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Bernstein W, Norris M, Chase A, Hayes R, Binda DD, Ortega R. Operating Room Fire Prevention: Video in Clinical Anesthesia. Anesth Analg 2024; 138:909-912. [PMID: 38489796 DOI: 10.1213/ane.0000000000006787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024]
Affiliation(s)
- Wendy Bernstein
- From the Department of Anesthesiology, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
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2
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Ortega R, Binda DD, Lavanier SA, Uminski JG. The Aqualumni Tree: Two Score Years Later. Anesth Analg 2024; 138:740-745. [PMID: 38489793 DOI: 10.1213/ane.0000000000006466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024]
Affiliation(s)
- Rafael Ortega
- From the Department of Anesthesiology, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
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3
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Binda DD, Kraus A, Gariépy-Assal L, Tang B, Wade CG, Olveczky DD, Molina RL. Anti-racism curricula in undergraduate medical education: A scoping review. Med Teach 2024:1-11. [PMID: 38431914 DOI: 10.1080/0142159x.2024.2322136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 02/19/2024] [Indexed: 03/05/2024]
Abstract
PURPOSE Medical educators have increasingly focused on the systemic effects of racism on health inequities in the United States (U.S.) and globally. There is a call for educators to teach students how to actively promote an anti-racist culture in healthcare. This scoping review assesses the existing undergraduate medical education (UME) literature of anti-racism curricula, implementation, and assessment. METHODS The Ovid, Embase, ERIC, Web of Science, and MedEdPORTAL databases were queried on 7 April 2023. Keywords included anti-racism, medical education, and assessment. Inclusion criteria consisted of any UME anti-racism publication. Non-English articles with no UME anti-racism curriculum were excluded. Two independent reviewers screened the abstracts, followed by full-text appraisal. Data was extracted using a predetermined framework based on Kirkpatrick's educational outcomes model, Miller's pyramid for assessing clinical competence, and Sotto-Santiago's theoretical framework for anti-racism curricula. Study characteristics and anti-racism curriculum components (instructional design, assessment, outcomes) were collected and synthesized. RESULTS In total, 1064 articles were screened. Of these, 20 met the inclusion criteria, with 90% (n = 18) published in the past five years. Learners ranged from first-year to fourth-year medical students. Study designs included pre- and post-test evaluations (n = 10; 50%), post-test evaluations only (n = 7; 35%), and qualitative assessments (n = 3; 15%). Educational interventions included lectures (n = 10, 50%), multimedia (n = 6, 30%), small-group case discussions (n = 15, 75%), large-group discussions (n = 5, 25%), and reflections (n = 5, 25%). Evaluation tools for these curricula included surveys (n = 18; 90%), focus groups (n = 4; 20%), and direct observations (n = 1; 5%). CONCLUSIONS Our scoping review highlights the growing attention to anti-racism in UME curricula. We identified a gap in published assessments of behavior change in applying knowledge and skills to anti-racist action in UME training. We also provide considerations for developing UME anti-racism curricula. These include explicitly naming and defining anti-racism as well as incorporating longitudinal learning opportunities and assessments.
