Functional medicine model linked to improvements in health-related quality of life

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In the first retrospective cohort study on the functional medicine model, researchers at the Cleveland Clinic found that functional medicine was associated with improvements in health-related quality of life. The study was published today in Journal of the American Medical Association Network Open.

The two-year study examined 1,595 patients treated at the Cleveland Clinic Functional Medicine Center and 5,657 patients seen in primary care at a family health center, evaluating health-related quality of life using PROMIS®, a questionnaire validated by NIH. PROMIS provides a measure of patients' overall physical and mental health that can be monitored over time by measuring factors such as fatigue, physical function, pain, gastrointestinal problems and emotional well-being.

The study investigated the association between the model of functional care medicine and health-related quality of life by comparing patients in functional medicine with patients seen in a primary care environment.

The researchers found that the patients visited by the Center for Functional Medicine showed beneficial and sustainable improvements in their overall physical health PROMIS. At 6 months, the patients visited by the Center for Functional Medicine showed significantly greater improvements in the overall physical health of PROMIS than those observed in a primary care environment. About 31% of the patients visited by the Center for Functional Medicine improved their PROMIS global physical health scores by 5 points or more, which is a clinically significant change and a significant effect on daily life. 22% of patients in primary care improved their score by 5 points or more. At 12 months, patients visited by the Center for Functional Medicine showed similar improvements to those observed at 6 months, but these were not significant when compared to the improvements observed in patients in primary care.

To further examine this aspect, the researchers evaluated the continuous changes over time of the global physical health of PROMIS in a smaller group of patients visited by the Center for Functional Medicine at 6 and 12 months and demonstrated improvements in the global physical health of PROMIS that they were significantly larger than patients seen in a primary care setting.

The researchers believe that the reasons for the improvements in health-related quality of life shown in patients in functional medicine include differences in the functional medicine model itself, the types of patients seeking functional medicine and adherence to treatment or belief in the model of care. Future prospective studies are needed to examine the functional medicine model of care and long-term results.

This is a unique study to evaluate the impact of the functional medicine model on the quality of life related to the health of patients. In the past, the evidence supporting the model was mainly anecdotal, published as a case report or based on specific and targeted interventions used as part of the functional medicine approach, such as nutritional changes. Functional medicine professionals have suggested that their patients are improving with a systematic approach to chronic disease. Now they have evidence that their approach is associated with a better quality of life ".

Michelle Beidelschies, Ph.D., director of research and education for the Cleveland Clinic Center for Functional Medicine and the lead author of the study

Patients visited in the core therapy center had a higher median income, higher mean baseline PROMIS scores and a higher prevalence of diabetes and hypertension.

Functional medicine looks at the body as a whole and focuses on the root causes of the disease rather than on an isolated set of symptoms. It is based on the evidence that lifestyle factors – such as nutrition, sleep, exercise, stress levels, relationships and genetics – make a decisive contribution to chronic diseases .

In 2014, the Cleveland Clinic became the first academic medical center to open a Functional Medicine Center. The Center for Functional Medicine at the Cleveland Clinic requires that all new patients see a registered dietitian and health care provider, as well as a supplier as part of their initial visit, which typically lasts 60 to 75 minutes. Patients also have the opportunity to meet a behavioral health therapist as part of each visit.

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