A 5-year follow-up study of a randomised controlled trial of the effects of mindfulness practice on medical professionals stress

Objectives: Stress and psychological distress are frequently experienced by doctors, which has adverse outcomes for both doctors and patients. This study aimed to investigate the long-term effects of a randomised controlled study which found a mindfulness intervention reduced stress and anxiety in senior medical students. It also aimed to explore junior doctors’ views on management of stress and potential ways to improve doctors’ wellbeing.

Methods: We conducted a mixed methods, 5-year follow-up study of a randomised controlled trial of medical professionals. The outcome measures used in the original trial were repeated to analyse the difference in scores over 5 year follow up on the Perceived Stress Scale (PSS) and the Depression, Anxiety and Stress Scale (DASS). Participants also completed a questionnaire regarding any ongoing mindfulness practice and their views on doctors’ psychological health and wellbeing. Participants were invited to undertake a semi-structured interview to discuss their views on doctor wellbeing.

Results: The response rate for the 5-year follow-up questionnaire was 32%. Nearly all responders (87.5%) have continued to use some form of mindfulness or relaxation exercise. Five-year follow-up of participants’ Perceived Stress Scale score and Depression, Anxiety and Stress Scale (DASS) scores revealed a 5 year follow PSS score of 13.8 (5.2) and stress scale of DASS of 10.9 (7.3) which were not significantly different than post intervention levels from the original RCT, suggesting a sustained beneficial effect in the long term. Almost all participants believe there were issues with the overall state of doctors’ health. Almost half recommended stress management as an intervention to improve the health and wellbeing of doctors. Qualitative analysis of issues impacting on octors wellbeing revealed four themes; challenges to doctor wellbeing, personal mechanisms for minimising work-related stress, strategies for improving personal wellbeing and workplace strategies for improving doctor wellbeing.

Conclusion: Those who adopt mindfulness practice showed a sustained improved effect on stress and anxiety. Mindfulness is a practical and useful long term intervention for stress management in medical students and doctors, which provides a sustained advantageous effect in the long term.