A Pilot Randomized Controlled Trial Comparing Mindfulness Meditation, Cognitive Therapy, and Mindfulness-Based Cognitive Therapy for Chronic Low Back Pain
Abstract Objective This pilot trial compared the feasibility, tolerability, acceptability, and effects of group-delivered mindfulness meditation (MM), cognitive therapy (CT), and mindfulness-based cognitive therapy (MBCT) for chronic low back pain (CLBP). Setting University of Queensland Psychology...
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| Published in | Pain medicine (Malden, Mass.) Vol. 20; no. 11; pp. 2134 - 2148 |
|---|---|
| Main Authors | , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
England
Oxford University Press
01.11.2019
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| Subjects | |
| Online Access | Get full text |
| ISSN | 1526-2375 1526-4637 1526-4637 |
| DOI | 10.1093/pm/pny273 |
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| Abstract | Abstract
Objective
This pilot trial compared the feasibility, tolerability, acceptability, and effects of group-delivered mindfulness meditation (MM), cognitive therapy (CT), and mindfulness-based cognitive therapy (MBCT) for chronic low back pain (CLBP).
Setting
University of Queensland Psychology Clinic.
Subjects
Participants were N = 69 (intent-to-treat [ITT] sample) adults with CLBP.
Design
A pilot, assessor-blinded randomized controlled trial.
Methods
Participants were randomized to treatments. The primary outcome was pain interference; secondary outcomes were pain intensity, physical function, depression, and opioid medication use. The primary study end point was post-treatment; maintenance of gains was evaluated at three- and six-month follow-up.
Results
Ratings of acceptability, and ratios of dropout and attendance showed that MBCT was acceptable, feasible, and well tolerated, with similar results found across conditions. For the ITT sample, large improvements in post-treatment scores for pain interference, pain intensity, physical function, and depression were found (P < 0.001), with no significant between-group differences. Analysis of the follow-up data (N = 43), however, revealed that MBCT participants improved significantly more than MM participants on pain interference, physical function, and depression. The CT group improved more than MM in physical function. The MBCT and CT groups did not differ significantly on any measures.
Conclusions
This is the first study to examine MBCT for CLBP management. The findings show that MBCT is a feasible, tolerable, acceptable, and potentially efficacious treatment option for CLBP. Further, MBCT, and possibly CT, could have sustained benefits that exceed MM on some important CLBP outcomes. A future definitive randomized controlled trial is needed to evaluate these treatments and their differences. |
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| AbstractList | This pilot trial compared the feasibility, tolerability, acceptability, and effects of group-delivered mindfulness meditation (MM), cognitive therapy (CT), and mindfulness-based cognitive therapy (MBCT) for chronic low back pain (CLBP).
University of Queensland Psychology Clinic.
Participants were N = 69 (intent-to-treat [ITT] sample) adults with CLBP.
A pilot, assessor-blinded randomized controlled trial.
Participants were randomized to treatments. The primary outcome was pain interference; secondary outcomes were pain intensity, physical function, depression, and opioid medication use. The primary study end point was post-treatment; maintenance of gains was evaluated at three- and six-month follow-up.
Ratings of acceptability, and ratios of dropout and attendance showed that MBCT was acceptable, feasible, and well tolerated, with similar results found across conditions. For the ITT sample, large improvements in post-treatment scores for pain interference, pain intensity, physical function, and depression were found (P < 0.001), with no significant between-group differences. Analysis of the follow-up data (N = 43), however, revealed that MBCT participants improved significantly more than MM participants on pain interference, physical function, and depression. The CT group improved more than MM in physical function. The MBCT and CT groups did not differ significantly on any measures.
