Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2021 Nov;33(11):e14132.
doi: 10.1111/nmo.14132. Epub 2021 Mar 28.

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

Thangam Venkatesan  1 , Anthony Porcelli  2 , Anagha Matapurkar  3 , Vishnu Charan Suresh Kumar  1 , Aniko Szabo  4 , Ziyan Yin  4 , Laura Wieloch  5
Affiliations
Randomized Controlled Trial

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

Thangam Venkatesan et al. Neurogastroenterol Motil. 2021 Nov.

Abstract

Background: Cyclic vomiting syndrome (CVS) is associated with psychosocial comorbidity and often triggered by stress. Since the current disease-centered care model does not 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.

Methods: We conducted a prospective randomized controlled trial: 49 patients with CVS (mean age: 34 ± 14 years; 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.

Key results: 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 6 months. They also leaned toward spirituality/religion as a coping measure (p ≤ 0.02 at 3 and 6 months). 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).

Conclusions and inferences: 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.

Keywords: care coordination; cyclic vomiting; heartfulness meditation; integrative medicine.

PubMed Disclaimer

Figures

FIGURE 1
FIGURE 1
Integrative HealthCare model. Based on the Chronic Care model proposed by Wagner et al.1999. The meditation logo was reproduced with permission from the Heartfulness Institute. CVSA, Cyclic Vomiting Syndrome Association; REDCap Research Electronic Data Capture
FIGURE 2
FIGURE 2
Flow diagram of recruitment and study participation
FIGURE 3
FIGURE 3
Changes in various domains of coping in CVS in the IHC group and controls
FIGURE 3
FIGURE 3
Changes in various domains of coping in CVS in the IHC group and controls
See this image and copyright information in PMC

References

    1. Tack J, Talley NJ, Camilleri M, et al. Functional gastroduodenal disorders. Gastroenterology. 2006;130:1466–1479. - PubMed
    1. Abell TL, Adams KA, Boles RG, et al. Cyclic vomiting syndrome in adults. Neurogastroenterol Motil. 2008;20:269–284. - PubMed
    1. Fleisher DR, Gornowicz B, Adams K, Burch R, Feldman EJ. Cyclic Vomiting Syndrome in 41 adults: the illness, the patients, and problems of management. BMC Med. 2005;3:20. - PMC - PubMed
    1. Stanghellini V, Chan FK, Hasler WL, et al. Gastroduodenal disorders. Gastroenterology. 2016;150:1380–1392. - PubMed
    1. Aziz I, Palsson OS, Whitehead WE, Sperber AD, Simren M, Tornblom H. Epidemiology, clinical characteristics, and associations for Rome IV functional nausea and vomiting disorders in adults. Clin Gastroenterol Hepatol. 2018;17(5):878–886. - PubMed

Publication types

Supplementary concepts