Characteristics and Components of Medical Group Visits for Chronic Health Conditions: A Systematic Scoping Review
Department of Family Medicine and Community Health; Center for Integrated Primary Care
Alternative and Complementary Medicine | Behavioral Medicine | Health Psychology | Health Services Administration | Integrative Medicine | Mental and Social Health | Primary Care | Psychiatry and Psychology
OBJECTIVES: Chronic health conditions are a major challenge to the health care system. Medical Group Visits (MGVs) are a valuable health care delivery model used in a variety of medical settings and patient populations. We conducted a systematic scoping review of MGV research literature for chronic health conditions to summarize the characteristics and individual components of MGVs in the United States of America and Canada.
DESIGN: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses scoping review methodology and searched five databases using nine widely used MGV-related terms.
SUBJECTS: We included studies conducted in the United States and Canada, whose participants were > 18 years old and attended an MGV conducted in a medical setting by a billable health care provider. We excluded groups related to diabetes, pregnancy, and cancer.
RESULTS: Of 3777 studies identified, we found 55 eligible studies of which 9 are randomized controlled trials and 46 are observational studies. The majority of studies were conducted in academic medical centers, were observational in design, and recruited patients using physician referrals. The three most frequently studied groups include a combination of several chronic conditions (n = 12), chronic pain conditions (n = 10), and cardiovascular disease (n = 9). Curriculum components included didactics (n = 55), experiential activities (n = 27), and socializing components (n = 12). Didactic areas include (1) medical topics such as symptoms management (n = 27) of which 14 included pain management, and (2) lifestyle/educational component (n = 33) that comprised of talks on nutrition (n = 29), exercise (n = 20), stress (n = 16), and sleep (n = 10). The top integrative medicine (IM) modalities (n = 13) included: mindfulness techniques (n = 8), meditation (n = 6), and yoga (n = 5). Substantial heterogeneity was observed in the recruitment, implementation, curriculum components, and outcomes reported.
CONCLUSION: The MGV is a model of patient-centered care that has captured the attention of researchers. IM modalities are well represented in the curriculum components of MGVs. Further investigation into the components identified by this study, may help in better targeting of group interventions to patients and contexts, where it is most likely to be effective.
systematic scoping review, medical group visit, shared medical appointments, integrative medicine, and chronic health condition
DOI of Published Version
J Altern Complement Med. 2019 Apr 4. doi: 10.1089/acm.2018.0524. [Epub ahead of print] Link to article on publisher's site
Journal of alternative and complementary medicine (New York, N.Y.)
Parikh, Manasi; Rajendran, Iniya; D'Amico, Salvatore; Luo, Man; and Gardiner, Paula, "Characteristics and Components of Medical Group Visits for Chronic Health Conditions: A Systematic Scoping Review" (2019). Center for Integrated Primary Care Publications. 84.