Development of tailored text messages to enhance medication adherence

"Poor medication adherence is a public health problem. Interventions that include multiple components e.g., informational, behavioral, and social support report success in enhancing adherence. Social support delivery options have not been well studied. Mobile health technology (mHealth) is an innovative way to deliver social support focused interventions."--Introduction

Data for "The effect of mindfulness interventions on stress in medical students : a systematic review and meta-analysis" from Comprehensive Meta-Analysis (CMA) software

DatasetThree research data sets for "The effect of mindfulness interventions on stress in medical students: A systematic review and meta-analysis" from Comprehensive Meta-Analysis (CMA) software

Summary statistics and forest plot with weighted means indicating the effect size, for the one-arm studies.

Summary statistics and forest plot with weighted means indicating the effect size, for the one-arm studies.</p

Details of search strategy.

BackgroundMedical students have high levels of stress, which is associated with higher incidents of burnout, depression, and suicide compared to age-matched peers. Mindfulness practices have been shown to reduce stress among medical students.PurposeThe purpose of this systematic review and meta-analysis was to examine if mindfulness interventions have an overall effect on stress outcomes in the high-stress population of medical students globally, particularly given the wide variety of interventions. Any intervention designed to promote mindfulness was included.MethodsA comprehensive literature search was completed to include multiple databases, ancestry, and hand-searching and 35 studies were included. Standardized mean difference effect sizes (ES) were synthesized across studies using a random-effects model for changes in stress levels in medical students ≥ 18. Moderator analyses were performed to explore variations in effects by participant and intervention characteristics.ResultsMindfulness interventions significantly improved stress among medical students in both the two-arm studies (d = 0.370, k = 19, n = 2,199, 95% CI 0.239–0.501, p d = 0.291, k = 30, n = 18 (two cohorts from Dyrbye et al), 95% CI 0.127–0.455, p = 0.001). Moderator analyses found trends in less hours and less required practice resulted in better improvement in stress.ConclusionsThis study further confirms that despite a wide variety of mindfulness interventions for medical students around the world, they produce an overall small-to-moderate effect on stress reduction. Future research looking at the most effective protocols for high-stress medical students would be beneficial.</div

PRISMA flow diagram for study selection.

BackgroundMedical students have high levels of stress, which is associated with higher incidents of burnout, depression, and suicide compared to age-matched peers. Mindfulness practices have been shown to reduce stress among medical students.PurposeThe purpose of this systematic review and meta-analysis was to examine if mindfulness interventions have an overall effect on stress outcomes in the high-stress population of medical students globally, particularly given the wide variety of interventions. Any intervention designed to promote mindfulness was included.MethodsA comprehensive literature search was completed to include multiple databases, ancestry, and hand-searching and 35 studies were included. Standardized mean difference effect sizes (ES) were synthesized across studies using a random-effects model for changes in stress levels in medical students ≥ 18. Moderator analyses were performed to explore variations in effects by participant and intervention characteristics.ResultsMindfulness interventions significantly improved stress among medical students in both the two-arm studies (d = 0.370, k = 19, n = 2,199, 95% CI 0.239–0.501, p d = 0.291, k = 30, n = 18 (two cohorts from Dyrbye et al), 95% CI 0.127–0.455, p = 0.001). Moderator analyses found trends in less hours and less required practice resulted in better improvement in stress.ConclusionsThis study further confirms that despite a wide variety of mindfulness interventions for medical students around the world, they produce an overall small-to-moderate effect on stress reduction. Future research looking at the most effective protocols for high-stress medical students would be beneficial.</div

Moderator analyses.

