able to describe the essential elements of the IMGV model, list populations for which this intervention is appropriate, and discuss potential benefits of this model on health outcomes.

Methods: IMGV is an 8-week intensive outpatient medical group visit program combining MBSR with patient education on self-care and activities such as yoga, massage, acupuncture, and nutrition. This prospective observational cohort study enrolled 66 participants between April 2012 and May 2014. All participants receive their primary care in a large urban hospital; most are low-income minorities. Patients completed questionnaires at baseline and after the last visit. Average pain in the previous week was assessed using an 11-point (0-10) numerical rating. Depression (PHQ-8) and exploratory outcomes (sleep quality, stress anxiety) were also assessed. We also recorded referrals to the program, patients screened for eligibility, total enrollment, loss to follow up, and attendance.

Results: Sixty-six patients enrolled in IMGV between April 2012 and May 2014. The attendance rate across cohorts was 64%, with 68% of participants attending =5 weekly sessions. For patients with baseline pain >4, the average reduction in pain was 0.8 (p=0.002). The average improvement in PHQ-8 score for patients with a baseline PHQ-8 >5 was 2.7 (p=0.0007).

Conclusions: Preliminary data suggest that an 8-week IMGV program for patients with chronic pain and depression is effective. The group visits model of care offers a potential solution to caring for complex patients with multiple chronic conditions. In the future, it will be important to explore various format and curriculum options for IMGV as well as to pilot the model with different patient populations.