title: Medical group visits: a feasibility study to manage patients with chronic pain in an underserved urban clinic.
abstract: BACKGROUND
  Chronic pain affects millions of racially diverse Americans. Evidence suggests that group medical visits are effective for treating chronic pain; similarly, a number of studies demonstrate the effectiveness of certain evidence-based complementary therapies in managing pain.
  
  
  OBJECTIVE
  The primary goal of this study is to evaluate the feasibility of the integrative medical group visit (IMGV) care model in an inner-city racially diverse outpatient clinic. IMGV combines patient-centered, non-pharmacologic strategies and principles of mindfulness-based stress-reduction with a group medical visit to reduce pain and associated symptoms.
  
  
  METHODS
  We surveyed patients pre and post an 8-session IMGV program to evaluate changes in pain in the last week (0-10 point scale) and comorbid symptoms including depression (Patient Health Questionaire-8 [PHQ-8]), perceived stress, and sleep quality. We also recorded referrals to the program, patients screened for eligibility, total enrollment, loss to follow-up, and attendance.
  
  
  RESULTS
  Seventy patients joined IMGV, and of these, 65 (93%) enrolled in the study. Over the course of 12 months, 7 groups met (median 9 patients/group; range 8-13 participants). Mean difference in pain level for all patients between baseline and 8 weeks was 0.7 (SD=2.0, P=.005). Mean difference in PHQ-8 depression score for patients with baseline score ≥5 was 2.6 (SD=4.6, P<.001). Statistically significant improvements were also seen in sleep quality and perceived stress.
  
  
  CONCLUSIONS
  A group visits program combining conventional and integrative medicine for predominantly racially diverse patients is feasible.
authors.affiliation: Program for Integrative Medicine and Health Disparities, Department of Family Medicine, Boston Medical Center, Massachusetts, United States.
authors.forename: Paula
authors.initials: P
authors.lastname: Gardiner
authors.affiliation: Program for Integrative Medicine and Health Disparities, Department of Family Medicine, Boston Medical Center, Massachusetts, United States.
authors.forename: Danielle
authors.initials: D
authors.lastname: Dresner
authors.affiliation: Program for Integrative Medicine and Health Disparities, Department of Family Medicine, Boston Medical Center, Massachusetts, United States.
authors.forename: Katherine Gergen
authors.initials: KG
authors.lastname: Barnett
authors.affiliation: Program for Integrative Medicine and Health Disparities, Department of Family Medicine, Boston Medical Center, Massachusetts, United States.
authors.forename: Ekaterina
authors.initials: E
authors.lastname: Sadikova
authors.affiliation: Program for Integrative Medicine and Health Disparities, Department of Family Medicine, Boston Medical Center, Massachusetts, United States.
authors.forename: Robert
authors.initials: R
authors.lastname: Saper
keywords: Group medical visit; chronic pain; integrative medical group visits; mindfulness-based stress reduction; patient-centered non-pharmacologic strategies
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