Briefly describe a specific question, or set of related questions, about a health care test or treatment that this program should consider.

Mindfulness meditation encompasses a range of meditation techniques that have been increasingly used to treat behavioral disorders, especially those associated with stress. Some of these were previously described in AHRQ Publication No. 07-E010, along with many other forms of meditation. This query seeks to focus on mindfulness approaches, across the broad range of mental health (psychiatric disorders, substance abuse, stress associated with care-giving or other stressful occupations)

Does your question include a comparison of different health care approaches? (If no, your topic will still be considered.)

no

If yes, explain the specific technologies, devices, drugs, or interventions you would like to see compared:

only for different variants of mindfulness

What patients or group(s) of patients does your question apply to? (Please include specific details such as age range, gender, coexisting diagnoses, and indications for therapy.)

all relevant patients, although any phenotype-dependent effects would be of interest

Are there subgroups of patients that your question might apply to? (For example, an ethnic group, stage or severity of a disease.)

stressed or illnesses known to interact with the HPA axis (e.g., anxiety, depression, substance abuse, PTSD., etc.)

Describe the health-related benefits you are interested in. (For example, improvements in patient symptoms or problems from treatment or diagnosis.)

decreased symtomology associated with above diseases, or decreased stress

Describe any health-related risks, side effects, or harms that you are concerned about.

few - burden (how much training is required), or dose (6 versus 8 weeks of training), any phenotype-dependent effects would be of interest

Appropriateness for EHC Program

Does your question include a health care drug, intervention, device, or technology available (or likely to be available) in the U.S.?

yes

Which priority area(s) and population(s) does this topic apply to? (check all that apply)

EHC Priority Conditions (updated in 2008)

• Dementia, including Alzheimer's disease
• Depression and other mental health disorders
• Developmental delays, attention-deficit hyperactivity disorder, and autism
• Diabetes mellitus
• Obesity
• Substance abuse

AHRQ Priority Populations

• Low income groups
• Minority groups
• Women
• Elderly
• Individuals with special health care needs, including individuals with disabilities or who need chronic care or end-of-life health care

Federal Health Care Program

None

Importance

Describe why this topic is important.

This is a relatively inexpensive approach to manage a condition that affects everyone's health, that may be appropriate to promote to the attention of insurance providers

What specifically motivated you to ask this question? (For example, you are developing a clinical guideline, working with a policy with large uncertainty about the appropriate approach, costly intervention, new research you have read, items in the media you may have seen, a clinical practice dilemma you know of, etc.)

We fund a lot of studies in the area of mindfulness, and would like to see an independent assessment of efficacy. We would be particularly interested in putative mediators or mechanisms purposed for mindfulness (e.g., attentional processing, emotional regulation) and whether evaluation of them is possible

Does your question represent uncertainty for clinicians and/or policy-makers? (For example, variations in clinical care, controversy in what constitutes appropriate clinical care, or a policy decision.)

yes

If yes, please explain:

There are those who disagree that it is as effective as some would believe (Tonneatto & Nguyen, La Revue Canadienne de Psychiatrie, 2007) and one wonder if efficacy has been established for

Potential Impact

How will an answer to your research question be used or help inform decisions for you or your group?

We are interested in finding out more about the science of successful CAM therapies - this will help us decide which are the most promising to pursue. Stress reduction is seen as having a very wide and strong impact on the disease process.

Describe the timeframe in which an answer to your question is needed.

Within one & 1/2 to two years

Describe any health disparities, inequities, or impact on vulnerable populations your question applies to.

CAM approaches are used by all segments of society, and often by well-educated. Further information on their effectiveness may promote programs to provide similar services to under-represented/served populations

Nominator Information

Other Information About You: (optional)

Please choose a description that best describes your role or perspective: (you may select more than one category if appropriate)

We are interested in finding out more about the science of successful CAM therapies - this will help us decide which are the most promising to pursue. Stress reduction is seen as having a very wide and strong impact on the disease process.

Are you making a suggestion as an individual or on behalf of an organization?

Organization

Please tell us how you heard about the Effective Health Care Program

Richard Nahin