BackgroundMedical students have high levels of stress, which is associated with higher incidents of burnout, depression, and suicide compared to age-matched peers. Mindfulness practices have been shown to reduce stress among medical students.PurposeThe purpose of this systematic review and meta-analysis was to examine if mindfulness interventions have an overall effect on stress outcomes in the high-stress population of medical students globally, particularly given the wide variety of interventions. Any intervention designed to promote mindfulness was included.MethodsA comprehensive literature search was completed to include multiple databases, ancestry, and hand-searching and 35 studies were included. Standardized mean difference effect sizes (ES) were synthesized across studies using a random-effects model for changes in stress levels in medical students ≥ 18. Moderator analyses were performed to explore variations in effects by participant and intervention characteristics.ResultsMindfulness interventions significantly improved stress among medical students in both the two-arm studies (d = 0.370, k = 19, n = 2,199, 95% CI 0.239–0.501, p d = 0.291, k = 30, n = 18 (two cohorts from Dyrbye et al), 95% CI 0.127–0.455, p = 0.001). Moderator analyses found trends in less hours and less required practice resulted in better improvement in stress.ConclusionsThis study further confirms that despite a wide variety of mindfulness interventions for medical students around the world, they produce an overall small-to-moderate effect on stress reduction. Future research looking at the most effective protocols for high-stress medical students would be beneficial.</div

PRISMA 2020 checklist.

BackgroundMedical students have high levels of stress, which is associated with higher incidents of burnout, depression, and suicide compared to age-matched peers. Mindfulness practices have been shown to reduce stress among medical students.PurposeThe purpose of this systematic review and meta-analysis was to examine if mindfulness interventions have an overall effect on stress outcomes in the high-stress population of medical students globally, particularly given the wide variety of interventions. Any intervention designed to promote mindfulness was included.MethodsA comprehensive literature search was completed to include multiple databases, ancestry, and hand-searching and 35 studies were included. Standardized mean difference effect sizes (ES) were synthesized across studies using a random-effects model for changes in stress levels in medical students ≥ 18. Moderator analyses were performed to explore variations in effects by participant and intervention characteristics.ResultsMindfulness interventions significantly improved stress among medical students in both the two-arm studies (d = 0.370, k = 19, n = 2,199, 95% CI 0.239–0.501, p d = 0.291, k = 30, n = 18 (two cohorts from Dyrbye et al), 95% CI 0.127–0.455, p = 0.001). Moderator analyses found trends in less hours and less required practice resulted in better improvement in stress.ConclusionsThis study further confirms that despite a wide variety of mindfulness interventions for medical students around the world, they produce an overall small-to-moderate effect on stress reduction. Future research looking at the most effective protocols for high-stress medical students would be beneficial.</div

Funnel plot for publication bias for the two-arm and RCTs in the meta-analysis.

Funnel plot for publication bias for the two-arm and RCTs in the meta-analysis.</p

Comparison with recent meta-analyses.

BackgroundMedical students have high levels of stress, which is associated with higher incidents of burnout, depression, and suicide compared to age-matched peers. Mindfulness practices have been shown to reduce stress among medical students.PurposeThe purpose of this systematic review and meta-analysis was to examine if mindfulness interventions have an overall effect on stress outcomes in the high-stress population of medical students globally, particularly given the wide variety of interventions. Any intervention designed to promote mindfulness was included.MethodsA comprehensive literature search was completed to include multiple databases, ancestry, and hand-searching and 35 studies were included. Standardized mean difference effect sizes (ES) were synthesized across studies using a random-effects model for changes in stress levels in medical students ≥ 18. Moderator analyses were performed to explore variations in effects by participant and intervention characteristics.ResultsMindfulness interventions significantly improved stress among medical students in both the two-arm studies (d = 0.370, k = 19, n = 2,199, 95% CI 0.239–0.501, p d = 0.291, k = 30, n = 18 (two cohorts from Dyrbye et al), 95% CI 0.127–0.455, p = 0.001). Moderator analyses found trends in less hours and less required practice resulted in better improvement in stress.ConclusionsThis study further confirms that despite a wide variety of mindfulness interventions for medical students around the world, they produce an overall small-to-moderate effect on stress reduction. Future research looking at the most effective protocols for high-stress medical students would be beneficial.</div

Funnel plot for publication bias of the one-arm studies in the meta-analysis.

Funnel plot for publication bias of the one-arm studies in the meta-analysis.</p