A whole system approach to caring for chronic disease patients in primary care: A six month mindfulness-based therapeutic lifestyle change program

The prevalence of chronic disease is steadily escalating and projected to dominate the provision of healthcare in the next decade. With the rise in chronic disorders is the concomitant burden on providers who have insufficient time and training to deliver appropriate care to this population. The Tallahassee Family Medicine Residency Program (FMRP) has taken an innovative inter-professional, whole systems approach to meet both patient and provider needs by developing a 24 week group-based mindfulness program for patients with chronic disease. This program can be exported to other residency, community based hospital and public health programs. The program addresses five evidence-based domains of health and lifestyle that are modifiable by patient choice and control. These include nutrition, movement, restful sleep, stress management and resiliency, and relationships. Weekly 2.0 hour instruction occurs in these areas, co-facilitated by a collaborative care team (a psychologist, dietitian, and yoga instructor). Daily homework as well as participation in bi-weekly individual visits with an acupuncturist are additional program components. Preliminary data on patient outcomes were collected with 29 enrolled patients. Multiple parameters were assessed at baseline, three and six month intervals, including clinical measures of anthropometrics, inflammatory and metabolic biomarkers and medication use as well as standard quality-of-life (SF-12) and mindfulness (FFMQ) instruments. Over 75% of patients completed the program. Significant differences were evident from baseline to program completion on the majority of measured outcomes. Information on program results, curriculum outlines, lessons learned from implementation, and resources needed for adaption to other settings will be discussed.