Integrative medicine group visits: A new model of care for managing health and well-being

The burden of chronic illness, increasing cost of health care, and fragmentation of health care delivery are critical problems facing the U.S. health care system. Despite advances in science and medical technology, patients continue to experience suffering from chronic health conditions. Integrative Medicine Group Visits (IMGVs) are an innovation in care developed to respond to these issues. IMGVs deliver integrative medicine principles and modalities using the group visit model of health care delivery. The IMGV intervention begins with an intensive 8-week clinical program that combines Mindfulness-Based Stress Reduction (MBSR) with patient education and CAM therapies. After the 8 weeks, patients participate in follow-up groups at one-three month intervals. IMGVs take place in the Family Medicine clinic at Boston Medical Center. Each week, 10-12 patients with chronic pain, diabetes and/or other comorbidities meet for 2.5 hours in a group co-led by a family medicine physician and mindfulness instructor. Patients practice MBSR, engage in a health discussion with the physician, and participate in a CAM therapy. Fifty-one patients have completed the IMGV program (n = 5 groups). Sixty-four percent of participants are African American. Twenty-four percent are unemployed and 41% disabled. Sixty-one percent live on less than twenty thousand dollars per year. The average baseline pain score of 7.2 decreased to 6.4 (p=0.02) after 8 weeks. Statistically significant improvements were seen in depression and sleep measures as well. Across all groups the average attendance rate was 65%. Results on the feasibility and effectiveness of offering an Integrated Medicine Group Visits program for low-income diverse populations will inform a larger, adequately powered study.