Highlights of 2015: BMC Program for Integrative Medicine & Health Disparities
At BMC we believe all of our patients, regardless of their social or economic status, should have access to every available treatment. Gifts from our benefactors and other forms of much needed support from friends and colleagues helped create access to integrative care for the whole person, from hands-on therapies such as massage and acupuncture to the personal empowerment facilitated through learning self-care practices such as yoga and mindfulness meditation.
It’s our pleasure to share highlights of 2015 with you, featuring exciting new clinical partnerships, innovative research projects, and a novel program that supports the education of integrative healthcare providers.
We would love to have your support for low-income patients who would not otherwise have access to these innovative forms of healthcare. Please consider an end of year gift to our Program.
Rob, Paula, Katherine and Maria
New Clinical Partnerships
PEDIATRIC PAIN CLINIC
Our longstanding partnership with the New England School of Acupuncture formed the basis for a new partnership with the Department of Pediatrics to establish a Pediatric Pain Clinic. The clinic incorporates best practice in complex chronic pain management with integrative medicine. This partnership involves multiple members of our team in weekly case conferences with the pain clinic core team. In the ten months since the clinic launched, we have successfully obtained funding from the Marino Health Foundation to expand the clinic to include pediatric massage, yoga classes, Reiki and aromatherapy. Our collaboration with Pediatrics is featured in the December special issue on pediatrics in Medical Acupuncture.
ACUPUNCTURE FOR PATIENTS WITH HIV/AIDS
Through an innovative partnership with Infectious Disease, our Program now provides free acupuncture to patients with HIV/AIDS. Services include a mix of individual and group acupuncture, delivered both at BMC and at Victory Programs’ Boston Living Center, a nonprofit community resource agency that fosters the wellness of all HIV positive people through education, treatment information and support services.
The monies garnered for this program allowed us to add Elizabeth Sommers, PhD, MPH, LAc, a national figure in HIV acupuncture research, integrative public health and program evaluation to our
INTEGRATIVE MEDICINE GROUP VISITS
Paula Gardiner, MD, MPH’s PCORI contract enables the inclusion of Codman Square and Dorchester House Health Centers on important research on the impact of Integrative Medicine Group Visits.
Paula and the teams in the health centers are doing breakthrough work on telehealth for the underserved. They have developed and piloted Our Whole Lives (OWL), an interactive web-based resource. OWL provides all integrative medicine group visit materials online including videos of clinician-led talks (stress reactivity, understanding pain, insomnia, obesity, depression, nutrition, and goal setting). Patients are also introduced to self-massage techniques, acupressure, and healthy cooking. They are also empowered to track their vitals, health goals, and participate in a monitored discussion group with peers. Patients can access OWL using a computer, tablet, or smartphone. Preliminary data indicate that this mHealth tool offers a feasible means of increasing access to non-pharmacologic options for treating chronic pain among low-income, medically underserved populations. A new award to Paula from the Aetna Foundation will build on her growing expertise in web-based delivery of self-care tools for meditation, yoga, and nutrition.
Our first integrative medicine fellow, Dr. Oscar Cornelio-Flores, is providing integrative medicine group visits in Spanish for our Latino patients at the East Boston Neighborhood Health Center.
MUSIC AND MASSAGE
Our study “Moving Music and Massage Therapy from Nice to Necessary,” which examined the feasibility and effectiveness of conducting a randomized controlled trial comparing massage therapy and music therapy to usual care on the BMC family medicine 6 West inpatient unit. We successfully recruited all 90 participants in less than six months. We were particularly proud of being able to offer the study in both English and Spanish. Preliminary quantitative and qualitative analyses suggest strong feasibility for the intervention, high satisfaction among patients, and strong engagement with the nursing staff.
