Open Access. Powered by Scholars. Published by Universities.®

Alternative and Complementary Medicine Commons

Open Access. Powered by Scholars. Published by Universities.®

PDF

Anxiety

Discipline
Institution
Publication Year
Publication
Publication Type

Articles 1 - 30 of 56

Full-Text Articles in Alternative and Complementary Medicine

Biopsychosocial Case Report, David F. Lo, Gaurav Kumar, Don D. Shamilov May 2024

Biopsychosocial Case Report, David F. Lo, Gaurav Kumar, Don D. Shamilov

Rowan-Virtua Research Day

Ms. R, a 32-year-old Hispanic female, suffers from severe anxiety exacerbated by a car accident and past struggles with depression and substance use. Evaluation reveals hypothyroidism, mild anemia, and GAD as the primary diagnosis. Factors contributing to her condition include genetic predispositions, medical issues, and social stressors. Treatment involves pharmacotherapy, psychotherapy, and monitoring her physiological health. Research on wearable data for GAD severity offers potential insights for her treatment. A holistic approach, considering biological, psychological, and social factors, guides her tailored treatment plan for overall well-being.


Trichotillomania Case Report, Kimberly Kluglein, David F. Lo, Don D. Shamilov May 2024

Trichotillomania Case Report, Kimberly Kluglein, David F. Lo, Don D. Shamilov

Rowan-Virtua Research Day

Trichotillomania is a psycho-dermatologic disorder involving self-inflicted hair loss through pulling. Often complicated by anxiety and depression. Multifactorial etiology and limited evidence-based treatment options makes management difficult. Treatment approaches include a combination of pharmacotherapy, CBT, HRT, and ACT. Case presentation involves a 24-year-old female, diagnosed with treatment-resistant trichotillomania who achieved remission and hair regrowth through mindset reframing, physical barriers, and community support. Novel approaches focusing on mindset and community support can yield positive outcomes.


Interactive Distraction Techniques Versus Midazolam In Anxiolysis In Pediatric Patients: A Systematic Review And Meta-Analysis, Uzay Cagatay, Jon Elias, Alexander King May 2024

Interactive Distraction Techniques Versus Midazolam In Anxiolysis In Pediatric Patients: A Systematic Review And Meta-Analysis, Uzay Cagatay, Jon Elias, Alexander King

Rowan-Virtua Research Day

Background: Many pediatric patients experience high levels of anxiety prior to undergoing surgery. Midazolam is currently one of the most commonly used sedative drugs in the pediatric preoperative environment. A number of studies have evaluated the use of non-pharmacological methods of relaxing pediatric patients prior to surgery, known as ‘Interactive Distraction’. These techniques involve using various methods of distracting the child from the preoperative anesthetic procedures. Some examples of these methods involve giving the patient an iPad with which they can play video games. There have yet to be any systematic reviews comparing the usage of Midazolam alone against utilizing …


Calming The Body, Calming The Mind: A Pilot Study On The Use Of Zero Balancing To Reduce Anxiety, Misty L. Rhoads, Mary Murphy Feb 2024

Calming The Body, Calming The Mind: A Pilot Study On The Use Of Zero Balancing To Reduce Anxiety, Misty L. Rhoads, Mary Murphy

Journal of Transformative Touch

Background: The predominance of anxiety is currently at record levels, and the need for non-pharmaceutical approaches to help alleviate and decrease the harmful effects of anxiety on an individual and collective level is necessary. This study explored how Zero Balancing supports individuals with anxiety to manage their physical, mental, and emotional health more effectively. Researchers hypothesized that Zero Balancing would lower the perceived severity of general anxiety and lower perceived anxiety symptoms.

Methods: To honor the holistic nature of bodywork and the participants' lived experiences, the researchers utilized a concurrent mixed-methods phenomenological research design. Each participant received one Zero Balancing …


Impact Of Equine Interaction During Psychotherapy On Anxiety And Depression For Residential Treatment Program Patients Experiencing Substance Withdrawal, Molly M. Friend, Molly C. Nicodemus, Clay Cavinder, Caleb Lemley, Pauline Prince, Katherine A. Cagle-Holtcamp, Rebecca M. Swanson Feb 2024