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Affiliation(s)
- Dhanesh D Binda
- Master of Medical Sciences in Medical Education Program, Harvard Medical School, Boston, MA, USA
- Department of Anesthesiology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Alexandria Kraus
- Master of Medical Sciences in Medical Education Program, Harvard Medical School, Boston, MA, USA
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Laurence Gariépy-Assal
- Master of Medical Sciences in Medical Education Program, Harvard Medical School, Boston, MA, USA
- Department of Pediatrics, Université de Montreal, Montréal, QC, Canada
| | - Brandon Tang
- Master of Medical Sciences in Medical Education Program, Harvard Medical School, Boston, MA, USA
- Division of General Internal Medicine, University of Toronto, Toronto, ON, Canada
| | - Carrie G Wade
- Countway Library of Medicine, Harvard Medical School, Boston, MA, USA
| | - Daniele D Olveczky
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Rose L Molina
- Department of Obstetrics and Gynecology, Division of Global and Community Health, Beth Israel Deaconess Medical Center, Boston, MA, USA
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4
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Binda DD, Baker MB, Varghese S, Wang J, Badenes R, Bilotta F, Nozari A. Targeted Temperature Management for Patients with Acute Ischemic Stroke: A Literature Review. J Clin Med 2024; 13:586. [PMID: 38276093 PMCID: PMC10816923 DOI: 10.3390/jcm13020586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 01/03/2024] [Accepted: 01/11/2024] [Indexed: 01/27/2024] Open
Abstract
Despite significant advances in medical imaging, thrombolytic therapy, and mechanical thrombectomy, acute ischemic strokes (AIS) remain a major cause of mortality and morbidity globally. Targeted temperature management (TTM) has emerged as a potential therapeutic intervention, aiming to mitigate neuronal damage and improve outcomes. This literature review examines the efficacy and challenges of TTM in the context of an AIS. A comprehensive literature search was conducted using databases such as PubMed, Cochrane, Web of Science, and Google Scholar. Studies were selected based on relevance and quality. We identified key factors influencing the effectiveness of TTM such as its timing, depth and duration, and method of application. The review also highlighted challenges associated with TTM, including increased pneumonia rates. The target temperature range was typically between 32 and 36 °C, with the duration of cooling from 24 to 72 h. Early initiation of TTM was associated with better outcomes, with optimal results observed when TTM was started within the first 6 h post-stroke. Emerging evidence indicates that TTM shows considerable potential as an adjunctive treatment for AIS when implemented promptly and with precision, thereby potentially mitigating neuronal damage and enhancing overall patient outcomes. However, its application is complex and requires the careful consideration of various factors.
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Affiliation(s)
- Dhanesh D. Binda
- Department of Anesthesiology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA 02118, USA; (D.D.B.); (M.B.B.); (S.V.); (J.W.); (A.N.)
| | - Maxwell B. Baker
- Department of Anesthesiology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA 02118, USA; (D.D.B.); (M.B.B.); (S.V.); (J.W.); (A.N.)
| | - Shama Varghese
- Department of Anesthesiology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA 02118, USA; (D.D.B.); (M.B.B.); (S.V.); (J.W.); (A.N.)
| | - Jennifer Wang
- Department of Anesthesiology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA 02118, USA; (D.D.B.); (M.B.B.); (S.V.); (J.W.); (A.N.)
| | - Rafael Badenes
- Department Anesthesiology, Surgical-Trauma Intensive Care and Pain Clinic, Hospital Clínic Universitari, University of Valencia, 46010 Valencia, Spain
| | - Federico Bilotta
- Department of Anaesthesiology, Critical Care and Pain Medicine, Policlinico Umberto I Teaching Hospital, Sapienza University of Rome, 00185 Rome, Italy;
| | - Ala Nozari
- Department of Anesthesiology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA 02118, USA; (D.D.B.); (M.B.B.); (S.V.); (J.W.); (A.N.)
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5
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Esmaeeli S, Binda DD, Rendon LF, Logan CM, Leung JL, Nguyen HM, Michael CE, Baker MB, Xu L, Nozari A. Bibliometric Indices As Indicators of Research Output: Analyzing Anesthesiologists as a Paradigm for Surgical Disciplines. Cureus 2024; 16:e53028. [PMID: 38410300 PMCID: PMC10895319 DOI: 10.7759/cureus.53028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2024] [Indexed: 02/28/2024] Open
Abstract
Anesthesiology is one of the increasingly competitive surgical specialties with a growing emphasis on scholarly activity. A metric of productivity and citation influence, the Hirsch index (h-index), can help identify mentors capable of guiding postgraduate trainees toward successful academic achievements. This study sought to determine associations between h-indices or m-quotients and manuscript publication in anesthesiology. Using the American Society of Anesthesiologists (ASA) website, accepted abstracts from the ASA Annual Meetings from 2019 to 2021 were screened (n=2146). The first author (FAHi) and senior author (SAHi) h-indices, as well as the first author (FAMq) and senior author (SAMq) m-quotients, were collected for each abstract using the Scopus database. Whether an accepted abstract was subsequently published as a manuscript in a peer-reviewed journal was also noted, along with the number of days between ASA presentation and publication date. Linear and logistic regression models were used for statistical analyses. In total, 348 (34.4%) of the 1012 eligible abstracts were published as manuscripts. Mean FAHi, SAHi, FAMq, and SAMq, were significantly higher for accepted ASA abstracts that were later published in peer-reviewed journals compared to accepted abstracts that were not published (p<0.001). FAHi, SAHi, FAMq, and SAMq had significant positive associations with odds of publication (p=0.002; p<0.001; p=0.006; p<0.001, respectively). There was no statistical significance between FAHi, SAHi, FAMq, or SAMq and the number of days between ASA presentation and publication. Our study uniquely demonstrates the positive, direct association between h-indices and m-quotients with the probability of publication in anesthesiology. We propose that bibliometric indices are adapted to provide a refined perspective of a physician-scientist's capabilities. Postgraduate trainees can use these indices to discern research mentors primed to foster academic excellence.
