Integrative Health and the Underserved
Secondary Topic: Integrative medicine delivery models
Tertiary Topic: Mind-body (including meditation and yoga)
Comparisons of IMGV and Clinical Visits in Improving the Application of Adaptive Stress Management Techniques among Patients with Chronic Pain and Depression
Salvatore D'Amico, BS; Man Luo, MPH; Paula Gardiner, MD, MPH, , Boston, MA, United States
Late Breaker: No
Background: For low income racially diverse patients with chronic pain and depression, high stress levels are very common. Integrative Medicine Group Visits (IMGV) teach the principles of Mindfulness and Evidence Based Integrative Medicine Techniques, such as stress management techniques. This analysis aims to compare the effectiveness of IMGV group to a clinical visit in improving applications of adaptive stress management techniques.
Methods: This was a randomized control trial (RCT). Participants were randomized into intervention (IMGV, n=76) group or control (PCP, n=79) group. Outcomes were measured repeatedly at baseline, 9 weeks, and 21 weeks. We pre-defined seven positive stress management techniques as adaptive techniques (including meditation, exercise, prayer, social connection, music, shopping, and walking) and three non-adaptive techniques (alcohol, cigarettes, drug).
We performed descriptive analysis, Wilcoxon Test, Chi-square test, Fisher’s Exact Test, multivariate regression with Poisson distribution, and logistic regression.
Results: This study included 155 participants, among which 86% were female, 58% were self-reported Black, and the average age was 50. At baseline, participants who did exercise had significantly lower pain medication use (p=0.04) and opioid use (p<0.01) than those did not exercise. For summary scores, intervention group had more adaptive techniques than control group at week 9 (p=0.09) and week 21 (p=0.14). The use of non-adaptive stress management techniques was similar between intervention and control groups. For individual adaptive techniques, there was a significant increase in doing exercise among intervention participants at both week 9 (RR: 3.25, CI: 1.14, 10.47) and week 21 (RR: 4.05, CI: 1.18, 15.75) compared to control group. Intervention group also had a significant increase in doing meditation compared to control at week 9 (RR: 7.98, CI: 2.37, 33.00) adjusted for baseline meditation.
Conclusion: The study suggested that IMGV is a good method to increase participants’ positive stress management techniques, such as doing exercise and meditation.