Impact Of Equine Interaction During Psychotherapy On Anxiety And Depression For Residential Treatment Program Patients Experiencing Substance Withdrawal, Molly M. Friend, Molly C. Nicodemus, Clay Cavinder, Caleb Lemley, Pauline Prince, Katherine A. Cagle-Holtcamp, Rebecca M. Swanson

People and Animals: The International Journal of Research and Practice

As incidences of substance use disorders (SUD) increase in the wake of the COVID-19 pandemic, there is a need for more effective treatment approaches. Further, treatment approaches currently available struggle to retain patients during the period of substance withdrawal in early treatment due to patients’ withdrawal symptoms including increased feelings of anxiety and depression. Withdrawal symptoms have been linked to dysregulated cortisol concentrations present in this period. Psychotherapy incorporating equine interaction (PIE) has emerged in other populations as a treatment that decreases cortisol concentrations and improves treatment retention. The present study investigated the impact of 4 weeks of PIE on …


The Impact Of Brief Electronic Guided Mindfulness Meditation On Anxiety Scores, Sierra King Feb 2024

The Impact Of Brief Electronic Guided Mindfulness Meditation On Anxiety Scores, Sierra King

DNP Scholarly Projects

In the United States, anxiety rates are on the rise for the general population (Goodwin et al., 2020a). Prolonged and frequent anxiety can become unprompted and problematic (American Psychiatric Association, 2021). Management of anxiety is crucial for overall wellbeing. Access to treatment and resources for anxiety may be limited in rural geographical locations (Morales et al., n.d.). This DNP project sought to determine whether a brief intervention of electronic guided mindfulness meditation (MM) by Insight Timer is effective in decreasing anxiety in a rural populous. Convenience sampling recruited a final total of 11 rural participants who participated in seven sessions …


Zen Your College Experience, Anna Sharshon Oct 2023

Zen Your College Experience, Anna Sharshon

BUHealth

When college students transition from life at home to life at school, they may be faced with a variety of stressors such as navigating a more rigorous academic environment or an overload of new commitments and responsibilities. Struggling with the change in environment is one of the major problems faced among college students and often leads to more stress and anxiety, lack of sleep hygiene, and poor eating habits. Fortunately, mindful meditation has been proven to help with these issues. Mindful meditation is the practice of focusing or clearing the mind by using certain mental and physical techniques. It has …


The Musical Touch On Mental Illness, Skylar Dunn Apr 2023

The Musical Touch On Mental Illness, Skylar Dunn

Senior Honors Theses

To understand the relationship amongst anxiety, depression, and music therapy, this integrative review synthesizes the major themes and relevant education of articles discussing mental health and the benefit of music. While most existing studies focus on using music therapy to treat pain and clinical anxiety, the content of this paper is written to emphasize how the same principles can be used in unmanageable stress and emotional decomposition. Each topic is analyzed and reviewed individually, pooling several sources for a thorough examination, and understanding of the subject. Once each area is fully summarized, the gap is addressed by pulling evidence from …


Homoeopathy In The Management Of Generalised Anxiety Disorder: A Case Report, Karunakara Moorthi, Radhika P Mar 2023

Homoeopathy In The Management Of Generalised Anxiety Disorder: A Case Report, Karunakara Moorthi, Radhika P

Indian Journal of Research in Homoeopathy

Introduction: Generalised anxiety disorder (G.A.D.) is characterised by excessive, pervasive and uncontrollable worry. G.A.D. is a chronic and recurrent disorder with a low rate of remission with a considerable impact on quality of life. There is a scarcity of literature published on homoeopathy on G.A.D. This case report illustrates an improvement without recurrence of a G.A.D. case treated exclusively with homoeopathic medicine.

Case Summary: A 36-year-old man presented with anxiety about least trifles, easily irritable, palpitation, gastric disturbances, tension, excessive sweating, sleep disturbances and difficulty in concentration. After thorough case-taking, homoeopathic treatment with Lycopodium 200C and Sulphur 1000C led to …


Acupressure Modality Effectiveness: Research Results For Pain And Anxiety, Deanna Waggy Otr, Carroll Noel Mozer Otr/L, Marilyn Zurwaski Otr/L Feb 2023

Acupressure Modality Effectiveness: Research Results For Pain And Anxiety, Deanna Waggy Otr, Carroll Noel Mozer Otr/L, Marilyn Zurwaski Otr/L

Journal of Transformative Touch

According to recent studies, including Monson et all, JACM, 2019, there is growing evidence for the effective and safe use of acupressure as a non-pharmacological approach to reducing pain and anxiety. Acupressure can quiet the mind, promoting a sense of well-being by decreasing anxiety.

