A Randomized Trial of a Group-Based Integrative Medicine Approach Compared to Waitlist Control on Irritable Bowel Syndrome Symptoms in Adults.

INTRODUCTION: Irritable bowel syndrome (IBS) is a chronic debilitating functional gastrointestinal disorder that affects a large proportion of the general population. Dietary and mind-body approaches have shown some effectiveness in reducing IBS symptoms. OBJECTIVES: The purpose of this project was to test the feasibility of a low cost, group-oriented integrative medicine approach to IBS, and to explore whether such an approach improves participant outcomes. METHODS: This was a randomized-controlled trial involving a 4-week group-oriented treatment intervention combining dietary intervention and mind-body therapies followed by 8-weeks of telephonic health coaching. Differences between the intervention and control groups on IBS-specific measures were examined at baseline, 4, 8, and 12-week. RESULTS: Fifty-two participants completed the study, 30 in the control group and 22 in the intervention group. On the IBS Symptom Severity Score, at 4 weeks the intervention group showed statistically significant improvement compared to the control group (p < .02), which was sustained at the 8 and 12-week data points as well, with the proportion of the intervention group experiencing moderate to severe symptoms decreasing from 81.3% at baseline to 45% at week 4 and 54.5% at week 12. A statistically significant improvement was also seen on the CES-D measure of depression between baseline and week 12 in the intervention group compared to controls. On the IBS Quality of Life measure we did not observe a statistically significant difference between the groups. CONCLUSIONS: This low-cost, group-oriented intervention approach offers a strategy to address the challenge of access to this type of integrative approach for patients of low socioeconomic status or limited means.

Acupuncture Therapy in a Group Setting for Chronic Pain.

Objective: This project was designed to test the feasibility and effectiveness of acupuncture therapy given in a group setting for chronic pain. Design: Nonrandomized, repeated measures quasi-experimental trial. Setting: Care was delivered in a primary care clinic waiting area after clinic hours. Subjects: Included were primary care patients (≥18 years old) with chronic pain of the neck, back, shoulder, or osteoarthritis of any site of at least three months' duration. Methods: Subjects received eight weekly acupuncture therapy sessions in a group setting. Acupuncture therapy included a combination of palpation, acupuncture needling, Tui na, Gua sha, and auricular treatment. Baseline pain levels were established in a two- to four-week run-in; assessment of the intervention impact on pain intensity, mood, and functional status were made at the end of the treatment period (eight weeks) and 16 weeks after completion of intervention (24 weeks). Results: Of the total 113 participants recruited for the trial, 96 completed the 24-week protocol. We found a statistically and clinically significant decrease in pain severity, pain interference, and depression in our study population. There were no serious adverse events. Conclusions: Acupuncture therapy offered in the group setting was effective in reducing pain severity, pain interference, and depression in patients with chronic neck, back, or shoulder pain or osteoarthritis. Benefit persisted through the 24-week measure despite no additional treatment. This finding has potentially important implications for improving access to effective acupuncture treatment for patients with limited financial resources.