Combination of interventions may combat physician burnout

Individual-focused interventions, such as mindfulness, stress management, and small group discussions, and structural or organizational interventions can be effective approaches to reduce physician burnout, a study found.

Researchers conducted a systematic review and meta-analysis by reviewing the literature through Jan. 15, 2016, for studies of interventions to prevent and reduce physician burnout, including single-arm pre-post comparison studies. Studies had to provide physician-specific burnout data using measures with validity support from commonly accepted sources of evidence. The study outcomes were changes in overall burnout and measures of emotional exhaustion and depersonalization.

Results appeared in The Lancet on Sept. 28.

The review and meta-analysis involved 15 randomized trials including 716 physicians and 37 cohort studies including 2,914 physicians. Overall burnout decreased from 54% to 44% (difference, 10%; 95% CI, 5% to 14%; P<0.0001; 14 studies), emotional exhaustion score decreased from 23.82 points to 21.17 points (difference, 2.65 points; 95% CI, 1.67 to 3.64 points; P<0.0001; 40 studies), and depersonalization score decreased from 9.05 to 8.41 (difference, 0.64 point; 95% CI, 0.15 to 1.14 points; P=0.01; 36 studies). The rate of high emotional exhaustion decreased from 38% to 24% (difference, 14%; 95% CI, 11% to 18%; P<0.0001; 21 studies) and rate of high depersonalization decreased from 38% to 34% (difference, 4%; 95% CI, 0% to 8%; P=0.04; 16 studies).

“Our results substantiate that both individual-focused and structural or organisational interventions can reduce physician burnout,” the authors wrote. “Although no specific physician burnout interventions have been shown to be better than are other interventions, both strategies are probably necessary.”