A collaborative retrospective analysis of self-rated pain and anxiety scores before and immediately after administration of a stress release protocol indicate that acupressure is a highly satisfactory complementary therapy. Results were clinically significant for a decrease in self-rated pain and anxiety scores.

Occupational therapy practitioners as well as those who use the Kawa model of reference …


Mental Health Problems Among Elementary School Students Mandated To E-Learning: A Covid-19 Rapid Review Caveatmandated To E-Learning: A Covid-19 Rapid Review Caveat, Renee M. D'Amore, Angelina N. Halpern, Lauren R. Reed, Kevin M. Gorey Jan 2023

Mental Health Problems Among Elementary School Students Mandated To E-Learning: A Covid-19 Rapid Review Caveatmandated To E-Learning: A Covid-19 Rapid Review Caveat, Renee M. D'Amore, Angelina N. Halpern, Lauren R. Reed, Kevin M. Gorey

Social Work Publications

Extended lockdowns during the COVID-19 pandemic mandated millions of students worldwide to e- learning and by default made many of their parents proxy homeschool teachers. Preliminary anecdotal, journalistic and qualitative evidence suggested that elementary school children and their parents were probably most vulnerable to this stressor and most likely to experience mental health problems because of it. We responded with a rapid review of 15 online surveys to estimate the magnitude of such risks and their predictors between 2020 and 2021. The pooled relative risk of mental health problems among school children and their parents was substantial (RR = 1.97). …


Utilizing The Zebrafish Species, Danio Rerio, To Assess The Effect Of Acute Treatment With St. John’S Wort Supplements On Anxiety As Measured By The Novel Dive Tank Test, Sebastian Woodson, Lori Mcgrew Dr. Jan 2023

Utilizing The Zebrafish Species, Danio Rerio, To Assess The Effect Of Acute Treatment With St. John’S Wort Supplements On Anxiety As Measured By The Novel Dive Tank Test, Sebastian Woodson, Lori Mcgrew Dr.

Research Projects

Background: The zebrafish species, Danio rerio, is a widely utilized model organism with well-characterized behaviors including anxiety-like behavior when placed into a novel environment. In addition, the fish can be treated with substances by immersion.

St. John’s Wort has been suggested as a plant-based treatment for depression and anxiety because it contains compounds that inhibit the serotonin transporter (SERT) among other effects. A number of St. John’s Wort supplements are commercially available.

The National Institute of Mental Health (NIMH) estimates that about 19% of US adults suffer an anxiety disorder each year and about 31% will experience an anxiety disorder …


Academic Stress And Anxiety In Nursing Students: An Aerobic Exercise Intervention, Mariko Danielle Aka Jan 2023

Academic Stress And Anxiety In Nursing Students: An Aerobic Exercise Intervention, Mariko Danielle Aka

DNP Research Projects

Abstract

Background: The demands of rigorous nursing education programs often cause students to experience high levels of stress and anxiety during their schooling. Moderate to high academic stress and anxiety levels impact nursing students around the world. This is significant as academic stress and anxiety contribute to decreased academic success, program completion, and student health.

Local Problem: Students at Kettering College and Southern Adventist University were found to have moderate academic stress and anxiety using the SNSI and GAD-7.

Intervention: Participants (N = 24) engaged in a 4-week aerobic-exercise intervention. They were required to complete a minimum of 80 …


Alternative Pharmacology: Exploring Ketamine Use For Treatment Resistant Mental Health Disorders, Kiersten L. Ash Jan 2023

Alternative Pharmacology: Exploring Ketamine Use For Treatment Resistant Mental Health Disorders, Kiersten L. Ash

Soaring: A Journal of Undergraduate Research

No abstract provided.


