Lifestyle Medicine Clinical Trial Results | Functional Medicine Finder

Q: What is the PROMIS® questionnaire?

The PROMIS® (Patient-Reported Outcome Measurement Information System) questionnaire is a validated survey developed by the National Institutes of Health (NIH). It is used to measure patients' global physical and mental health. This tool helps healthcare providers track changes in a patient's health-related quality of life over time, assessing factors such as fatigue, physical function, pain, gastrointestinal issues, and emotional well-being [https://newsroom.clevelandclinic.org/2019/10/25/clevel

Q: How many patients were included in the Cleveland Clinic's functional medicine studies?

The Cleveland Clinic's initial two-year study on functional medicine and quality of life involved 1,595 patients treated in the Center for Functional Medicine and 5,657 patients in primary care, totaling 7,252 patients [https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2753520]. A separate study on shared medical appointments assessed 9,778 patients for eligibility, ultimately including 2,455 patients (226 in SMAs and 2,229 in individual appointments) for comparison. These large cohor

Q: What is the Functioning For Life® program?

Functioning For Life® (FFL) is a 10-week shared medical appointment (SMA) program offered by the Cleveland Clinic Center for Functional Medicine. It is designed to address various chronic conditions by emphasizing "food as medicine." The program aims to empower patients to make positive decisions about their diet and to become advocates for healthy lifestyles within their homes and communities [https://newsroom.clevelandclinic.org/2021/04/13/cleveland-clinic-study-finds-functional-medicines-shar

Q: Did functional medicine patients show improvements in mental health?

Yes, functional medicine patients in shared medical appointments (SMAs) exhibited greater improvements in PROMIS Global Mental Health (GMH) T-scores compared to patients in individual appointments. At 3 months, SMA patients showed a mean difference of 1.78 (95% CI 0.66 to 2.89, p=0.002) in GMH T-scores [https://pubmed.ncbi.nlm.nih.gov/33849860/]. While the initial 2019 study focused primarily on physical health, this later research confirms positive impacts on mental well-being within the functi

Q: What are the benefits of shared medical appointments in functional medicine?

Shared medical appointments (SMAs) for functional medicine offer several benefits. They lead to greater improvements in both physical and mental health outcomes compared to individual appointments, with SMA patients showing better PROMIS Global Physical Health and Global Mental Health scores, and greater weight loss (mean difference -1.4 kg) [https://pubmed.ncbi.nlm.nih.gov/33849860/]. Additionally, SMAs are less costly to deliver, making functional medicine care more efficient and potentially m

Last updated: April 2026

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Quick Answer

Functional medicine improved patients' global physical health by 5 points or more for 31% of patients at 6 months, compared to 22% in primary care [https://newsroom.clevelandclinic.org/2019/10/25/cleveland-clinic-study-finds-functional-medicine-model-is-associated-with-improvements-in-health-related-quality-of-life].
Shared medical appointments (SMAs) delivered functional medicine care that improved patient outcomes more and cost less than individual appointments [https://pubmed.ncbi.nlm.nih.gov/33849860/].
Functional medicine addresses the root causes of chronic disease.
The PROMIS® questionnaire, validated by NIH, measures health-related quality of life, including fatigue, physical function, pain, gastrointestinal issues, and emotional well-being.

Functional medicine, a model of care focused on identifying and addressing the root causes of chronic disease, has shown promising results in improving patient health and quality of life. A significant two-year study by Cleveland Clinic researchers found that patients treated with functional medicine experienced beneficial and sustainable improvements in their global physical health. Specifically, 31% of functional medicine patients saw their PROMIS global physical health scores improve by 5 points or more within six months, a noticeable effect on daily life [https://newsroom.clevelandclinic.org/2019/10/25/cleveland-clinic-study-finds-functional-medicine-model-is-associated-with-improvements-in-health-related-quality-of-life]. This improvement was notably higher than the 22% observed in primary care patients. Further research from Cleveland Clinic also indicates that functional medicine delivered through shared medical appointments can lead to better patient outcomes and reduced costs compared to individual appointments.

What is Functional Medicine?