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Affiliation(s)
- Shooka Esmaeeli
- Anesthesiology, Boston University Chobanian & Avedisian School of Medicine, Boston, USA
| | - Dhanesh D Binda
- Anesthesiology, Boston University Chobanian & Avedisian School of Medicine, Boston, USA
| | - Luis F Rendon
- Anesthesiology, Boston University Chobanian & Avedisian School of Medicine, Boston, USA
| | - Connor M Logan
- Anesthesiology, Boston University Chobanian & Avedisian School of Medicine, Boston, USA
| | - Jacob L Leung
- Anesthesiology, Boston University Chobanian & Avedisian School of Medicine, Boston, USA
| | - Hannah M Nguyen
- Anesthesiology, Boston University Chobanian & Avedisian School of Medicine, Boston, USA
| | - Cara E Michael
- Anesthesiology, Boston University Chobanian & Avedisian School of Medicine, Boston, USA
| | - Maxwell B Baker
- Anesthesiology, Boston University Chobanian & Avedisian School of Medicine, Boston, USA
| | - Lan Xu
- Anesthesiology, Boston University Chobanian & Avedisian School of Medicine, Boston, USA
| | - Ala Nozari
- Anesthesiology, Boston University Chobanian & Avedisian School of Medicine, Boston, USA
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6
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Binda DD, Regenbogen I, Nozari A, Ortega R. Suministro de Oxígeno en el Hospital: Video en Anestesia Clinica. Anesth Analg 2024; 138:226-230. [PMID: 38100807 DOI: 10.1213/ane.0000000000006703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Affiliation(s)
- Dhanesh D Binda
- From the Department of Anesthesiology, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
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7
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Binda DD, Regenbogen I, Nozari A, Ortega R. Hospital Oxygen Supply: Video in Clinical Anesthesia. Anesth Analg 2024; 138:221-225. [PMID: 38100806 DOI: 10.1213/ane.0000000000006702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Affiliation(s)
- Dhanesh D Binda
- From the Department of Anesthesiology, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
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8
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Binda DD, Logan CM, Rosales V, Nozari A, Rendon LF. Targeted Temperature Management After Cardiac Arrest in COVID-19 Patients. Ther Hypothermia Temp Manag 2023. [PMID: 37582193 DOI: 10.1089/ther.2023.0033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/17/2023] Open
Abstract
There is a paucity of evidence regarding the utility of targeted temperature management (TTM) in COVID-19 patients who suffer cardiac arrest. This systematic review and meta-analysis aimed to use the available data of how temperature predicts outcomes in COVID-19 patients and the association between active cooling and outcomes in non-COVID-19 cardiac arrest patients to give recommendations for the utility of TTM in COVID-19 survivors of cardiac arrest. The PubMed, Embase, and Web of Science databases were queried in August 2022 for two separate searches: (1) temperature as a predictor of clinical outcomes in COVID-19 and (2) active cooling after return of spontaneous circulation (ROSC) in non-COVID-19. Forest plots were generated to summarize the results. Of the 4209 abstracts screened, none assessed the target population of TTM in COVID-19 victims of cardiac arrest. One retrospective cohort study evaluated hyperthermia in critically ill COVID-19 patients, two retrospective cohort studies evaluated hypothermia in septic COVID-19 patients, and 20 randomized controlled trials evaluated active cooling in non-COVID-19 patients after ROSC. Risk of death was higher in COVID-19 patients who presented with hyperthermia (risk ratio [RR] = 1.87) or hypothermia (RR = 1.77; p < 0.001). In non-COVID-19 victims of cardiac arrest, there was no significant difference in mortality (RR = 0.94; p = 0.098) or favorable neurological outcome (RR = 1.05; p = 0.41) with active cooling after ROSC. Further studies are needed to evaluate TTM in COVID-19 victims of cardiac arrest. However, given the available evidence that hyperthermia or hypothermia in COVID-19 patients is associated with increased mortality as well as our findings suggesting limited utility for active cooling in non-COVID-19 cardiac arrest patients, we posit that TTM to normothermia (core body temperature ∼37°C) would most likely be optimal for the best outcomes in COVID-19 survivors of cardiac arrest.
