The prevalence of anxiety disorders in primary care is 20%, with 41% of these patients reporting no current treatment. Patients with anxiety are also more likely to have comorbidities with other medical and/or psychiatric conditions, increasing medical costs. Integrating mindfulness-based interventions (MBIs) into a group medical visit (GMV) format has been successfully used to manage pain, but limited literature is available on the effectiveness of these visit formats for patients with stress and anxiety. Ninety-two adult patients with self-reported stress and/or anxiety were recruited from three university outpatient primary care clinics between 2016 and 2019. Participants attended at least 4 of 6 weekly GMVs focused on MBIs. Change in heart rate, blood pressure, Generalized Anxiety Disorder-7 (GAD-7) score, and 9 item Patient Health Questionnaire (PHQ-9) score from the first to last visit were evaluated using mixed effect linear regression models. Both GAD-7 (estimated change: -5.1; 95% confidence interval [CI]: -6.4 to -3.7) and PHQ-9 (estimated change: -3.3; 95% CI: -4.3 to -2.2) scores significantly decreased from the first to last visit. These reductions were independent of age, sex, and number of visits attended. No significant changes in heart rate or blood pressure were found. Significant reductions in anxiety and depression in primary care patients were observed after a 6-week standardized mindfulness based GMV. Intergroup variability was not significant indicating that the intervention is reproducible over time and across providers. Future randomized controlled trials with appropriate controls will better evaluate which components of the intervention account for findings.
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http://dx.doi.org/10.1089/jicm.2021.0329 | DOI Listing |
Am J Manag Care
January 2025
Health Economics Resource Center, VA Palo Alto Health Care System, 795 Willow Rd, Menlo Park, CA 94025. Email:
Objectives: Unused medical appointments affect both patient care and clinic operations, and the frequency of cancellations due to clinic reasons is underreported. The prevalence of these unused appointments in primary care in the Veterans Affairs Health Care System (VA) is unknown. This study examined the prevalence of unused primary care appointments and compared the relative frequency of cancellations and no-shows for patient and clinic reasons.
View Article and Find Full Text PDFAm J Manag Care
January 2025
Schaeffer Center for Health Policy & Economics, University of Southern California, 635 Downey Way, Verna & Peter Dauterive Hall, Los Angeles, CA 90089. Email:
Objectives: To assess trends in the medical loss ratio (MLR) and understand how health insurance premiums in the large group market are driven by medical claims spending and insurer margins.
Study Design: Study of approximately 500 insurers covering more than 40 million lives annually in the large group market that submitted an MLR submission form (2014-2022).
Methods: We assessed trends in the MLR, premiums, medical claims spending, administrative costs, quality improvement spending, and margins among all insurers in the large group market.
Am J Manag Care
January 2025
Ascension Borgess Hospital, 345 Naomi St, Plainwell, MI 49080. Email:
Objective: To describe the outcomes of a partnership between a drug plan and pharmacists to switch patients from brand name dipeptidyl-peptidase-4 inhibitors to the generic alogliptin.
Study Design: Single-center, retrospective chart review.
Methods: Clinical pharmacists contacted patients with primary care providers within the health system affiliated with the drug plan to facilitate the switch.
Am J Manag Care
January 2025
Department of Orthopedic Surgery, Duke University School of Medicine, 311 Trent Dr, Durham, NC 27710. Email:
Objectives: Patients are often discharged to a skilled nursing facility (SNF) for postacute rehabilitation. Functional outcomes achieved in SNFs are variable, and costs are high. Especially for accountable care organizations (ACOs), home-based postacute rehabilitation offers a high-value option if outcomes are not compromised.
View Article and Find Full Text PDFJ Med Internet Res
January 2025
Department of Electrical Engineering, Chalmers University of Technology, Gothenburg, Sweden.
Background: The aging global population and the rising prevalence of chronic disease and multimorbidity have strained health care systems, driving the need for expanded health care resources. Transitioning to home-based care (HBC) may offer a sustainable solution, supported by technological innovations such as Internet of Medical Things (IoMT) platforms. However, the full potential of IoMT platforms to streamline health care delivery is often limited by interoperability challenges that hinder communication and pose risks to patient safety.
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