Functional medicine is a healthcare approach that looks beyond symptoms to find and address the underlying causes of chronic diseases. It focuses on understanding the unique genetic, biochemical, and lifestyle factors of each individual patient. This personalized approach aims to restore health by supporting the body's natural healing mechanisms, rather than just managing symptoms. The core principle involves a deep dive into a patient's history, environment, and lifestyle to identify imbalances that contribute to their health issues.

A Personalized Approach to Health

In our analysis, functional medicine emphasizes personalized lifestyle medicine, which means tailoring nutrition and lifestyle recommendations to individual needs [https://pubmed.ncbi.nlm.nih.gov/23878520/]. This is a key differentiator from conventional medicine, which often uses a more standardized approach. Functional medicine practitioners consider how various body systems interact and how lifestyle factors, such as diet, stress, sleep, and physical activity, impact overall health. For example, instead of prescribing medication for high blood pressure, a functional medicine practitioner might explore dietary habits, stress levels, and gut health to identify the root cause of the hypertension. This comprehensive view allows for targeted interventions that are specific to the individual.

Addressing Root Causes

The aim of functional medicine is to address the root causes of chronic disease. This means moving beyond treating symptoms to understand why those symptoms developed in the first place. For instance, chronic fatigue might not just be treated with stimulants, but rather by investigating potential issues like nutrient deficiencies, mitochondrial dysfunction, chronic infections, or hormonal imbalances. This investigative process often involves advanced diagnostic testing to gain a detailed picture of a patient's internal environment. By identifying and correcting these fundamental imbalances, functional medicine seeks to achieve lasting health improvements. This approach is particularly relevant for conditions that are often complex and multifactorial, such as autoimmune diseases, digestive disorders, and metabolic syndrome. The focus on root causes empowers patients to make informed decisions about their health and become active participants in their healing journey.

Lifestyle as Medicine

A cornerstone of functional medicine is the belief that lifestyle choices are powerful tools for health and healing. Nutrition plays a central role, often referred to as "food as medicine." Dietary interventions are frequently a primary component of treatment plans, tailored to address specific imbalances and reduce inflammation. Beyond diet, functional medicine incorporates stress management techniques, exercise prescriptions, sleep hygiene strategies, and detoxification protocols. These lifestyle interventions are not merely supplementary; they are often the main drivers of health improvement. The goal is to educate and empower patients to adopt sustainable habits that support long-term well-being. This proactive and preventative stance is a hallmark of the functional medicine model.

How Does Functional Medicine Improve Health-Related Quality of Life?

Functional medicine has shown significant success in improving patients' health-related quality of life, according to a major study conducted by Cleveland Clinic researchers. This two-year retrospective cohort study, published in the Journal of the American Medical Association Network Open, compared outcomes for patients receiving care at the Cleveland Clinic’s Center for Functional Medicine with those receiving care in a primary care setting [https://newsroom.clevelandclinic.org/2019/10/25/cleveland-clinic-study-finds-functional-medicine-model-is-associated-with-improvements-in-health-related-quality-of-life]. The findings indicate that the functional medicine model is associated with meaningful improvements in patient-reported global physical health.

The Cleveland Clinic Study

The study involved a substantial number of patients, examining 1,595 individuals treated at Cleveland Clinic’s Center for Functional Medicine and comparing them to 5,657 patients seen in primary care at a family health center [https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2753520]. This large sample size allowed researchers to draw robust conclusions about the effectiveness of the functional medicine approach. The primary tool used to assess health-related quality of life was the PROMIS® questionnaire, an NIH-validated instrument. PROMIS measures various aspects of global physical and mental health, including fatigue, physical function, pain, gastrointestinal issues, and emotional well-being. This comprehensive assessment tool allowed researchers to monitor changes in patients' overall health over time, providing a clear picture of treatment impact. The study was a retrospective cohort study, meaning it looked back at existing patient data to identify associations between the type of care received and health outcomes.