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Affiliation(s)
- Dhanesh D Binda
- Department of Anesthesiology, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Connor M Logan
- Department of Anesthesiology, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Victoria Rosales
- Department of Anesthesiology, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Ala Nozari
- Department of Anesthesiology, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Luis F Rendon
- Department of Anesthesiology, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
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9
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Esmaeeli S, Binda DD, Mejias Garcia J, Vaynberg E. Caudal epidural steroid injections with paracoccygeal injections for management of postpartum coccydynia: a case series. Int J Obstet Anesth 2023; 55:103897. [PMID: 37270858 DOI: 10.1016/j.ijoa.2023.103897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 04/21/2023] [Accepted: 05/04/2023] [Indexed: 06/06/2023]
Affiliation(s)
- S Esmaeeli
- Department of Anesthesiology, Boston University Chobanian and Avedisian School of Medicine, USA
| | - D D Binda
- Department of Anesthesiology, Boston University Chobanian and Avedisian School of Medicine, USA.
| | - J Mejias Garcia
- Department of Anesthesiology, Boston University Chobanian and Avedisian School of Medicine, USA
| | - E Vaynberg
- Department of Anesthesiology, Boston University Chobanian and Avedisian School of Medicine, USA
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10
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Binda DD, Gonzalez M, Rosales V, Black W, Ortega R. When Veterinary Drugs Reach Human Hospitals: A Problem-Based Learning Discussion. A A Pract 2023; 17:e01705. [PMID: 37463288 DOI: 10.1213/xaa.0000000000001705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
The delivery of drugs from the manufacturer to the hospital is a complex process. Despite numerous safeguards, lapses may occur, creating the potential for patient harm. Recently, an urban tertiary care medical center received a shipment of isoflurane bottles labeled for veterinary use. This error was not identified until the veterinary isoflurane reached the operating room automated medication dispensing system. No patients received the anesthetic. This report describes how such an error occurred, explains the differences between veterinary and human medications, and emphasizes the importance of vigilance in the drug supply chain to prevent patient harm.
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Affiliation(s)
- Dhanesh D Binda
- From the Department of Anesthesiology, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
| | - Mauricio Gonzalez
- From the Department of Anesthesiology, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
| | - Victoria Rosales
- From the Department of Anesthesiology, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
| | - William Black
- Department of Pharmacy Services, Boston Medical Center, Boston, Massachusetts
| | - Rafael Ortega
- From the Department of Anesthesiology, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
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11
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Binda DD, Weinberg JM, Nguyen T, Morone NE. Characterizing Interprofessional Collaboration and Referral to Mindfulness-Based Stress Reduction Programs. Glob Adv Health Med 2022; 11:2164957X221126484. [PMID: 36118601 PMCID: PMC9478712 DOI: 10.1177/2164957x221126484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background In 2017, the American College of Physicians (ACP) designated Mindfulness-Based Stress
Reduction (MBSR), an eight-week group program, as first-line non-pharmacological
treatment for chronic low back pain. However, interprofessional collaboration between
mindfulness instructors and Primary Care Providers (PCP) remains largely unknown. Objective We developed a survey to assess communication between mindfulness instructors and PCPs,
identify predictors of referral to MBSR, and determine areas where interventions could
increase patient access to MBSR. Methods The 25-question survey was sent via email to PCPs at the Division of General Internal
Medicine, University of Pittsburgh, PA, the Piedmont Health Services Family Medicine
Section, Chapel Hill, NC, the Boston Medical Center General Internal Medicine and Family
Medicine Sections, Boston, MA, and the UMass Memorial Medical Center Family Medicine
Section, Worcester, MA. We used descriptive statistics and logistic regression to
analyze the data. Results Among 118 eligible respondents, 85 (72.0%) were female PCPs, mean age was approximately
41.5±10.1, and the majority (65.2%) had been in medical practice ≤10 years. Of these
PCPs, 83 (70.1%) reported familiarity with MBSR (95% CI: 62.1, 78.5), and 49 (59.0%) of
them referred patients at least yearly. Of those who referred, 8 (16.3%) reported
collaboration with mindfulness instructors. PCPs who were quite a bit or very much
familiar with MBSR had 5.10 (1.10, 22.50) times the odds (P=.03), and those who were 50
years or younger had 3.30 times the odds (P=.04) of referring patients to MBSR.