The Anxiolytic Effects Of Aromatherapy On Preprocedural Anxiety: An Integrated Review, Rebekah Smith Apr 2022

The Anxiolytic Effects Of Aromatherapy On Preprocedural Anxiety: An Integrated Review, Rebekah Smith

Senior Honors Theses

Anxiety before procedures can negatively impact patients by increasing cortisol levels which delays wound healing and increases infection risk, increasing pain and sedation medication needs, and increasing hospitalization time. This review was conducted to find how inhaled essential oils affect pre-procedural anxiety of adults in acute care settings. Nine databases and some gray literature were searched within the past ten years, and documented using the PRISMA flow chart. Ten articles fitting the inclusion criteria were retrieved. Nine of the articles found a significant difference between the aromatherapy group and control group and pre- and post- intervention anxiety scores, and none …


Music Intervention And Its Effect On State Anxiety: An Integrative Literature Review, Courtney Olek Feb 2022

Music Intervention And Its Effect On State Anxiety: An Integrative Literature Review, Courtney Olek

Nursing Masters Papers

Approximately 5 million patients are admitted to Intensive Care Units (ICU) in the United States for acute or life-threatening medical problems or injuries annually. The ICU patient experience has been described in the literature as dehumanizing, stressful, and anxiety provoking. Given the adverse physiological and psychological effects of sustained state anxiety, it is important anxiety is effectively managed in the ICU environment. Standard care for management of anxiety often relies heavily upon sedative medications and are correlated with poor outcomes when used in high doses and over a long duration. The SCCM recommends nonpharmacologic adjunctive measures to decrease the occurrence …


Utilization Of The Calm Apparatus To Adult Men And Women With Atrial Fibrillation To Decrease Emergency Department Visits For Atrial Fibrillation, Ami Klein Feb 2022

Utilization Of The Calm Apparatus To Adult Men And Women With Atrial Fibrillation To Decrease Emergency Department Visits For Atrial Fibrillation, Ami Klein

DNP Scholarly Projects

The purpose of this project is two-fold. The first is to determine if the CALM APP use by adult men and women with atrial fibrillation (AF) will decrease anxiety. The second is to determine if decreased anxiety utilizing the CALM APP will deter admissions to the emergency department (ED) for AF in the first month post-catheter ablation of AF. The Zung SAS was used to determine the pre- and post-anxiety scores. The Seven Days of Calm (free app) was used to teach deep breathing and meditation. This study showed a moderate decrease in ED visits with use of the Calm …


Analysis Of Zero Balancing Case Studies Through An Occupational Therapy Lens, Deanna Waggy Otr, Msa, Czb, Csla Jan 2022

Analysis Of Zero Balancing Case Studies Through An Occupational Therapy Lens, Deanna Waggy Otr, Msa, Czb, Csla

Journal of Transformative Touch

Does Zero Balancing positively impact occupational performance? This is a question many Occupational Therapists (OTs) ask when discerning if Zero Balancing (ZB) is an evidence-based treatment modality. Case studies from the book Experiencing the Power of Zero Balancing: Case Studies of Journeys to Health and Wholeness (Quarry & King, 2016) were reviewed and compared to the Occupational Therapy domain of practice to show clear evidence that each case study had a positive impact on occupational performance. A comparison chart shows a direct link between the occupational categories and documented evidence of improved occupational performance through practitioner observation and client feedback …


Effects Of Mindfulness And Stress Management On Neurocardiovascular And Psychological Outcomes, Aditi P. Vyas Jan 2022

Effects Of Mindfulness And Stress Management On Neurocardiovascular And Psychological Outcomes, Aditi P. Vyas

Dissertations, Master's Theses and Master's Reports

There has been a higher prevalence of developing anxiety due to frequent episodes of stress among adults in recent years. Chronic anxiety can contribute to the prevalence of elevated blood pressure and hypertension. High anxiety and stress also contribute to overactivation of the sympathetic nervous system which can be quantified by increased muscle sympathetic nerve activity (MSNA). Sympathetic overactivation can lead to vasoconstriction and loss of arterial elasticity. Anxiety, MSNA, blood pressure, and arterial stiffness are all interconnected, thus studying these relationships is crucial to understand the underlying mechanisms for prevention and treatment of cardiovascular disease (CVD). Non-pharmacological and mind-body …


A Comparison Of The Magnitude Of The Mental Health Benefits Of Exercising Outdoors Vs Exercising Indoors: A Review, Greta M. Rueschmann Jan 2022

A Comparison Of The Magnitude Of The Mental Health Benefits Of Exercising Outdoors Vs Exercising Indoors: A Review, Greta M. Rueschmann