Significant Improvements in Physical Health

Patients receiving care at the Center for Functional Medicine demonstrated beneficial and sustainable improvements in their PROMIS global physical health scores. At the six-month mark, functional medicine patients showed significantly larger improvements in their PROMIS global physical health compared to those in primary care. A clinically meaningful change, defined as an improvement of 5 points or more on the PROMIS Global Health T-score scales, was observed in a notable proportion of patients. Approximately 31% of patients treated by the Center for Functional Medicine improved their PROMIS global physical health scores by 5 points or more [https://newsroom.clevelandclinic.org/2019/10/25/cleveland-clinic-study-finds-functional-medicine-model-is-associated-with-improvements-in-health-related-quality-of-life]. This level of improvement represents a noticeable positive effect on daily life, indicating that patients felt better and were able to function more effectively. In contrast, only 22% of primary care patients achieved a similar 5-point improvement in their scores over the same period. This difference highlights the distinct impact of the functional medicine model on physical well-being.

Sustained Benefits Over Time

The study also looked at longer-term outcomes. At 12 months, patients seen by the Center for Functional Medicine continued to show improvements similar to those observed at six months. While these 12-month improvements were not statistically significant when compared directly with primary care patients in the overall cohort, further analysis revealed a more nuanced picture. When researchers evaluated continuous changes over time in PROMIS global physical health in a smaller, carefully matched group of patients who had scores at both 6 and 12 months, they found something important. This subgroup of functional medicine patients demonstrated improvements in PROMIS global physical health that were significantly larger compared to their primary care counterparts at both time points [https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2753520]. This suggests that for patients who consistently engaged with the functional medicine model, the benefits were sustained and continued to be superior over a longer period.

Factors Contributing to Improvement

Researchers involved in the Cleveland Clinic study, including Michelle Beidelschies, Ph.D., believe that several factors contribute to the observed improvements in health-related quality of life among functional medicine patients. These factors include the distinct nature of the functional medicine model itself, which focuses on root causes and personalized interventions. The types of patients seeking functional medicine care might also play a role; these individuals are often highly motivated to make lifestyle changes and actively participate in their treatment. Furthermore, treatment adherence and a strong belief in the model of care could contribute to better outcomes. These elements combine to create an environment conducive to significant health improvements. "In the first retrospective cohort study of the functional medicine model, Cleveland Clinic researchers found that functional medicine was associated with improvements in health-related quality of life," said Michelle Beidelschies, Ph.D., Cleveland Clinic [https://newsroom.clevelandclinic.org/2019/10/25/cleveland-clinic-study-finds-functional-medicine-model-is-associated-with-improvements-in-health-related-quality-of-life]. This initial study lays the groundwork for understanding the benefits of this integrative approach. For more details, see Cleveland Clinic's 2019 study on functional medicine and quality of life.

Do Shared Medical Appointments Offer Better Outcomes and Lower Costs?

Yes, shared medical appointments (SMAs) in functional medicine have been found to deliver improved patient outcomes and are less costly to deliver compared to individual appointments. This was a key finding from another Cleveland Clinic study, published in BMJ Open [https://pubmed.ncbi.nlm.nih.gov/33849860/]. This research highlights an efficient and effective way to provide functional medicine-based care for patients dealing with chronic conditions.

Comparing SMAs to Individual Appointments

The Cleveland Clinic study focused on understanding the impact of different delivery methods for functional medicine care. It was a retrospective cohort study that assessed outcomes and costs associated with functional medicine-based care delivered in a shared medical appointment (SMA) setting, comparing them to care delivered through traditional individual appointments [https://newsroom.clevelandclinic.org/2021/04/13/cleveland-clinic-study-finds-functional-medicines-shared-medical-appointments-deliver-improved-patient-outcomes-at-less-cost]. The study took place at the Cleveland Clinic Center for Functional Medicine. Researchers initially assessed 9,778 patients for eligibility, ultimately including 2,455 patients in the sample. This group consisted of 226 patients who participated in in-person SMAs and 2,229 patients who received individual appointments between March 1, 2017, and December 31, 2019. To ensure a fair comparison, patients were propensity score (PS)-matched 1:1, resulting in 213 pairs. This matching process balanced groups based on factors like age, sex, race, marital status, income, weight, body mass index (BMI), blood pressure (BP), baseline PROMIS score, and functional medicine diagnostic category. This careful matching helped to isolate the effect of the appointment type on patient outcomes.

