Self-directed Mindfulness Training and Improvement in Blood Pressure, Migraine Frequency, and Quality of Life. Author: Oberg EB, Rempe M, Bradley R. Affiliation: Bastyr University-California, San Diego, United States. Conference/Journal: Glob Adv Health Med. Date published: 2013 Mar Other: Volume ID: 2 , Issue ID: 2 , Pages: 20-25 , Word Count: 276 in English, Chinese, Spanish BACKGROUND: Interest in case studies has undergone a resurgence concurrent with increasing prioritization of illustrations of patient-centered care. However, substantial inclusion of the patient in these reports remains limited. Here, a doctor and patient collaborate to present her case report of self-directed 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). Self-reported 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: Self-directed 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 self-efficacy. Additionally, case studies that combine the voice of the clinician and the patient can provide useful illustrations of truly patient-centered care. KEYWORDS: Mindfulness, case report, complementary and alternative medicine, hypertension, meditation, migraine, patient-centered care, self directed PMID: 24278842