Professional coaching was found likely to be effective in reducing some aspects of professional burnout among physicians, according to a study published in the Annals of Internal Medicine. Mindfulness-based interventions seemed to reduce burnout among nurses, midwives and some other health care professionals (HCPs) but not among physicians.

In their systemic review and meta-analysis, including 9,330 participants from 99 randomized controlled trials, George Collett, PhD, et al., focused both on single-concept burnout measurements and separate outcomes from the Maslach Burnout Inventory (MBI): emotional exhaustion (EE), which they identify as the core of burnout; depersonalization; and sense of personal accomplishment (PA).

Intervention types included mindfulness-based (including incorporating yoga, meditation or art); job-role training; resilience, well-being and stress management; debriefing/support/Balint groups; and professional coaching for goal-setting, work-life balance and developing a sense of purpose. Most interventions lasted at least four weeks and were evaluated on changes in the MBI-EE, depersonalization and PA subscales, or the Professional Quality of Life burnout subscale.

Results among physicians found that professional coaching reduced both EE (standardized mean difference [SMD], –0.37; GRADE: low certainty) and depersonalization (SMD, –0.30; moderate certainty), whereas mindfulness-based interventions were less effective in reducing EE (SMD, –0.46; very low certainty) or depersonalization (SMD, –0.09; moderate certainty).

However, mindfulness-based interventions may be effective in reducing EE (SMD, –0.90; low certainty) among nurses and midwives. These types of interventions may also be effective in reducing EE (SMD, –0.40; low certainty) and depersonalization (SMD, –0.33; low certainty) and promote a sense of PA (SMD, 0.48; moderate certainty) among other health care professionals.

In their discussion of individual-level interventions, Collett and colleagues write of the need for studies with a broader scope. "Policymakers must not neglect the organizational-level drivers of burnout," they suggest. "These findings will be valuable to policymakers developing support strategies, especially given the health care shortages and high rates of burnout, particularly among primary care physicians and nurses around the world."

The results from Collett and colleagues "also emphasize the continuing need for more studies evaluating system-level initiatives, integrating principles from organizational and implementation science, human factors engineering, and evidence-based work design," Colin P. West, MD, PhD, writes in an accompanying editorial, noting that there are additional gaps in work on job-specific stresses and how the health care team functions as a whole.