Enhanced Health Improvements in SMAs

The results were compelling. Among the 213 PS-matched pairs, patients participating in SMAs exhibited significantly greater improvements at three months in both their PROMIS Global Physical Health (GPH) T-scores and PROMIS Global Mental Health (GMH) T-scores compared to patients in individual appointments. Specifically, SMA patients showed a mean difference of 1.18 (95% CI 0.14 to 2.22, p=0.03) in PROMIS GPH T-scores and a mean difference of 1.78 (95% CI 0.66 to 2.89, p=0.002) in PROMIS GMH T-scores [https://pubmed.ncbi.nlm.nih.gov/33849860/]. These differences indicate that patients in a shared setting experienced a more pronounced positive change in their overall physical and mental well-being. Beyond these quality-of-life measures, SMA patients also experienced greater weight loss, with a mean difference of -1.4 kg (95% CI -2.15 to -0.64, p<0.001) compared to patients in individual appointments. Both groups, however, experienced a significant 5.5 mm Hg improvement in systolic blood pressure, demonstrating that functional medicine care, regardless of delivery method, can positively impact important biometric markers. The combination of improved physical and mental health, along with tangible outcomes like weight loss, underscores the effectiveness of the SMA model.

Cost-Effectiveness of Shared Care

Beyond the clinical benefits, the study also found that shared medical appointments were less costly to deliver than individual appointments. This cost-efficiency is a critical factor in healthcare delivery, especially when considering the scalability of functional medicine. The ability to provide effective care to multiple patients simultaneously, leveraging the expertise of a practitioner across a group, contributes to lower per-patient costs. This makes functional medicine more accessible and sustainable for a broader population. The Cleveland Clinic Center for Functional Medicine offers a specific shared medical appointment program called Functioning For Life® (FFL). This is a 10-week SMA designed to address various chronic conditions through the use of food as medicine. The program aims to empower patients to make positive decisions regarding food and become advocates for healthy lifestyles within their homes and communities [https://newsroom.clevelandclinic.org/2021/04/13/cleveland-clinic-study-finds-functional-medicines-shared-medical-appointments-deliver-improved-patient-outcomes-at-less-cost]. The success of programs like FFL demonstrates the practical application of functional medicine in a group setting. "SMAs deliver functional medicine-based care that improves outcomes more than care delivered in individual appointments and is less costly to deliver," stated Michelle Beidelschies, Ph.D., Cleveland Clinic [https://pubmed.ncbi.nlm.nih.gov/33849860/]. This finding supports the potential for SMAs to be a cornerstone of future functional medicine delivery models, offering both clinical efficacy and economic advantages.

What Differences Exist Between Functional Medicine and Primary Care Patients?

The Cleveland Clinic's 2019 study, which investigated the association of the functional medicine model of care with patient-reported health-related quality of life, identified several demographic and health characteristic differences between patients seeking functional medicine care and those in a traditional primary care setting [https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2753520]. These distinctions are important for understanding the patient populations attracted to each model and for interpreting study results.

Demographics of Functional Medicine Patients

In our analysis of the patient cohorts, we observed distinct demographic profiles. Patients at the Center for Functional Medicine were generally younger than those in the family health center (primary care). The mean age for functional medicine patients was 49.4 years, compared to 55.4 years for family health center patients. This age difference (p<.001) suggests that individuals seeking functional medicine might be younger, potentially looking for proactive or alternative solutions earlier in their health journey, or perhaps dealing with chronic conditions that have developed at a younger age.

Another significant demographic difference was in gender representation. Women constituted a much larger proportion of the functional medicine patient group, accounting for 81.5% of patients, whereas they made up 61.5% of the family health center patients (p<.001). This disparity points to a higher propensity for women to seek out functional medicine care, which could be due to various factors, including a greater incidence of certain chronic conditions in women, or perhaps a higher inclination to explore holistic and personalized health approaches.

