By John M. de Castro, Ph.D.
“people who have battled with health problems for years find relief through accepting and working with their condition in a new way, dropping the desperate struggle to make things different from how they are. Mindfulness training makes it possible for a different kind of healing to take place, creating an open space of awareness from which people can start choosing to live well, as best they can, even with a serious illness.” – Goguen-Hughes
Mindfulness training has taken its place in healthcare as a primary treatment or in combination with more traditional treatments for a wide variety of health issues. Most of the studies of these medical applications of mindfulness recruit patients who have been diagnosed with specific disorders. But, primary care physicians see patients with a mix of complaints that they treat and don’t require referral to a specialist. This raises the question of generalizability. It mindfulness training helpful for the heterogeneous kind of patients seen by primary care practitioners?
In today’s Research News article “The Efficacy of Mindfulness-Based Interventions in Primary Care: A Meta-Analytic Review.” See:
or below or view the full text of the study at:
Demarzo and colleagues reviewed the published studies employing mindfulness training for patients recruited from primary care physicians. They found that the appropriate literature was sparse with only 6 randomized controlled trials reported. But the results were rather consistent. Mindfulness training groups compared to randomly assigned control groups had significantly improved general health, psychological health, and quality of life. These benefits of the training were maintained, albeit at generally lower levels, 6-months after the conclusion of training.
Hence, they found that the small number of published research studies available report that mindfulness training improves health and well-being in patients treated by primary care providers. It makes sense that since mindfulness training appears to be effective for the individual conditions that it would also be effective for a mixed group of patients with these disorders. But, the patients treated in primary care generally have milder disorders. It is reassuring that mindfulness training is effective over a range of illness intensities.
How can mindfulness training be affective over such a wide range of physical and psychological illnesses at a wide range of intensities? I am not aware of any other treatment that even comes close to this widespread applicability. It is not known exactly how mindfulness training affects all of these conditions, but certain effects of the training appear to be helpful with almost any condition. In particular, the ability of mindfulness training to reduce the psychological and physiological responses to stress would ameliorate the exacerbation of the disorders produced by stress. Mindfulness training also appears to strengthen the immune system and reduce the inflammatory response, which would be helpful in preventing or fighting off many illnesses. Finally, the ability of mindfulness training to focus the individual on the present moment and reduce thinking about the past and future would reduce, anxiety, worry, and rumination which contribute to many psychological problems.
Mindfulness training is not a panacea. But, it is ubiquitously applicable and helpful to most patients. So, improve the health of patients in primary care with mindfulness.
“In fact, the health effects of meditation can be even more dramatic — a matter of life and death. Williams points to a National Institutes of Health study that showed a 23 percent decrease in mortality, a 30 percent decrease in death due to cardiovascular problems and a big decrease in cancer mortality as well. “This effect is equivalent to discovering an entirely new class of drugs (but without the inevitable side effects).” – Mark Williams
CMCS – Center for Mindfulness and Contemplative Studies
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Demarzo, M. M. P., Montero-Marin, J., Cuijpers, P., Zabaleta-del-Olmo, E., Mahtani, K. R., Vellinga, A., … García-Campayo, J. (2015). The Efficacy of Mindfulness-Based Interventions in Primary Care: A Meta-Analytic Review. Annals of Family Medicine, 13(6), 573–582. http://doi.org/10.1370/afm.1863
PURPOSE: Positive effects have been reported after mindfulness-based interventions (MBIs) in diverse clinical and nonclinical populations. Primary care is a key health care setting for addressing common chronic conditions, and an effective MBI designed for this setting could benefit countless people worldwide. Meta-analyses of MBIs have become popular, but little is known about their efficacy in primary care. Our aim was to investigate the application and efficacy of MBIs that address primary care patients.
METHODS: We performed a meta-analytic review of randomized controlled trials addressing the effect of MBIs in adult patients recruited from primary care settings. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and Cochrane guidelines were followed. Effect sizes were calculated with the Hedges g in random effects models.
RESULTS: The meta-analyses were based on 6 trials having a total of 553 patients. The overall effect size of MBI compared with a control condition for improving general health was moderate (g = 0.48; P = .002), with moderate heterogeneity (I2 = 59; P <.05). We found no indication of publication bias in the overall estimates. MBIs were efficacious for improving mental health (g = 0.56; P = .007), with a high heterogeneity (I2 = 78;P <.01), and for improving quality of life (g = 0.29; P = .002), with a low heterogeneity (I2 = 0; P >.05).
CONCLUSIONS: Although the number of randomized controlled trials applying MBIs in primary care is still limited, our results suggest that these interventions are promising for the mental health and quality of life of primary care patients. We discuss innovative approaches for implementing MBIs, such as complex intervention and stepped care.