Relaxation response

Relaxation-response techniques, such as meditation, yoga, and prayer,
could reduce the need for health care services by 43 percent, according
to a study at Harvard-affiliated Massachusetts General Hospital (MGH)
that looked at participants in a relaxation-response-focused training
program.

Previous studies have shown that eliciting the relaxation response — a
physiologic state of deep rest — not only relieves stress and anxiety,
but also affects physiologic factors such as blood pressure, heart rate,
and oxygen consumption.

The paper's authors noted that stress-related illnesses, such as anxiety
and depression, are the third-highest causes of health expenditures in
the United States after heart disease and cancer (which also are
affected by stress).

The study, based at MGH's Institute for Technology Assessment and the
Benson-Henry Institute (BHI) for Mind Body Medicine, found that
individuals in the relaxation-response program used fewer health care
services in the year after their participation than in the preceding
year.

The report was published Tuesday in the open-access journal PLOS ONE.

"Our study's primary finding is that programs that train patients to
elicit the relaxation response — specifically those taught at the BHI —
can also dramatically reduce health care utilization," said James E.
Stahl of the MGH Institute for Technology Assessment, who led the study.
"These programs promote wellness and, in our environment of constrained
health care resources, could potentially ease the burden on our health
delivery systems at minimal cost and at no real risk." Previously
affiliated with the Benson-Henry Institute, Stahl is now based at
Dartmouth-Hitchcock Medical Center.

The relaxation response was first described more than 40 years ago by
Harvard Medical School Professor Herbert Benson, founder and director
emeritus of the BHI and a co-author of the current study. The
physiologic opposite of the well-documented fight-or-flight response,
the relaxation response is elicited by practices including meditation,
deep breathing, and prayer, and has been shown to be helpful in the
treatment of stress-related disorders ranging from anxiety to
hypertension.

To analyze the potential impact of mind-body interventions like the
relaxation response on use of health care services, the researchers
examined information available through the Research Patient Data
Registry (RPDR) of Partners HealthCare. The research team gathered data
on individuals participating in the BHI Relaxation Response Resiliency
Program (3RP) from 2006 to 2014. The program combined elicitation of the
relaxation response with social support, cognitive-skills training, and
positive psychology designed to build resiliency.

Data regarding more than 4,400 3RP participants' use of Partners system
services in the years before and after their participation was compared
with information from a demographically matched control group of almost
13,150 Partners patients over a similar two-year period. To address the
possibility that 3RP participants had been more frequent users of health
services in the year before their participation, the researchers also
compared a subgroup of almost 1,200 3RP participants that excluded those
with the highest pre-participation utilization levels with a subgroup of
222 controls whose initial healthcare utilization exactly matched those
of the 3RP participants in the first of the two studied years.

Based on the number of health care encounters in the studied period,
which included interactions in any setting — imaging studies, lab tests,
and procedures — the 3RP participants had an average reduction of 43
percent in their use of health care services in the year after their
participation.

The control group had an overall, but not statistically significant,
increase in service utilization in the second year. The
utilization-matched 3RP subgroup had a reduction of around 25 percent
across all clinical services. Clinical areas in which 3RP participation
was associated with the greatest reduction in service utilization were
neurologic, cardiovascular, musculoskeletal, and gastrointestinal. The
investigators estimate that the price of participating in programs like
3RP would be made up in costs savings in four to six months or less.

Stahl noted that the results of this investigation need to be validated
by a prospective study that would also explore where and when best to
use mind-body interventions like the Benson-Henry Relaxation Response
Resiliency Program.

"I think of it this way: There are many gates to wellness, but not
everyone is ready to walk through a particular gate at a given time.
From a public health perspective, it is better to be prepared to offer
these tools to people in their customary settings than to wait for them
to seek out these interventions. For that reason, we feel that mind-body
interventions — which are both low-cost and essentially risk-free —
should perhaps be incorporated into regular preventive care."

Benson added, "From the outset, our primary goal has been to enhance the
health and well-being of people by counteracting the harmful effects of
stress and alleviating the many diseases that are caused or exacerbated
by stress. The challenge now is to disseminate these findings, which we
feel will be of great interest to health care payors [such as insurance
companies] and policy makers."

Benson is the Mind Body Professor of Medicine at Harvard Medical School,
and Stahl is an associate professor of Medicine at the Geisel School of
Medicine at Dartmouth-Hitchcock.

Additional co-authors of the PLOS ONE paper were Michelle Dossett, John
Denninger, Darshan Mehta, Roberta Goldman, and Gregory Fricchione of the
Benson-Henry Institute; and Scott LaJoie of the University of
Louisville.

"Mind-Body Medicine: New Science and Best Practices to Meet Public
Health Challenges" will take place Nov. 5-8 at Harvard Medical School's
Joseph Martin Conference Center. The conference features Herbert Benson
and Jon Kabat-Zinn, who will explore the scope, current status, and
future of mind-body medicine as part of conventional health care
protocol.

--
http://www.fastmail.com - Or how I learned to stop worrying and
love email again