An integrative healthcare model with heartfulness meditation and care coordination improves outcomes in cyclic vomiting syndrome.

Abstract

Cyclic vomiting syndrome (CVS) is associated with psychosocial comorbidity and often triggered by stress. Since the current disease-centered care model doesnot address psychosocial factors, we hypothesized that holistic, patient-centered care integrating meditation and addressing psychosocial needs through a care coordinator will improve healthcare outcomes in CVS. We conducted a prospective randomized controlled trial: 49 patients with CVS (mean age: 34±14years; 81% female) were randomized to conventional health care (controls) or Integrative Health care (IHC) (27: controls, 22: IHC). The IHC group was assigned a care coordinator and received meditation with a certified instructor. Outcomes including psychological distress, coping strategies to manage chronic stress, cognitive symptom management, and Health-Related Quality of Life (HRQoL) were measured. In intention-to-treat analyses, patients receiving IHC showed significant improvement in multiple domains of coping including positive reframing, planning, and reduction in self-blame (p values ≤0.05), and physical HRQoL (p=0.03) at 6months. They also leaned toward spirituality/religion as a coping measure (p≤0.02 at 3 and 6months). Subgroup analysis of compliant patients showed additional benefit with significant reduction in psychological distress (p=0.04), improvement in sleep quality (p=0.03), reduction in stress levels (0.02), improvement in physical HRQoL (0.04), and further improvement in other domains of coping (p<0.05). An IHC model incorporating meditation and care coordination improves patient outcomes in CVS and is a useful adjunct to standard treatment. Studies to determine the independent effects of meditation and care coordination are warranted.