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Meta-Analysis
. 2021 May 1;96(5):751-764.
doi: 10.1097/ACM.0000000000003936.

Mindfulness-Based Interventions to Reduce Burnout and Stress in Physicians: A Systematic Review and Meta-Analysis

Johannes C Fendel  1 , Johannes J Bürkle  2 , Anja S Göritz  3
Affiliations
Meta-Analysis

Mindfulness-Based Interventions to Reduce Burnout and Stress in Physicians: A Systematic Review and Meta-Analysis

Johannes C Fendel et al. Acad Med. .

Abstract

Purpose: To perform a systematic review and meta-analysis of studies evaluating the effectiveness of mindfulness-based interventions (MBIs) in reducing burnout and stress among physicians.

Method: The authors searched records in MEDLINE, Embase, PsycINFO, PSYNDEX, Web of Science, CINAHL, and CENTRAL from database inception to August 8, 2019, using combinations of terms for mindfulness, interventions, and physicians. Eligible studies were randomized controlled trials (RCTs) and nonrandomized trials (NRTs), including controlled and noncontrolled before-after studies, all assessing burnout and stress among physicians preintervention and postintervention via validated instruments. Two reviewers independently screened records, extracted data, assessed risk of bias, and rated overall quality of evidence. The authors used random-effects modeling to calculate pooled effect sizes and conducted prespecified subgroup and sensitivity analyses to explore potential moderators.

Results: Of 6,831 identified records, 25 studies (with 925 physicians) were ultimately included. MBIs were associated with significant small reductions in burnout in between-group analyses (5 comparisons: standardized mean difference [SMD] = -0.26; 95% confidence interval [CI] = -0.50, -0.03) and pre-post analyses (21 comparisons: SMD = -0.26; 95% CI = -0.37, -0.15), and with a significant medium reduction in stress in between-group analyses (4 comparisons: SMD = -0.55; 95% CI = -0.95, -0.14) and a significant small reduction in stress in pre-post analyses (17 comparisons: SMD = -0.41; 95% CI = -0.61, -0.20). Versions of established MBIs showed higher effectiveness in reducing stress than other forms of MBIs or a mindfulness app. Reductions were maintained over an average follow-up of 5.3 months. The risk of bias was moderate with RCTs and high with NRTs. The overall quality of evidence was low to very low.

Conclusions: MBIs can be effective in reducing physicians' burnout and stress. Shortcomings in the quality of evidence highlight the need for high-quality controlled trials providing long-term follow-up data.

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References

    1. Shanafelt TD, Hasan O, Dyrbye LN, et al. Changes in burnout and satisfaction with work-life balance in physicians and the general US working population between 2011 and 2014. Mayo Clin Proc. 2015;90:1600–1613.
    1. Patel RS, Bachu R, Adikey A, Malik M, Shah M. Factors related to physician burnout and its consequences: A review. Behav Sci (Basel). 2018;8:98.
    1. Kuhn CM, Flanagan EM. Self-care as a professional imperative: Physician burnout, depression, and suicide. Can J Anaesth. 2017;64:158–168.
    1. Wallace JE, Lemaire JB, Ghali WA. Physician wellness: A missing quality indicator. Lancet. 2009;374:1714–1721.
    1. Dyrbye LN, West CP, Satele D, et al. Burnout among U.S. medical students, residents, and early career physicians relative to the general U.S. population. Acad Med. 2014;89:443–451.

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