Embedding Brief Mindfulness Based Interventions in Medical Settings to Improve Patient Outcomes: Results from 6 RCTs

Mindfulness based interventions (MBIs) are emerging as efficacious treatment options for a range of clinical concerns, including pain and substance misuse. However, traditional MBIs tend to follow an eight-week model, with each session lasting two hours. Such a substantial time and resource investment may not possible for some patients and may not be necessary for others. By embedding MBIs in standard medical care pathways more patients can be exposed to an efficacious behavioral intervention that may be able to improve coping, prevent symptom escalation, and encourage well-being.

This presentation will briefly review six different randomized clinical trials (RCTs) examining how embedding a brief, single session, MBI in various medical settings (e.g., cancer hospital, general hospital, orthopedic surgery center) can improve patient outcomes. First, an audio-guided MBI delivered while patients waited for an osteopathic manipulation session (N=39) increased patients’ mindful connection to and safety within their bodies as well as their session satisfaction relative to listening to an informational recording. Second, an audio-guided MBI delivered while cancer patients’ warmed-up for their first exercise training session (N=99) decreased cancer related fatigue and increased physical performance at the 3-month exercise re-evaluation relative to warming-up as usual. Third, an in-person MBI delivered to hospitalized patients reporting “intolerable pain” or “inadequate pain control” (N=244) decreased pain, increased relaxation, and increased pleasant body sensations relative to pain psychoeducation. Fourth (N=128), a three minute nurse-led MBI delivered during a standard preoperative nurse consultation immediately decreased knee and hip replacement patients’ pain intensity, pain unpleasantness, and pain medication desire. Fifth (N=285) and sixth (N=118), an in-person MBI delivered preoperatively to knee and hip replacement patients was found to 1) immediately decrease pain, anxiety, and pain medication desire, 2) decrease postoperative pain and opioid use, and 3) increase postoperative physical function relative to cognitive behavioral pain psychoeducation.

The MBIs reviewed in this presentation are highly feasible, capable of being delivered by nearly any social worker and requiring minimal clinic time given their brevity. They also appear to work. Taken together, these results suggest that medical patients could be offered the opportunity for a dose of mindfulness at nearly every visit without over burdening either the patient or the provider. By equipping social workers with the knowledge and opportunity to provide these brief MBIs, we may be able to significantly improve outcomes for the millions of patients seeking medical services each year.