This is the first study to examine MBCT for CLBP management. The findings show that MBCT is a feasible, tolerable, acceptable, and potentially efficacious treatment option for CLBP. Further, MBCT, and possibly CT, could have sustained benefits that exceed MM on some important CLBP outcomes. A future definitive randomized controlled trial is needed to evaluate these treatments and their differences. This pilot trial compared the feasibility, tolerability, acceptability, and effects of group-delivered mindfulness meditation (MM), cognitive therapy (CT), and mindfulness-based cognitive therapy (MBCT) for chronic low back pain (CLBP).OBJECTIVEThis pilot trial compared the feasibility, tolerability, acceptability, and effects of group-delivered mindfulness meditation (MM), cognitive therapy (CT), and mindfulness-based cognitive therapy (MBCT) for chronic low back pain (CLBP).University of Queensland Psychology Clinic.SETTINGUniversity of Queensland Psychology Clinic.Participants were N = 69 (intent-to-treat [ITT] sample) adults with CLBP.SUBJECTSParticipants were N = 69 (intent-to-treat [ITT] sample) adults with CLBP.A pilot, assessor-blinded randomized controlled trial.DESIGNA pilot, assessor-blinded randomized controlled trial.Participants were randomized to treatments. The primary outcome was pain interference; secondary outcomes were pain intensity, physical function, depression, and opioid medication use. The primary study end point was post-treatment; maintenance of gains was evaluated at three- and six-month follow-up.METHODSParticipants were randomized to treatments. The primary outcome was pain interference; secondary outcomes were pain intensity, physical function, depression, and opioid medication use. The primary study end point was post-treatment; maintenance of gains was evaluated at three- and six-month follow-up.Ratings of acceptability, and ratios of dropout and attendance showed that MBCT was acceptable, feasible, and well tolerated, with similar results found across conditions. For the ITT sample, large improvements in post-treatment scores for pain interference, pain intensity, physical function, and depression were found (P < 0.001), with no significant between-group differences. Analysis of the follow-up data (N = 43), however, revealed that MBCT participants improved significantly more than MM participants on pain interference, physical function, and depression. The CT group improved more than MM in physical function. The MBCT and CT groups did not differ significantly on any measures.RESULTSRatings of acceptability, and ratios of dropout and attendance showed that MBCT was acceptable, feasible, and well tolerated, with similar results found across conditions. For the ITT sample, large improvements in post-treatment scores for pain interference, pain intensity, physical function, and depression were found (P < 0.001), with no significant between-group differences. Analysis of the follow-up data (N = 43), however, revealed that MBCT participants improved significantly more than MM participants on pain interference, physical function, and depression. The CT group improved more than MM in physical function. The MBCT and CT groups did not differ significantly on any measures.This is the first study to examine MBCT for CLBP management. The findings show that MBCT is a feasible, tolerable, acceptable, and potentially efficacious treatment option for CLBP. Further, MBCT, and possibly CT, could have sustained benefits that exceed MM on some important CLBP outcomes. A future definitive randomized controlled trial is needed to evaluate these treatments and their differences.CONCLUSIONSThis is the first study to examine MBCT for CLBP management. The findings show that MBCT is a feasible, tolerable, acceptable, and potentially efficacious treatment option for CLBP. Further, MBCT, and possibly CT, could have sustained benefits that exceed MM on some important CLBP outcomes. A future definitive randomized controlled trial is needed to evaluate these treatments and their differences. Objective. This pilot trial compared the feasibility, tolerability, acceptability, and effects of group-delivered mindfulness meditation (MM), cognitive therapy (CT), and mindfulness-based cognitive therapy (MBCT) for chronic low back pain (CLBP). Setting. University of Queensland Psychology Clinic. Subjects. Participants were N=69 (intent-to-treat [ITT] sample) adults with CLBP. Design. A pilot, assessor-blinded randomized controlled trial. Methods. Participants were randomized to treatments. The primary outcome was pain interference; secondary outcomes were pain intensity, physical function, depression, and opioid medication use. The primary study end point was posttreatment; maintenance of gains was evaluated at three- and six-month follow-up. Results. Ratings of acceptability, and ratios of dropout and attendance showed that MBCT was acceptable, feasible, and well tolerated, with similar results found across conditions. For the ITT sample, large improvements in post-treatment scores for pain interference, pain intensity, physical function, and depression were found (P < 0.001), with no significant between-group differences. Analysis of the follow-up data (N= 43), however, revealed that MBCT participants improved significantly more than MM participants on pain interference, physical function, and depression. The CT group improved more than MM in physical function. The MBCT and CT groups did not differ significantly on any measures. Conclusions. This is the first study to examine MBCT for CLBP management. The findings show that MBCT is a feasible, tolerable, acceptable, and potentially efficacious treatment option for CLBP. Further, MBCT, and possibly CT, could have sustained benefits that exceed MM on some important CLBP outcomes. A future definitive randomized controlled trial is needed to evaluate these treatments and their differences. Key Words: Chronic Low Back Pain; Randomized Controlled Trial; Mindfulness-Based Cognitive Therapy; Mindfulness Meditation; Cognitive Therapy Abstract Objective This pilot trial compared the feasibility, tolerability, acceptability, and