A recent study published in The Journal of Rheumatology demonstrated that the evidence supporting interventions to prevent burnout among physicians is limited in quality. Study authors suggest physicians address symptoms of burnout by practicing mindfulness.
Investigators conducted an overview of reviews assessing interventions designed to prevent physician burnout and identified additional strategies that could be implemented within rheumatology practices. The included reviews consisted of studies with a minimum of 10% participation from physicians, with burnout or a similar measure of work-related stress as the primary outcome.
The investigators noted the presence of significant heterogeneity and low-quality evidence, risk for bias, and variability in terms of study designs, interventions, outcome measures, and burnout conceptualizations among the considered reviews. Review findings suggested cautious interpretation due to this variability.
Each review included a varying number of primary studies, ranging from 6 to 81 (median, 19 studies; interquartile range [IQR], 13-36 studies). Additionally, the number of relevant primary studies for each review ranged from 2 to 24 (median, 7 studies; IQR, 5-11 studies).
Meta-analyses were conducted within 6 of the reviews, with results suggesting that the tested interventions resulted in slight to moderate reductions in burnout. In 2 comparative analyses, organization-directed interventions were found to be more effective than physician-directed interventions. The third comparative analysis demonstrated that physician-directed interventions were more effective.
Use of the AMSTAR-2 measurement tool (designed to assess the methodological quality of systematic reviews) led to the exclusion of the realist review and umbrella review. Among the remaining reviews assessed, 1 review received a moderate rating, 6 were rated as low, and 9 were classified as critically low.
This study was limited by inconsistencies among the included reviews. Additionally, while the current study focused on burnout as an outcome, other outcomes such as depression or anxiety may contribute to burnout and should be considered in future reviews.
The study authors concluded, “Future work should focus on interventions that address physician workflow, organizational strategies, peer support, formal communication training, leadership support, and addressing stress, mental health, and mindfulness.”
This article originally appeared on Rheumatology Advisor
Kheirkhah H, Hartfeld NMS, Widdifield J, et al. An overview of reviews to inform organization-level interventions to address burnout in rheumatologists. J Rheumatol. Published online September 1, 2023. doi:10.3899/jrheum.2023-0437