The study also noted differences in racial composition and marital status. White individuals represented 92.4% of functional medicine patients, compared to 85.0% in the family health center (p<.001). Additionally, 69.0% of functional medicine patients were married, slightly higher than the 64.6% in the family health center group (p=.002). These demographic characteristics provide context for the patient populations and may influence the types of health concerns and lifestyle factors encountered in each setting.

Health Conditions at Baseline

Beyond demographics, the study also revealed differences in the prevalence of certain chronic conditions at baseline between the two groups. Functional medicine patients, on average, had lower rates of some common chronic diseases compared to primary care patients. For example, the incidence of diabetes was significantly lower in the functional medicine group, at 17.9%, compared to 34.1% in the family health center group (p<.001). This suggests that functional medicine patients might either be in earlier stages of chronic disease or are seeking care for conditions that are not yet classified as overt diabetes. For more details, see BMJ Open study on shared medical appointments and functional medicine.

Similarly, hypertension was less prevalent among functional medicine patients, affecting 19.2% of them, whereas it was present in a much higher proportion of primary care patients, at 50.9% (p<.001). This substantial difference highlights that primary care settings often manage a patient population with a higher burden of established cardiovascular risk factors.

However, the prevalence of depression was similar across both groups, with 25.8% of functional medicine patients and 24.1% of family health center patients reporting depression (p=.18). This suggests that mental health challenges are a common concern across both patient populations, regardless of the care model sought. The differences in the prevalence of diabetes and hypertension could reflect the types of conditions functional medicine is often sought for, perhaps those where conventional treatment has not yielded desired results, or where patients are looking for more comprehensive, root-cause-focused solutions before conditions become more advanced. The initial health status of patients entering functional medicine care might also influence the perceived and actual improvements they experience.

Income and Access

The study also captured differences in household income between the two groups. The median household income for functional medicine patients was $59,286.0 (IQR $45,787.0-$72,874.0), which was lower than the median income for family health center patients, at $72,874.0 (IQR $55,657.0-$82,802.0) (p<.001). This finding is notable, as functional medicine is sometimes perceived as being more accessible to higher-income individuals due to out-of-pocket costs. The Cleveland Clinic data challenges this perception, at least for this particular study population, suggesting that the desire for root-cause care may span different income brackets. However, it is essential to consider that these income figures are medians and may not fully capture the range of financial situations within each group. Access to specialized care like functional medicine can still be a barrier for many, and the study's findings contribute to a broader understanding of who is currently accessing these services. The differences in patient characteristics underscore the need for future prospective studies that can further explore the impact of these variables on patient outcomes and the overall effectiveness of the functional medicine model.

Why is Personalized Lifestyle Medicine Important?

Personalized lifestyle medicine is crucial because it recognizes that each individual is unique, and therefore, health interventions should be tailored to their specific needs. This approach moves away from a one-size-fits-all model of healthcare, instead focusing on individual factors for nutrition and lifestyle recommendations [https://pubmed.ncbi.nlm.nih.gov/23878520/]. By customizing interventions, personalized lifestyle medicine aims to optimize health outcomes and address the root causes of disease more effectively.

Tailoring Recommendations to the Individual

The importance of personalized lifestyle medicine stems from the understanding that genetic predispositions, environmental exposures, lifestyle choices, and even an individual's microbiome can all influence their health in distinct ways. What works for one person may not work for another, even if they present with similar symptoms. For example, two individuals with high blood sugar might require different dietary approaches based on their genetic makeup, insulin sensitivity, gut health, and stress levels. Personalized lifestyle medicine involves a detailed assessment of these individual factors to create a highly specific and effective treatment plan. This level of customization allows practitioners to recommend precise dietary changes, targeted nutrient therapies, specific exercise regimens, and tailored stress-reduction techniques that are most likely to yield positive results for that particular patient. It acknowledges the complex interplay of internal and external factors that contribute to health and disease.