MSU Graduate Theses

Many people in the United States suffer from poor mental health which can lead to suicide, self-harm, or negative effects on job performance and relationships. Not everyone can afford traditional therapy nor feels comfortable with it. With a greater emphasis placed on taking care of one’s mental health during the COVID-19 pandemic, there should also be a greater emphasis placed on finding alternative types of therapy that can be matched to individuals based on their personalities and preferences. One such alternative is outdoor exercise. This review was conducted to examine whether exercising or performing physical activity outdoors results in greater …


Mindfulness-Based Interventions For Prenatal Stress, Anxiety, And Depression, Fiona Kate Rice May 2021

Mindfulness-Based Interventions For Prenatal Stress, Anxiety, And Depression, Fiona Kate Rice

Expressive Therapies Capstone Theses

Pregnant people in the United States (US) face myriad barriers to resource accessibility when seeking support, including financial gatekeeping, discrimination, and cis-gendering of the process. Commodification of prenatal support is exhaustive and contributes to a growing exclusivity of traditionally accessible interventions designed to reduce stress, anxiety, and depression, and to promote positive fetal outcomes and parent-child bond. Mindfulness-based interventions are particularly appropriate for reducing stress, anxiety, and depression in pregnancy. Mindfulness-based interventions are intersectional, accessible means of pregnancy and childbirth support with evidence-based outcomes of positive birth experiences and results. Mindfulness is defined as nonjudgmental awareness of the present moment. …


Exploring The Usefulness Of Mindfulness Practices Through Zoom Meetings In Reducing Anxiety And/Or Stress Of Adults With Learning And Developmental Disabilities During The Covid-19 Pandemic, Thatiane Abra May 2021

Exploring The Usefulness Of Mindfulness Practices Through Zoom Meetings In Reducing Anxiety And/Or Stress Of Adults With Learning And Developmental Disabilities During The Covid-19 Pandemic, Thatiane Abra

Expressive Therapies Capstone Theses

This thesis explored which mindfulness meditations or mindfulness practices could be beneficial in the online sessions, the extent to which adults with learning and developmental disabilities could learn the practices remotely, and how stress and anxiety disorders could be reduced through online mindfulness interventions. Furthermore, it was also necessary to address the online sessions as the only mental health treatment possibility during the Coronavirus pandemic for the clients observed and the benefits and limitations of these interventions. Additionally, the importance of structure and routine for this population, the multi-modal structure of the interventions, and how attunement plays an important role …


Using Mindfulness To Decrease Stress In College Students, Saska Pavlovic May 2021

Using Mindfulness To Decrease Stress In College Students, Saska Pavlovic

Evidence-Based Practice Project Reports

The prevalence of stress is increasing in colleges, where students are experiencing anxiety at an alarming rate, with anxiety being the topic most discussed in university counseling centers. The purpose of this evidence-based practice project was to determine the effect of mindfulness exercises on college students’ perceived stress. The Stetler Model guided the project development and implementation. The literature search revealed that best practice included mindfulness exercises through a combination of face-to-face instruction and remote online audio meditation for a duration of eight weeks. For this project, 56 undergraduate students (health care-leadership, health-science, and nursing majors) enrolled in a health …


Complementary And Alternative Medicine: The Effects Of Aromatherapy On New And Expectant Mothers, Heather Tran May 2021

Complementary And Alternative Medicine: The Effects Of Aromatherapy On New And Expectant Mothers, Heather Tran

Nursing | Senior Theses

Complementary and alternative medicine (CAM) is vastly expanding and is now being used in the clinical setting as an effective management of various symptoms. Pregnancy, labor, and the postpartum period can be beautiful yet overwhelming moments in a woman’s life. The symptoms that are usually accompanied along this journey include nausea, vomiting, anxiety, pain, fatigue, stress and more. Aromatherapy has been proven to be a safe and natural, non-pharmacological method in reducing these symptoms that may make it harder for the mother to enjoy her pregnancy. This holistic approach to treatment is inexpensive, noninvasive, does not require a prescription from …


The Influence Of Prenatal Yoga On Mental Health In Pregnancy During The Covid-19 Pandemic, Cathryn Duchette Apr 2021

The Influence Of Prenatal Yoga On Mental Health In Pregnancy During The Covid-19 Pandemic, Cathryn Duchette

