Self-directed mindfulness training and improvement in blood pressure, migraine frequency, and quality of life

Abstract

Background: Interest in case studies has undergone a resurgence concurrent with increasing prioritization of illustrations of patientcentered care. However, substantial inclusion of the patient in these reports remains limited. Here, a doctor and patient collaborate to present her case report of selfdirected mindfulness training and the subsequent changes in blood pressure, migraine frequency, and quality of life. Methods: After receiving encouragement from her naturopathic doctor, the patient initiated an 8-week program in mindfulness training following the Kabat-Zinn protocol and logged her daily blood pressure and symptoms before and after meditation sessions over an 11-week period. Results: Patient-reported outcomes included decreased perceived stress, increased focus, and a newfound sense of centeredness and calm. Changes in objective outcomes were clinically and statistically significant, including reductions in mean systolic and diastolic blood pressure between week 1 and week 11 (P = .0001 and P = .0004 for systolic and diastolic, respectively, by paired, 2-sided t-tests). Selfreported frequency of chronic migraine was also reduced. Critical to the patient's success was that mindfulness training was first approached in a simple, accessible manner prior to embarking on a deeper, extended experience. Discussion and Conclusion: Selfdirected mindfulness training can have a meaningful impact on both subjective and objective health outcomes. It may take years of encouragement from a healthcare provider before a patient is ready to adopt a mind-body practice; it is important to recognize and counsel patients with messages appropriate to their stage of change and selfefficacy. Additionally, case studies that combine the voice of the clinician and the patient can provide useful illustrations of truly patientcentered care.