YOGA FOR CHRONIC LOW BACK PAIN
Back to Health contributes to the growing evidence base for non-pharmacological approaches to treat chronic pain in low income minorities. We are currently completing a manuscript of our results to be submitted to a high impact journal. Among 320 patients recruited from BMC and our health centers, yoga was as effective as physical therapy but less expensive for reducing the impact of back pain. These findings have the potential to justify integration of yoga into mainstream health care settings for pain management.
We recently launched a new study, Veterans Back to Health, which compares yoga to education for 120 Veterans with back pain recruited from the Bedford VA. The strength of these studies led to our Program being awarded a large contract from PCORI for a pragmatic trial in five cities (Boston, Pittsburgh, Charleston, Salt Lake City, Baltimore) to test the effectiveness of targeted physical therapy interventions for prevent high risk patients with acute low back pain from progressing to chronic back pain.
We continue to extend our research on integrative medicine for the underserved. We initiated data collection for PREMIER this fall, a Practice Based Research Network launched by Bravenet, beginning with surveying patients in Family Medicine, but eventually including data collection also in Oncology and Infectious Disease. As one of only two safety net hospitals in Bravenet, our participation is key to ensuring the database will represent underserved patients.
Our Patients’ Experience: In Their Own Words
I was depressed most of the time. When I started with the group, I met these people who had the similar situation I had with pain. For me it helped me learn how I could relax. And since I was in the group, I’m calm, I’m relaxed. I’m not depressed anymore. – Integrative Medicine Group Visit Patient
The group really helped me changed my mindset around the pain … like now when I’m feeling the pain, I can sit and meditate and be like, okay – let me focus on my breathing, calm down and kinda say like, this isn’t the first time I’ve been in pain, it’s not going to be the last time I’m in pain, it is what it is and it doesn’t overwhelm me. – Integrative Medicine Group Visit Patient
During the time that I was working with the music therapist, I was so completely engaged in what the two of us were doing together…. Pain no longer was part of my focus. – Music Therapy Participant
The massage therapy sessions made me feel like I mattered in the hospital. – Massage Therapy Participant
This is what it means to work at BMC! I’m being paid to have a massage on the job! – BMC Nurse
It’s going to have to be something that’s part of my life. I’m going to do this for a long time. So I’m looking at it as a medical treatment-it’s not just a yoga class. – Yoga for Back Pain Patient
I felt good because I was doing something, not sitting around waiting for a diagnosis, not taking another pill. I was involved in my treatment, that’s how I felt. – Yoga for Back Pain Patient
Healthcare Provider Education
Our recently awarded HRSA funding will support an extension of our partnership with BMC Preventive Medicine and Internal Medicine on resident education and enhancing our program with inter-disciplinary case conferences. Rob Saper, MD, MPH and his team partnered with the Suzanne Hanser,
MMus,EdD of the Berklee School of Music to bring their first cohort of Master’s Music Therapy students to BMC to experience our program and learn from its leaders. We will be funding a music therapist to enable an internship program at BMC. And, our exciting new partnership with the Human Resources team at BMC will support a pilot of mindfulness and resiliency training (Breathe, Move, Connect) for BMC staff that will serve as the chassis for a hospital-wide program.
Our team evolved this year in wonderful ways, with new additions, significant promotions, and fond good-byes. Maria Broderick, EdD,LicAc joined the team as Director of Programs. Paula Gardiner, MD, MPH was promoted to Associate Professor.Katherine Gergen Barnett, MD continues her commitment to healthcare for the underserved through her new role as Vice Chair of Primary Care Innovation and Transformation for the Department of Family Medicine. Ellen Highfield, LicAc our Director of Acupuncture, moved her focus to private practice while retaining her research connections to BMC. Chelsey Lemaster, MPH, was promoted to Project Manager for research under Rob Saper, MD, MPH. We said fond farewells to long-term contributors to our clinical team, Lisa Spellman, LicAc, Paula Nesoff, LMT, MSW, and our clinical coordinator, Breighl Mobley, MPH.
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