Health care is not just about diagnosing and treating patients in the exam room and helping them avoid illnesses. It is also about considering the “mind, body, and spirit” together in order to encourage both physical and mental wellness. At Kaiser Permanente, our focus is the total health of patients. In this month’s research roundup, the Institute for Health Policy highlights KP research on ways to improve the well-being of our members.
Service Dogs for Veterans
Dr. Carla Green testified to an Oregon legislative subcommittee about the benefits of providing service dogs to veterans. Initial findings from the Pairing Assistance-Dogs with Soldiers (PAWS) Study showed that veterans with service dogs had fewer symptoms of post-traumatic stress disorder (PTSD), lower levels of depression, better personal relationships, and lower rates of substance abuse. In her testimony, Dr. Green described one veteran’s experience with a dog that would regularly wake him from nightmares of past traumatic events. Each dog has a one-time cost of $10,000 to breed and train. However, that may be small compared to the $5,635 to $31,695 spent on care for a veteran with PTSD, major depression, or co-occurring PTSD and major depression in the first two years after returning from combat. In order to support this kind of intervention, lawmakers need more data that service dogs are beneficial. Dr. Green’s research shows promise, and the U.S. Department of Veterans Affairs has also resumed its own research on service dogs and PTSD. With additional evidence, the government may decide to provide services dogs to veterans in the future.
Reducing the Risk of Depression Among Pregnant Women
Women with a history of depression are at greater risk of encountering the illness in the weeks before and after childbirth. Researchers in Colorado, including Dr. Arne Beck, recently published a study about using mindfulness-based cognitive theory (MBCT) for pregnant women at risk of a depressive relapse. MBCT combines mindfulness, meditation, and cognitive behavioral strategies. It also helps individuals become more aware of negative thoughts and feelings and respond to these states before they lead to depression. The intervention includes brief exercises that women can use even while handling the demands of caring for a newborn. Women who went through the intervention had a lower risk (18% compared to 30%) of developing depressive symptoms during pregnancy and six months postpartum. A larger study needs to be conducted to ensure the efficacy of this approach and to see if it is helpful for other pregnant women at risk of depression.
Mindfulness Training for Cancer Patients
In Northern California, Dr. Ai Kubo is building on the work of other Kaiser Permanente researchers who found that mindfulness-based stress reduction (MBSR) training improved the mood and quality of life of cancer patients. Standard MBSR requires over 30 hours of in-person training over 8 weeks, making it nearly impossible for busy and highly stressed caregivers or patients actively undergoing chemotherapy. Therefore the Kaiser Permanente study provided trainings through audio recordings on CDs, so that patients could listen during treatment and at home. Due to the success of this pilot study, Dr. Kubo is currently conducting a follow-up study. She is collaborating with a popular mindfulness app company, Headspace, to test if mindfulness training provided on a mobile app is accepted and helpful among cancer patients and caregivers. Dr. Kubo hopes to examine whether an 8-week regimen of mobile mindfulness exercises result in better quality of life and sleep, as well as lower levels of stress and fewer side effects from treatment.
Strategies to improve the well-being of patients can be provided alongside traditional office-based care to maintain the total health of patients. Look for next month’s research roundup on improving screenings. For more information about the research studies, please contact Al Martinez at Albert.Martinez@kp.org.