Research summary: can skills in relaxation and resiliency reduce doctor visits?

Summary
Researchers found a program to decrease stress response and increase resiliency reduced health care utilisation i.e. the number of times participants visited a hospital or sought a health care service. They studied 4452 people and compared them to 13149 controls.

Name of paper Relaxation response and resiliency training and its effect on healthcare resource utilisation (read full paper)
Authors James E. Stahl, Michelle L. Dossett,A. Scott LaJoie, John W. Denninger, Darshan H. Mehta, Roberta Goldman, Gregory L. Fricchione, Herbert Benson
Research location MGH Benson-Henry Institute at Massachussetts General Hospital
Journal PLOS | One (open access online journal) October 13 2015

What the researchers wanted to find out
If mind body training reduces hospital and health care visits.

How they did it
4452 people who had completed Relaxation Response Resiliency Program (or 3RP, an integrated program of relaxation response focused on skills to reduce the stress response and increase resiliency) were compared to a control group of 13149. Researchers measured the number of encounters each person had with health care.

What they found
Use of health care services decreased by 43% in a range of areas. For example, emergency department visits decreased from 3.6 to 1.7 per year.

Of note
Researchers cite a number of papers showing the link between stress and illness, and on the cost of stress-related disorders on the health care system. Their premise is that if stress-related illness is a major drain on the health system, reducing stress should reduce costs.

The 3RP training is “an integrated program of relaxation response eliciting meditation and mindfulness exercises, social support, cognitive skills training and positive psychology, focused on developing skills to reduce stress response, elicit relaxation response and enhance resiliency”.

Measurement was number of uses of health care, not the cost.

Research subjects were primarily high-users of health care resources. Savings may decrease over time as they become lower service users.

Practical pointers for working with people with pain

  • Chronic pain costs Australia upwards of $34b per year. There is potentially a very large financial benefit for the country by reducing health care visits.
  • Pain is exacerbated by stress, and stress can be exacerbated by pain.
  • Medical imaging (scans, x-rays etc) for people with chronic pain has been shown to be done more often than unnecessary. Rather than ruling out the worst, needless scanning can in fact be unhelpful and increase worry. Programs that help patients be more selective about when they see a doctor may reduce unnecessary tests, and further reduce anxiety.
  • Yoga for Pain Training covers similar skills and themes as the 3RP program (mindfulness, social support and reflective activities to decrease stress response, increase relaxation response and enhance resiliency).
  • As researchers point out, many people already use yoga, Tai Chi or Qi Gong, effectively carrying out their own preventative health care.

This research summary was produced by Rachael West, Yoga for Pain teacher and trainer. It is provided for information and shouldn’t be regarded as medical advice. Please read the full paper in the link above for a full understanding of the topic.

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