insights

IFM’s vision is to advance the highest expression of individual health, a goal that includes ensuring access to functional medicine for all communities. Key to such expansion is demonstrating the feasibility and efficacy of functional medicine interventions in varied settings and populations. IFM partner Cleveland Clinic Center for Functional Medicine has published several recent studies that add to the evidence base supporting the efficacy of functional medicine in primary care and within a group visit model. Now, a new study from the Center for Functional Medicine published in BMC Public Health extends those findings by demonstrating that a community-based functional medicine group visit model can succeed in a chronically underserved population.¹

In the new study, a group of 15 participants, the majority of whom were older African American women, attended 10 weekly community-based shared medical appointment (SMA) sessions at a community center in a resource-challenged Cleveland neighborhood. SMAs, or group visits, are a healthcare delivery model that incorporate a multidisciplinary team of caregivers to deliver medical care and/or education to groups of patients with the same medical condition. The sessions focused on weight management, utilizing IFM’s Cardiometabolic Food Plan. The results showed improvements in mean systolic (-10.5 [7.7] mmHg, p=0.0001) and diastolic (-4.7 [6.7] mmHg, p=0.17) blood pressures and weight (-5.7 [6.3] pounds, p=0.003) at three months, not long after the sessions ended. Participants reported improvements in health status, daily fruit and vegetable intake, and sleep compared to baseline. There were no significant changes in other wellness indices, self-efficacy, trust in medical researchers, hemoglobin A1c, insulin, or LDL cholesterol.¹

Focus groups data found that participants reported several health changes as a result of the community-based SMA program, including a greater understanding of dietary changes and the impacts of consuming specific foods, increased water intake, improved gut function, more mindful eating practices, and improved energy levels. Participants also appreciated the time for and method of explanation given for nutrition choices, test results, and use of dietary supplements.

Click here to see the full text of the published study.

Previous research conducted by the Center for Functional Medicine demonstrated that individual functional medicine clinic-based care improved health-related quality of life outcomes compared to primary care² and that inflammatory arthritis patients treated using the functional medicine model showed improvement in all primary outcomes compared to standard of care alone.³ In 2021, the Center for Functional Medicine published a study showing that functional medicine–based SMAs had improved outcomes, including better patient-reported physical and mental health scores and increased weight, than those who had individual appointments, all while costing less to deliver.⁴

The current work demonstrates proof of concept that delivering functional medicine via SMAs in an underserved community can lead to improvements both in physiological measures and perceived health and well-being. In addition, it shows that a lifestyle-focused, functional medicine approach can succeed in a community-based group visit model outside of the walls of a healthcare institution, a critical aspect of improving access to functional medicine care for all.

References

1. Bharmal N, Beidelschies M, Alejandro-Rodriguez M, et al. A nutrition and lifestyle-focused shared medical appointment in a resource-challenged community setting: a mixed-methods study. BMC Public Health. 2022;22(1):447. doi:1186/s12889-022-12833-6
2. Beidelschies M, Alejandro-Rodriguez M, Ji X, Lapin B, Hanaway P, Rothberg MB. Association of the functional medicine model of care with patient-reported health-related quality-of-life outcomes. JAMA Netw Open. 2019;2(10):e1914017. doi:1001/jamanetworkopen.2019.14017
3. Droz N, Hanaway P, Hyman M, Jin Y, Beidelschies M, Husni ME. The impact of functional medicine on patient-reported outcomes in inflammatory arthritis: a retrospective study. PLoS One. 2020;15(10):e0240416. doi:1371/journal.pone.0240416
4. Beidelschies M, Alejandro-Rodriguez M, Guo N, et al. Patient outcomes and costs associated with functional medicine-based care in a shared versus individual setting for patients with chronic conditions: a retrospective cohort study. BMJ Open. 2021;11(4):e048294. doi:1136/bmjopen-2020-048294