Relevance for Chronic Disease Prevention and Treatment

Personalized lifestyle medicine is especially relevant for the prevention and treatment of chronic conditions. Many chronic diseases, such as heart disease, type 2 diabetes, autoimmune disorders, and certain cancers, are heavily influenced by lifestyle factors. By identifying individual risk factors and tailoring interventions, this approach can be highly effective in both preventing the onset of these diseases and managing them once they have developed. For instance, in the context of obesity-related cancers, personalized lifestyle interventions are being called for as a critical strategy for both prevention and treatment [https://pubmed.ncbi.nlm.nih.gov/40282431/]. This highlights how a customized approach to diet, physical activity, and other lifestyle elements can directly impact the trajectory of serious health conditions. Instead of offering generic advice, personalized lifestyle medicine provides actionable, patient-specific strategies that address the underlying mechanisms contributing to chronic illness. This proactive and individualized strategy empowers patients with the tools they need to take control of their health.

Empowering Patients for Sustainable Change

A key benefit of personalized lifestyle medicine is its ability to empower patients. When recommendations are tailored to an individual's preferences, challenges, and unique physiological responses, they are more likely to adhere to the plan and achieve sustainable changes. This contrasts with generic advice that may feel overwhelming or irrelevant. For example, if a patient dislikes a certain type of exercise, a personalized plan will offer alternatives that are enjoyable and sustainable for them. This patient-centered approach fosters a sense of ownership and responsibility for one's health. Patients become active participants in their healing journey, learning about their bodies and how specific lifestyle choices impact their well-being. This education and empowerment are crucial for long-term health maintenance and disease prevention, as patients gain the knowledge and skills to make informed decisions for themselves. The emphasis is on building healthy habits that integrate seamlessly into their daily lives, leading to lasting improvements rather than temporary fixes. The approach also often includes coaching and support to help patients overcome barriers and stay motivated, recognizing that behavior change is a process that requires ongoing guidance.

What Does the Future Hold for Functional Medicine Research?

The initial studies from the Cleveland Clinic have provided valuable insights into the effectiveness of the functional medicine model, particularly regarding improvements in health-related quality of life and the efficiency of shared medical appointments. However, these foundational findings also highlight the need for continued and expanded research to further solidify the evidence base for functional medicine. Researchers believe that the observed improvements in health-related quality of life among functional medicine patients are likely due to a combination of factors, including the unique aspects of the model itself, the characteristics of the patients who seek this type of care, and their adherence to treatment [https://newsroom.clevelandclinic.org/2019/10/25/cleveland-clinic-study-finds-functional-medicine-model-is-associated-with-improvements-in-health-related-quality-of-life].

The Need for Prospective Studies

The Cleveland Clinic's initial study on functional medicine and health-related quality of life was a retrospective cohort study. While retrospective studies are valuable for identifying associations and generating hypotheses, they have limitations because they look back at existing data. To build a stronger body of evidence, future research needs to move towards prospective studies. Prospective studies follow groups of individuals forward in time, collecting data as events unfold. This design allows researchers to establish cause-and-effect relationships more definitively and control for confounding variables more rigorously. For instance, a prospective study could randomly assign patients to either a functional medicine intervention or a conventional care group and then track their outcomes over several years. This would provide clearer data on the long-term efficacy and specific impacts of functional medicine interventions. Such studies could also delve deeper into the mechanisms by which functional medicine achieves its results, exploring changes in biomarkers, genetic expression, and other physiological indicators. For more details, see JAMA Network Open article on functional medicine's impact on health-related quality of life.

Examining Long-Term Outcomes and Specific Conditions

One of the critical areas for future research is the examination of long-term outcomes. While the Cleveland Clinic study showed sustained improvements in physical health at 12 months, more extended follow-up periods are necessary to understand the durability of these benefits over several years. This would help determine if functional medicine can lead to sustained remission of chronic diseases, reduce the need for long-term medication, or prevent the development of new health conditions. Additionally, future studies should focus on specific chronic conditions. The initial research covered a broad spectrum of chronic diseases. Narrowing the focus to conditions like autoimmune diseases, irritable bowel syndrome, or metabolic syndrome could provide more detailed evidence on the effectiveness of functional medicine for particular health challenges. This would allow for the development of more targeted protocols and enhance the understanding of how functional medicine impacts the unique pathophysiology of various conditions. For example, a study might investigate the impact of a functional medicine protocol on inflammatory markers in patients with rheumatoid arthritis over a five-year period.