Masters Theses & Specialist Projects

The COVID-19 pandemic poses risks to the mental health of expecting mothers as studies have demonstrated increased levels of stress and anxiety for new and expectant mothers during the pandemic. Prenatal yoga has been shown to be effective for improving mental health during pregnancy, but no research has been done to determine its effect on mental health during a pandemic. The purpose of this study was to determine the influence of a 10-week prenatal yoga intervention on the mental health of pregnant women during the COVID-19 pandemic. Baseline levels of anxiety and depression were high, with an average depression score …


Addressing Psychosocial Outcomes Of Social Isolation In Older Adults, Megan Friesen, Madeline M. Christensen Feb 2021

Addressing Psychosocial Outcomes Of Social Isolation In Older Adults, Megan Friesen, Madeline M. Christensen

Nursing DNP Projects

Purpose and Rationale

The aim of the evidence-based practice (EBP) project is to improve psychological outcomes for socially isolated older adults enrolled in a Homebound Program (HP) through the implementation of an EBP intervention. Social isolation has a multitude of negative consequences, including impacting the psychological health (e.g. depression, loneliness, anxiety) of the older adult population.

Synthesis of Evidence

Meta-analyses, systematic reviews, and randomized controlled trials addressing the clinical problem of social isolation were identified. Through critical appraisal of the evidence, physical activity, psychotherapy, and socialization interventions have shown to decrease depression and loneliness in older adults. There were mixed …


Characterizing The Anxiolytic Potential And Synergistic Efficacy Of Cannabidiol And D-Limonene, Nathashi Jayawardena Feb 2021

Characterizing The Anxiolytic Potential And Synergistic Efficacy Of Cannabidiol And D-Limonene, Nathashi Jayawardena

Electronic Thesis and Dissertation Repository

Emerging evidence has elucidated the anxiolytic properties of the cannabis-derived phytochemicals cannabidiol (CBD) and d-limonene and the ‘Entourage Effect’ wherein, multiple components of cannabis synergize to produce stronger effects than their pure counterparts. However, no studies have yet explored this effect in combinations of CBD and limonene. Thus, the present thesis investigated the anxiolytic and synergistic potential of concurrently administered intra-nucleus accumbens shell CBD (1 ng/0.5 μl or 5 ng/0.5 μl) and inhaled limonene (200 μl or 2000 μl). Additionally, the role of the 5-HT1A receptor in mediating these effects was examined by co-application of the antagonist NAD299 and by …


The Effect Of Physical Activity On The Mental Health Of Pre-Nursing Students And Undergraduate Student Nurses, Larinda J. Fandrich Jan 2021

The Effect Of Physical Activity On The Mental Health Of Pre-Nursing Students And Undergraduate Student Nurses, Larinda J. Fandrich

DNP Research Projects

Abstract

Mental health concerns are on the rise among the college-aged student. College students face a great deal of stress, which can lead to depression and anxiety. Nursing students, as a sub-group of college students, are under even greater stress related to rigorous course work and the responsibility of caring for other people, which can lead to greater depression and anxiety. This study aimed to determine what effect, if any, physical activity has on depression and anxiety scores using the PHQ-9 and GAD-7 instruments in pre-nursing and nursing students. In this study, physical activity is defined as is “any bodily …


The Green Rx: An Intervention In Nurse Anxiety And Depression, Melissa Dawley Jan 2021

The Green Rx: An Intervention In Nurse Anxiety And Depression, Melissa Dawley

DNP Research Projects

No abstract provided.


A Retrospective Analysis Of Integrative Group Medical Visits For Low-Income Patients With Anxiety Disorders In Primary Care, Annamma Udaya Thomas Jan 2021

A Retrospective Analysis Of Integrative Group Medical Visits For Low-Income Patients With Anxiety Disorders In Primary Care, Annamma Udaya Thomas

Walden Dissertations and Doctoral Studies

High utilization of the emergency department (ED) by patients with anxiety symptoms has brought attention to mental health access disparities among low-income racially/ethnically diverse populations. The health system in this study attempted to increase access to mental health care with integrative group medical visits (IGMVs), a nonpharmacological intervention with biomedical care consultation, health education, and peer support. The purpose of this retrospective comparative analysis, guided by integrative health equity in primary care framework, was to determine whether patients with diagnoses of anxiety who attended four or more IGMVs had reduced nonemergent ED utilization, reduced prescribed doses of benzodiazepine (BZD), and …