Frequency of PCPs’ personal practice of mindfulness was not significantly associated
with referrals (P=.30). Conclusion This is the first study to assess interprofessional collaboration between mindfulness
instructors and PCPs. Suggestions for a potential integrative health care model are
included; further studies on methods to augment communication and education are
warranted to improve the referral process and ultimately increase accessibility and
utilization of mindfulness-based programs.
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Affiliation(s)
- Dhanesh D Binda
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA.,Boston University School of Medicine and Boston Medical Center, Boston, MA, USA
| | - Janice M Weinberg
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Tra Nguyen
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA.,Boston University School of Medicine and Boston Medical Center, Boston, MA, USA
| | - Natalia E Morone
- Boston University School of Medicine and Boston Medical Center, Boston, MA, USA
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12
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Binda DD, Greco CM, Morone NE. What Are Adverse Events in Mindfulness Meditation? Glob Adv Health Med 2022; 11:2164957X221096640. [PMID: 35464906 PMCID: PMC9024164 DOI: 10.1177/2164957x221096640] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 03/31/2022] [Accepted: 04/06/2022] [Indexed: 11/17/2022] Open
Abstract
Mindfulness meditation has become a successful treatment of both physical and psychosocial ailments over the past decade. Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT) are now implemented in various clinical and hospital settings for the treatment of stress, depression, substance abuse, and chronic pain. However, given mindfulness meditation's exponential rise in popularity, scientific and media reports have called for the evaluation of mindfulness meditation's safety for those who participate in its programs. Studies have described adverse events, such as anxiety and pain, and more severe events like psychosis, that have been associated with mindfulness meditation. However, there has not been a consistent, systematic way to define and report adverse events in meditation randomized control trials. The objective of our viewpoint was to dispel the notion that these emotive feelings and sensations are adverse events due to mindfulness meditation. Instead, they are actually expected reactions involved in the process of achieving the true benefits of mindfulness meditation. For the more severe outcomes of meditation, for example, psychosis and mania, these events are confounded by other factors, such as the intensity and length of the meditative practices as well as psychological stressors and the psychiatric histories of those affected. Comparatively, mindfulness-based programs like MBSR and MBCT are shorter in duration and less intense. They are designed to be adapted to their participants' needs as to not induce pain or panic. Mindfulness meditation teaches its students to learn how to deal with their minds and bodies instead of using maladaptive coping techniques. Thus, we urge that further research in mindfulness meditation consistently use the definition of adverse events as those which lead to severe outcomes or hospitalization.