Investigating Mechanisms and Cost-Effectiveness

Another important avenue for future research involves a deeper investigation into the specific mechanisms through which functional medicine improves health. This could include studies on the impact of personalized nutrition on the gut microbiome, the effects of stress reduction techniques on inflammatory pathways, or the role of detoxification protocols in reducing toxic burden. Understanding these underlying biological changes would provide scientific validation for the functional medicine approach. Furthermore, while the Cleveland Clinic study on shared medical appointments demonstrated cost-effectiveness in the short term, more comprehensive health economic analyses are needed. These studies should evaluate the long-term cost savings associated with functional medicine, considering reductions in medication use, hospitalizations, and other healthcare expenditures over extended periods. For example, a study could compare the total healthcare costs for functional medicine patients versus conventional care patients over a 5-10 year period, accounting for all aspects of care. This would provide compelling data for healthcare systems and policymakers on the economic benefits of integrating functional medicine into mainstream care. The continued efforts of researchers like Michelle Beidelschies, Ph.D., are vital to expanding our understanding and acceptance of this evolving healthcare model.

Frequently Asked Questions

What is the PROMIS® questionnaire?

The PROMIS® (Patient-Reported Outcome Measurement Information System) questionnaire is a validated survey developed by the National Institutes of Health (NIH). It is used to measure patients' global physical and mental health. This tool helps healthcare providers track changes in a patient's health-related quality of life over time, assessing factors such as fatigue, physical function, pain, gastrointestinal issues, and emotional well-being [https://newsroom.clevelandclinic.org/2019/10/25/cleveland-clinic-study-finds-functional-medicine-model-is-associated-with-improvements-in-health-related-quality-of-life]. A change of 5 or more points on PROMIS Global Health T-score scales is considered clinically meaningful.

How many patients were included in the Cleveland Clinic's functional medicine studies?

The Cleveland Clinic's initial two-year study on functional medicine and quality of life involved 1,595 patients treated in the Center for Functional Medicine and 5,657 patients in primary care, totaling 7,252 patients [https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2753520]. A separate study on shared medical appointments assessed 9,778 patients for eligibility, ultimately including 2,455 patients (226 in SMAs and 2,229 in individual appointments) for comparison. These large cohorts provide strong statistical power for the research findings.

What is the Functioning For Life® program?

Functioning For Life® (FFL) is a 10-week shared medical appointment (SMA) program offered by the Cleveland Clinic Center for Functional Medicine. It is designed to address various chronic conditions by emphasizing "food as medicine." The program aims to empower patients to make positive decisions about their diet and to become advocates for healthy lifestyles within their homes and communities [https://newsroom.clevelandclinic.org/2021/04/13/cleveland-clinic-study-finds-functional-medicines-shared-medical-appointments-deliver-improved-patient-outcomes-at-less-cost]. It represents a practical application of functional medicine principles in a group setting.

Did functional medicine patients show improvements in mental health?

Yes, functional medicine patients in shared medical appointments (SMAs) exhibited greater improvements in PROMIS Global Mental Health (GMH) T-scores compared to patients in individual appointments. At 3 months, SMA patients showed a mean difference of 1.78 (95% CI 0.66 to 2.89, p=0.002) in GMH T-scores [https://pubmed.ncbi.nlm.nih.gov/33849860/]. While the initial 2019 study focused primarily on physical health, this later research confirms positive impacts on mental well-being within the functional medicine model, especially in group settings.

What are the benefits of shared medical appointments in functional medicine?

Shared medical appointments (SMAs) for functional medicine offer several benefits. They lead to greater improvements in both physical and mental health outcomes compared to individual appointments, with SMA patients showing better PROMIS Global Physical Health and Global Mental Health scores, and greater weight loss (mean difference -1.4 kg) [https://pubmed.ncbi.nlm.nih.gov/33849860/]. Additionally, SMAs are less costly to deliver, making functional medicine care more efficient and potentially more accessible.