A wide variety of feasibility, effectiveness and qualitative studies have been conducted to gain more knowledge on the need for, barriers to and experiences of integrative approaches in the hospital setting as well as different forms of use, such as group visits and mHealth apps.
- Group Acupuncture for Pain (GAP) Study
Thanks to a generous grant from the Blavatnik Foundation, we conducted a study to test the feasibility and effectiveness of group acupuncture for the treatment of musculoskeletal pain (back, shoulder, neck pain or osteoarthritis). Participants took place in eight weekly acupuncture treatments delivered in a group setting. We collected information on their pain symptoms, mood, ability to move and medication use before, during and after the treatment period. The goal of this project was to develop a low-cost, effective integrative intervention for chronic pain. The physician in charge of this study was Benjamin Kligler, MD.
- Integrative approaches to managing Irritable Bowel Syndrome (IBS)
This study examined whether a low cost, group-oriented integrative medicine approach to irritable bowel syndrome improves participant outcomes, specifically decreased symptoms and improved function and quality of life.
The intervention combined nutrition counseling on the low FODMAP diet– which limits foods in the carbohydrate family such as some sugars (fructose, lactose and fructans) and non-digestible fibers (galactans and polyols), as well as mind-body training with follow-up health coaching.
Over the course of 18 months, participants were recruited from the Center for Health and Healing and other primary care and gastroenterologist offices in NYC. Participants were randomized to either 1) a four-week group-oriented treatment intervention incorporating a low FODMAP diet and mind-body therapies followed by an eight-week health coaching follow-up period or 2) a waitlist control group. At the end of the 12-week study period, waitlist subjects were offered the four-week nutrition and mind-body intervention. Over the 12-week study period, we examined and reported on the impact of this treatment intervention on IBS symptoms and quality of life in this population. Data was collected on IBS outcomes as well as on depression and stress.
McDonald E, Teets R, Ortiz C, Gilchrist G, Waltermaurer E, Perez E, Kligler B. A randomized trial of a group-based integrative medicine approach compared to waitlist control on irritable bowel syndrome symptoms in Adults. Explore (NY). 2018 Jul 20. [Epub ahead of print].
- MHealth study, diabetes app Diabetes: Your Way
This patient-centered, English/Spanish smartphone App, “Diabetes Your Way”, was funded through a grant from the Stavros Niarchos Foundation to the Center for Health and Healing, Mount Sinai Beth Israel. The Project Director was Marsha J. Handel, MLS who worked with a team of health professionals including Benjamin Kligler, MD, Research Director; Raymond Teets, MD; Diabetes Educator and registered dietician, Christina McGeough, MPH, RD, CDE, and two public health and integrative Clinical Nurse Specialists, Christine Gilchrist, RN, MSN, MPH, NC-BC and Caroline Ortiz, RN, MSN, MPH.
The primary purpose of this app was to help support the self-management capabilities of lower literacy, underserved patients with diabetes through two main strategies:
- Facilitate motivation and engagement with change through a variety of features including points and badges, social support, daily motivational quotes, push notifications, and goal setting with attention to the “readiness to change” continuum and how to set goals that match.
- Educational guidance on the role of food, exercise and relaxation in diabetes self-management and active support via online videos and interactive dietary features such as a) calculation of individual daily caloric intake (recalculated as they make changes in activity level and weight); b) seeing the percentage of calories, fat, carbs and fiber they are eating in each meal and over the course of the day, with the opportunity to substitute different foods to see the changes they produce in these values.
In year two the App was tested in partnership with the Institute for Family Health and their community health centers in the NYC area focused on underserved patient populations. Phase I of the study was begun in February 2016. This study evaluated ease of use, adoption rate, patient satisfaction and ability to increase self-efficacy regarding behavior change in diabetes self-management. Study results were gathered from two sources: 1) Analysis of statistics on usage via Google Analytics, which were coded into the app and 2) qualitative interviews with study participants.
- Acupuncture Integration in a Hospital Setting
This qualitative study was interested in the experience of acupuncturists, medical staff and patients who are a part of acupuncture in-patient care on selected floors of Mount Sinai Beth Israel. We have completed the first part of the study that described the experience of acupuncturists and we continue our research to describe the experience of physicians and nurses who collaborated with acupuncturists as well as the patients who received acupuncture treatments while being hospitalized at Mount Sinai Beth Israel. Primary Investigator: B. Basia Kielczynska, DMH, L.Ac; Co-Investigator: Benjamin Kligler, MD, MPH
- Evaluation of Charles Evans Integrative Stress Management Program
This program was directed at nursing staff at Mount Sinai Beth Israel teaching self-care stress management techniques including breathwork, centering and grounding, aromatherapy via hand M’ technique, Reiki and gentle yoga poses. A survey was administered to nursing staff on each clinical unit pre-intervention for baseline measures and was repeated every six months through the length of the program. The study goal was to evaluate the perception and experience of stress by clinical nursing staff on Mount Sinai Beth Israel unit floors.
