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Mindfulness-based interventions to reduce burnout and stress in physicians: a study protocol for a systematic review and meta-analysis
  1. Johannes Caspar Fendel1,
  2. Johannes Julian Bürkle1,2,
  3. Anja Simone Göritz1
  1. 1Department of Occupational and Consumer Psychology, Institute of Psychology, University of Freiburg, Freiburg im Breisgau, Baden-Württemberg, Germany
  2. 2Department of Psychosomatic Medicine and Psychotherapy, Faculty of Medicine, University Medical Center Freiburg, Freiburg im Breisgau, Baden-Württemberg, Germany
  1. Correspondence to Mr Johannes Caspar Fendel; johannes.fendel{at}


Introduction Physicians often suffer from burnout and stress, not only affecting themselves, but also their patients and the healthcare system in general. An increasing number of studies suggest that mindfulness-based interventions improve physicians’ well-being as well as the quality of care they deliver. However, the evidence is scattered, and a systematic review and meta-analysis is lacking. To the best of our knowledge, this systematic review and meta-analysis will be the first to assess the effectiveness of mindfulness-based interventions in reducing burnout and stress among physicians. Further, it aims to uncover potential moderators of intervention effectiveness.

Methods and analysis MEDLINE, Embase, PsycINFO, PSYINDEX, Web of Science, CINAHL and the Cochrane Central Register of Controlled Trials will be screened without language or publication date restrictions. In addition, backward and forward citation searches of included studies and relevant reviews will be conducted. Studies examining the effect of interventions for physicians explicitly based on mindfulness will be included. Primary outcomes will be pre-post changes in burnout and stress if assessed with validated measures. Two reviewers independently search, select and extract data, and rate the methodological quality of the studies. Both controlled and uncontrolled studies will be included. Randomised controlled trails will be meta-analysed separately using between-group effect. In addition, non-randomised trials including non-controlled before-after studies will be meta-analysed using within-group effect. Potential moderators and sources of between-study heterogeneity will be tested using meta-regression and subgroup analyses. Futhermore, a narrative synthesis will be pursued. The Grading of Recommendations Assessment, Development and Evaluation system (GRADE) will be used to assess the quality of the cumulated evidence.

Ethics and dissemination Ethical approval is not required. Results will be published in a peer-reviewed journal and presented at international conferences.

PROSPERO registration number CRD42019133077

  • mindfulness-based intervention
  • physician
  • burnout
  • stress
  • systematic review
  • meta-analysis

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

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  • JCF and JJB contributed equally.

  • Contributors JCF and JJB drafted the work and made substantial contributions to the conception. They wrote and approved the submitted version of the protocol and account for accuracy and integrity of any part of the work. ASG read, edited and approved several versions of the manuscript and consulted in all stages of the conception.

  • Funding This work represents independent research supported by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) under Project number 197396619—SFB 1015. The DFG also funded the article processing charge together with the University of Freiburg in the funding programme Open Access Publishing.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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