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Affiliation(s)
| | - Carol M Greco
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Natalia E Morone
- General Internal Medicine, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
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13
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Greco CM, Gaylord SA, Faurot K, Weinberg JM, Gardiner P, Roth I, Barnhill JL, Thomas HN, Dhamne SC, Lathren C, Baez JE, Lawrence S, Neogi T, Lasser KE, Castro MG, White AM, Simmons SJ, Ferrao C, Binda DD, Elhadidy N, Eason KM, McTigue KM, Morone NE. The design and methods of the OPTIMUM study: A multisite pragmatic randomized clinical trial of a telehealth group mindfulness program for persons with chronic low back pain. Contemp Clin Trials 2021; 109:106545. [PMID: 34455111 PMCID: PMC8691659 DOI: 10.1016/j.cct.2021.106545] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 08/20/2021] [Accepted: 08/23/2021] [Indexed: 01/04/2023]
Abstract
Mindfulness-based stress reduction (MBSR) is an evidence-based non-pharmacological approach for chronic low back pain (cLBP), yet it is not readily available or reimbursable within primary care clinics. Primary care providers (PCPs) who wish to avoid prescribing opioids and other medications typically have few options for their cLBP patients. We present the protocol of a pragmatic clinical trial entitled OPTIMUM (Optimizing Pain Treatment In Medical settings Using Mindfulness). OPTIMUM is offered online via telehealth and includes medical group visits (MGV) with a PCP and a mindfulness meditation intervention modeled on MBSR for persons with cLBP. In diverse health-care settings in the US, such as a safety net hospital, federally qualified health centers, and a large academic health system, 450 patients will be assigned randomly to the MGV + MBSR or to usual PCP care alone. Participants will complete self-report surveys at baseline, following the 8-week program, and at 6- and 12-month follow-up. Health care utilization data will be obtained through electronic health records and via brief monthly surveys completed by participants. The primary outcome measure is the PEG (Pain, enjoyment, and general activity) at the 6-month follow-up. Additionally, we will assess psychological function, healthcare resource use, and opioid prescriptions. This trial, which is part of the NIH HEAL Initiative, has the potential to enhance primary care treatment of cLBP by combining PCP visits with a non-pharmacological treatment modeled on MBSR. Because it is offered online and integrated into primary care, it is expected to be scalable and accessible to underserved patients. Clinical Trials.gov: NCT04129450.
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Affiliation(s)
- Carol M Greco
- Department of Psychiatry and Physical Therapy, University of Pittsburgh School of Medicine and School of Health and Rehabilitation Sciences, PA, United States of America
| | - Susan A Gaylord
- Program on Integrative Medicine, Department of Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill, North Carolina, United States of America
| | - Kim Faurot
- Program on Integrative Medicine, Department of Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill, North Carolina, United States of America
| | - Janice M Weinberg
- Department of Biostatistics, Boston University School of Public Health, MA, United States of America
| | - Paula Gardiner
- Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, MA, United States of America
| | - Isabel Roth
- Program on Integrative Medicine, Department of Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill, North Carolina, United States of America
| | - Jessica L Barnhill
- Program on Integrative Medicine, Department of Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill, North Carolina, United States of America
| | - Holly N Thomas
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, PA, United States of America
| | - Sayali C Dhamne
- Boston University School of Public Health, Boston Medical Center, MA, United States of America
| | - Christine Lathren
- Program on Integrative Medicine, Department of Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill, North Carolina, United States of America
| | - Jose E Baez
- General Internal Medicine, Boston Medical Center, MA, United States of America
| | - Suzanne Lawrence
- Department of Psychiatry, University of Pittsburgh, PA, United States of America
| | - Tuhina Neogi
- Section of Rheumatology, Department of Medicine, Boston University School of Medicine, United States of America
| | - Karen E Lasser
- Section of General Internal Medicine, Department of Medicine, Boston Medical Center, Boston University School of Medicine, Boston, MA, United States of America
| | - Maria Gabriela Castro
- Siler City Community Health Center, Piedmont Health Services, Department of Family Medicine, University of North Carolina at Chapel Hill, NC, United States of America
| | - Anna Marie White
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, PA, United States of America
| | | | - Cleopatra Ferrao
- General Internal Medicine, Boston Medical Center, MA, United States of America
| | - Dhanesh D Binda
- Boston University School of Medicine, Boston, MA, United States of America
| | - Nandie Elhadidy
- Program on Integrative Medicine, Department of Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill, North Carolina, United States of America
| | - Kelly M Eason
- Program on Integrative Medicine, Department of Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill, North Carolina, United States of America
| | - Kathleen M McTigue
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, PA, United States of America
| | - Natalia E Morone
- Section of General Internal Medicine, Department of Medicine, Boston Medical Center, Boston University School of Medicine, Boston, MA, United States of America.
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