New Canadian research finds a reduction in primary care visits among individuals receiving mindfulness-based therapy for depression.
Investigators discovered frequent health service users who received mindfulness-based cognitive therapy showed a significant reduction in non-mental health care visits over a one-year period, compared with those who received other types of group therapy.
The mindfulness therapy group had one fewer non-mental health visit per year, for every two individuals treated with this therapy – which translates into a reduction of nearly 2,500 visits to primary care physicians, emergency departments or non-psychiatric specialists in Ontario over eight years.
“We speculate that mindfulness-based cognitive therapy has elements that could help people who are high health-care utilizers manage their distress without needing to go to a doctor,” said Dr. Paul Kurdyak.
Senior author Zindel Segal, Ph.D., one of the developers of mindfulness-based cognitive therapy, said, “the goal of this therapy is to treat depression or anxiety so this unintended effect is striking, particularly as there is limited evidence on interventions that effectively reduce high health care use.”
Mindfulness-based cognitive therapy is a structured form of psychotherapy that combines elements of cognitive-behavior therapy with mindfulness meditation. It is delivered in a group setting for eight weekly sessions.
The therapy was originally developed to prevent relapse of symptoms among people with recurring depression, as an alternative to ongoing medication treatment. It has been proven effective in multiple studies, and has been applied to other conditions such as anxiety and chronic pain.
To conduct their study, researchers identified 10,633 individuals who received group-based mindfulness-based cognitive therapy between 2003 and 2010, based on billing records from the Ontario Health Insurance Plan (OHIP).
The therapy was delivered by 24 specially trained psychiatrists or family doctors. Among these patients, 4,851 (46 per cent) were considered high health service users, having more than five visits to a primary care physician, emergency department or other specialist in a year.
For comparison, researchers identified 29,795 who received group therapy, such as cognitive-behavior or interpersonal psychotherapy, without a mindfulness component, and who were matched for age, sex and neighborhood income; 13,274 of these controls were high service users.
For both groups, non-mental health care visits were examined one year before the therapy, and one year after it ended.
“Primary care physicians play a large role in managing patients with distress, and they often report feeling overwhelmed and unable to effectively deal with cases of medically unexplained symptoms,” said Kurdyak.
“This study shows the potential of mindfulness-based cognitive therapy to help both patients and their doctors.”