title: Value associated with mindfulness meditation and moderate exercise intervention in acute respiratory infection: the MEPARI Study.
abstract: OBJECTIVE
  Acute respiratory infection (ARI) is among the most common, debilitating and expensive human illnesses. The purpose of this study was to assess ARI-related costs and determine if mindfulness meditation or exercise can add value.
  
  
  METHODS
  One hundred and fifty-four adults ≥50 years from Madison, WI for the 2009-10 cold/flu season were randomized to (i) wait-list control (ii) meditation or (iii) moderate intensity exercise. ARI-related costs were assessed through self-reported medication use, number of missed work days and medical visits. Costs per subject were based on cost of generic medications, missed work days ($126.20) and clinic visits ($78.70). Monte Carlo bootstrap methods evaluated reduced costs of ARI episodes.
  
  
  RESULTS
  The total cost per subject for the control group was $214 (95% CI: $105-$358), exercise $136 (95% CI: $64-$232) and meditation $65 (95% CI: $34-$104). The majority of cost savings was through a reduction in missed days of work. Exercise had the highest medication costs at $16.60 compared with $5.90 for meditation (P = 0.004) and $7.20 for control (P = 0.046). Combining these cost benefits with the improved outcomes in incidence, duration and severity seen with the Meditation or Exercise for Preventing Acute Respiratory Infection study, meditation and exercise add value for ARI. Compared with control, meditation had the greatest cost benefit. This savings is offset by the cost of the intervention ($450/subject) that would negate the short-term but perhaps not long-term savings.
  
  
  CONCLUSIONS
  Meditation and exercise add value to ARI-associated health-related costs with improved outcomes. Further research is needed to confirm results and inform policies on adding value to medical spending.
authors.affiliation: Department of Family Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, WI 53715, USA. drakel@uwhealth.org
authors.forename: David
authors.initials: D
authors.lastname: Rakel
authors.forename: Marlon
authors.initials: M
authors.lastname: Mundt
authors.forename: Tola
authors.initials: T
authors.lastname: Ewers
authors.forename: Luke
authors.initials: L
authors.lastname: Fortney
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Zgierska
authors.forename: Michele
authors.initials: M
authors.lastname: Gassman
authors.forename: Bruce
authors.initials: B
authors.lastname: Barrett
mesh_terms: D000208:Acute Disease; D000553:Ambulatory Care / Q000191:economics; D017281:Cost of Illness; D003365:Costs and Cost Analysis; D005081:Exercise Therapy / Q000191:economics / Q000379:methods; D006801:Humans; D008297:Male; D055118:Medication Adherence; D019122:Meditation / Q000379:methods; D008875:Middle Aged; D064866:Mindfulness / Q000191:economics / Q000379:methods; D017063:Outcome Assessment, Health Care; D012141:Respiratory Tract Infections / Q000191:economics / Q000628:therapy; D018582:Sick Leave / Q000191:economics; D016896:Treatment Outcome; D014850:Waiting Lists
keywords: Complementary and alternative medicine; health economics; physical activity/exercise; prevention; upper respiratory infection/common cold; value.