Healthcare professionals across America are suffering from the inaccessibility of coping strategies that would help them to transform the excessive amounts of stress that they experience during each shift at the hospital or facility in which they work. Healthcare worker burnout, a disorder that manifests as physical exhaustion can be a side effect of a poor work-life balance. Other symptoms of burnout include problems with concentration as well as psychological disorders including depression and anxiety. Although it may seem odd, hospitals can start to implement programs utilizing alternative medicine in the form of mindfulness in combination with gratitude and vulnerability exercises that will not only create a positive corporate culture but also preemptively help these facilities save money by reducing rates of worker turnover, limiting the cost of employee treatment for burnout, and reducing the risk of employee accidents and poor quality of care leading to expensive patient lawsuits.

Yoga has become one of the most popular contemporary health approaches practiced by young adults in the United States. It is an ancient mind and body practice with origins in Indian philosophy dating to over 5,000 years ago. Yoga combines physical postures, rhythmic breathing, and meditative exercises to offer the participants a unique, holistic mind-body experience. In this report, the Sutras first introduced by Patanjali, an ancient Indian sage, are broken down into modern definitions. Each sutra has its own unique mental and physical benefits that can be attained by college students. Yama encourages maintaining a personal moral code. Niyama allows for personal connection and self-awareness. Asana refers to the poses that are still commonly practiced today. Pranayama helps to practice deep breathing. Pratyahara offers a disconnect from the world around us. Dharana allows us to focus and hone in on one thought. Dyana promotes a continuous flow of focus in meditation. Samadhi is reaching a state of pure relaxation. All of these take time and practice, but when implemented in different aspects of daily life, college students can reduce their overall stress and anxiety to improve focus and success.

Polypharmacy among psychiatric patients is a concerning trend. From 2007-2010, 58.2% of women and 41.8% of men reported taking five or more prescription drugs within the last 30 days (CDC, 2014). Negative outcomes include prescription drug abuse, side effects, interactions, treatment failure, patient dissatisfaction, and lack of treatment control. The associated practice challenges have led to the following PICOT question. In persons with mental health issues receiving care at an outpatient mental health clinic, does engaging in mindfulness practice versus no mindfulness practice change polypharmacy use over a 3-month period?

The project purpose was to evaluate the effectiveness of Insight Timer mobile mindfulness app at helping patients self-manage distressing symptoms and reduce polypharmacy. Over three weeks, mental health clinic nurse practitioners (NPs) voluntarily recruited patients (n=12) over age 18 using as needed prescriptions (PRNs), and agreed to use Insight Timer mobile mindfulness app for adjunct symptom management. Consenting participants downloaded the mobile app, and completed a brief questionnaire measuring PRN use at the start of app use, and PRN use at their next visit. A Wilcoxon signed-rank test indicated a 10-week mindfulness app trial did not significantly lower total PRN doses compared with pre-app dosing (Z = -.534, p = .593). Paired t-tests revealed no significant change in pre (M = 65.17, SD = 28.64) versus post (M = 67.75, SD = 20.22) OQ45 life functionality results (t(11) = -.420, p = .683) (d = .121) as a result of app use.

Clinically relevant results illustrated 83.33% of participants taking greater than nine PRN doses over the study period used the app six times or more in place of medication. High PRN users employed the app frequently in place of medication regardless of total PRN doses taken. Practice implications and sustainability recommendations include incorporating mobile app use in treatment plans for high PRN users and educating NP’s on the tangible benefits of mindfulness apps in reducing polypharmacy and easing symptom distress on an ongoing basis.
Keywords: mindfulness, mhealth, mobile apps, mobile smart phone, online, RCT, behavior change, polypharmacy.