- Integrative Approaches to Chronic Pain
SIMTAP (Study on Integrative Medicine Treatment Approaches for Pain), the BraveNet study of an integrative medicine approach to chronic pain, enrolled and followed over 400 patients at the nine BraveNet sites. The results of this study were recently published in the journal BMC Complementary and Alternative Medicine.
Abrams DI, Dolor R, Roberts R, et al. The BraveNet prospective observational study on integrative medicine treatment approaches for pain. BMC Complementary & Alternative Medicine. 2013;13:146.
- Acupuncture to Decrease Disparities of Pain Treatment (ADDOPT)
In collaboration with Albert Einstein College of Medicine Department of Family and Social Medicine Division (DFSM), we completed an NIH (National Center for Complementary and Alternative Medicine)-funded trial evaluating the impact of acupuncture on chronic pain in a group of community health centers in the Bronx.
McKee MD, Kligler B, Blank AE, Fletcher J, Jeffres A, Casalaina W, Biryukov F. The ADDOPT study (Acupuncture to Decrease Disparities in Outcomes of Pain Treatment): feasibility of offering acupuncture in the community health center setting. J Altern Complement Med. 2012 Sep;18(9):839-43.
- Acupuncture Integration in a Hospital Setting
This qualitative study was interested in the experience of acupuncturists, medical staff and patients who are a part of acupuncture in-patient care on selected floors of Mount Sinai Beth Israel. We have completed the first part of the study that described the experience of acupuncturists. The results were presented at the 2012 International Research Congress on Integrative Medicine and Health. Portland, Oregon, May 15-18, 2012 and at the Society of Acupuncture Research Conference in Ann Arbor April 18-21, 2013. They have now been published in Qualitative Health Research, Sept 2014.
Kielczynska, B. Basia, Benjamin Kligler, and Eileen Spechhio. "Integrating Acupuncture in an Inpatient Setting." Qualitative Health Research. 2014 Sep; 24(9): 1242-1252.
Kielczynska B, Kligler B. How Acupuncturists and physicians view the presence of in-patients acupuncture care at Mount Sinai Beth Israel – a phenomenological study. BMC Complementary and Alternative Medicine. 12(Suppl 1): 363, 2012.
- Relaxation Therapies, Aromatherapy and Acupuncture for Quality of Life in Patients with Head and Neck Cancer
In cooperation with Dr. Lou Harrison, Chief of the Cancer Centers at Continuum Health Partners we launched a clinical program of integrative medicine services in the Continuum Cancer Center and collaborated on two studies. The first examined the impact of relaxation therapies and aromatherapy on quality of life; the second examined the impact of acupuncture on xerostomia, the dry mouth condition extremely common in patients following radiation therapy.
- Impact of the Urban Zen “Optimal Healing Environment” on Quality of Life and Cost Outcomes in Patients Admitted to Hospital for Cancer Treatment
With support from the Urban Zen Initiative, a philanthropic effort aimed at improving the care of patients with cancer, we developed and evaluated a clinical intervention with a cohort of inpatients with cancer at Beth Israel testing an inpatient “optimal healing environment.” The research program evaluating this program found that this program improved the quality of patients’ experience when they are admitted to the hospital for cancer care as well as leading to cost savings for the hospital through reduced medication use.
Kligler B, Homel P, Harrison LB, Levenson JD, Kenney JB, Merrell W. Cost savings in inpatient oncology through an integrative medicine approach. Am J Manag Care 2011 Dec;17(12):779-84.
Kligler B, Homel P, Harrison LB, Sackett E, Levenson H, Kenney J, Fleishman SB, Serra D, Merrell W. Impact of the Urban Zen Initiative on patients’ experience of admission to an inpatient oncology floor: a mixed-methods analysis. J Altern Complement Med. 2011 Aug;17(8):729-34.
- Integrative Approach to Management of Asthma
This project, which was funded by a grant from the Medical Capital Corporation, investigated the impact of an integrative medicine approach—incorporating nutritional manipulation and supplements, yoga breathing, and journaling—on the clinical and cost outcomes of a group of patients with asthma.
Kligler B, Homel P, Blank AE, Kenney J, Levenson J, Merrell W. Randomized trial of the effect of an integrative medicine approach to the management of asthma in adults on disease-related quality of life and pulmonary function. Altern Ther Health Med. 2011 Jan-Feb;17(1):10-15.