effects of group-delivered mindfulness meditation (MM), cognitive therapy (CT), and mindfulness-based cognitive therapy (MBCT) for chronic low back pain (CLBP). Setting University of Queensland Psychology Clinic. Subjects Participants were N = 69 (intent-to-treat [ITT] sample) adults with CLBP. Design A pilot, assessor-blinded randomized controlled trial. Methods Participants were randomized to treatments. The primary outcome was pain interference; secondary outcomes were pain intensity, physical function, depression, and opioid medication use. The primary study end point was post-treatment; maintenance of gains was evaluated at three- and six-month follow-up. Results Ratings of acceptability, and ratios of dropout and attendance showed that MBCT was acceptable, feasible, and well tolerated, with similar results found across conditions. For the ITT sample, large improvements in post-treatment scores for pain interference, pain intensity, physical function, and depression were found (P < 0.001), with no significant between-group differences. Analysis of the follow-up data (N = 43), however, revealed that MBCT participants improved significantly more than MM participants on pain interference, physical function, and depression. The CT group improved more than MM in physical function. The MBCT and CT groups did not differ significantly on any measures. Conclusions This is the first study to examine MBCT for CLBP management. The findings show that MBCT is a feasible, tolerable, acceptable, and potentially efficacious treatment option for CLBP. Further, MBCT, and possibly CT, could have sustained benefits that exceed MM on some important CLBP outcomes. A future definitive randomized controlled trial is needed to evaluate these treatments and their differences. Objective This pilot trial compared the feasibility, tolerability, acceptability, and effects of group-delivered mindfulness meditation (MM), cognitive therapy (CT), and mindfulness-based cognitive therapy (MBCT) for chronic low back pain (CLBP). Setting University of Queensland Psychology Clinic. Subjects Participants were N = 69 (intent-to-treat [ITT] sample) adults with CLBP. Design A pilot, assessor-blinded randomized controlled trial. Methods Participants were randomized to treatments. The primary outcome was pain interference; secondary outcomes were pain intensity, physical function, depression, and opioid medication use. The primary study end point was post-treatment; maintenance of gains was evaluated at three- and six-month follow-up. Results Ratings of acceptability, and ratios of dropout and attendance showed that MBCT was acceptable, feasible, and well tolerated, with similar results found across conditions. For the ITT sample, large improvements in post-treatment scores for pain interference, pain intensity, physical function, and depression were found (P < 0.001), with no significant between-group differences. Analysis of the follow-up data (N = 43), however, revealed that MBCT participants improved significantly more than MM participants on pain interference, physical function, and depression. The CT group improved more than MM in physical function. The MBCT and CT groups did not differ significantly on any measures. Conclusions This is the first study to examine MBCT for CLBP management. The findings show that MBCT is a feasible, tolerable, acceptable, and potentially efficacious treatment option for CLBP. Further, MBCT, and possibly CT, could have sustained benefits that exceed MM on some important CLBP outcomes. A future definitive randomized controlled trial is needed to evaluate these treatments and their differences. |
| Audience | Academic |
| Author | Ward, L Charles Ehde, Dawn M Thorn, Beverly E Mattingley, Jason B Jensen, Mark P Barnier, Amanda Day, Melissa A Burns, John |
| Author_xml | – sequence: 1 givenname: Melissa A surname: Day fullname: Day, Melissa A email: m.day@uq.edu.au organization: School of Psychology, University of Queensland, Brisbane, Queensland, Australia – sequence: 2 givenname: L Charles surname: Ward fullname: Ward, L Charles organization: School of Psychology, University of Queensland, Brisbane, Queensland, Australia – sequence: 3 givenname: Dawn M surname: Ehde fullname: Ehde, Dawn M organization: Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA – sequence: 4 givenname: Beverly E surname: Thorn fullname: Thorn, Beverly E organization: Department of Psychology, University of Alabama, Tuscaloosa, Alabama, USA – sequence: 5 givenname: John surname: Burns fullname: Burns, John organization: Department of Behavioral Sciences, Rush University Medical Center, Chicago, Illinois, USA – sequence: 6 givenname: Amanda surname: Barnier fullname: Barnier, Amanda organization: Department of Cognitive Science, Macquarie University, Sydney, New South Wales, Australia – sequence: 7 givenname: Jason B surname: Mattingley fullname: Mattingley, Jason B organization: School of Psychology, University of Queensland, Brisbane, Queensland, Australia – sequence: 8 givenname: Mark P surname: Jensen fullname: Jensen, Mark P organization: Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/30605517$$D View this record in MEDLINE/PubMed |
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| Copyright | 2019 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com 2019 2019 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com. COPYRIGHT 2019 Oxford University Press 2019 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com |
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| Keywords | Mindfulness Meditation Mindfulness-Based Cognitive Therapy Cognitive Therapy Chronic Low Back Pain Randomized Controlled Trial |
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| PublicationDate_xml | – month: 11 year: 2019 text: 20191101 day: 01 |
| PublicationDecade | 2010 |
| PublicationPlace | England |
| PublicationPlace_xml | – name: England – name: Oxford |
| PublicationTitle | Pain medicine (Malden, Mass.) |
| PublicationTitleAlternate | Pain Med |
| PublicationYear | 2019 |
| Publisher | Oxford University Press |
| Publisher_xml | – name: Oxford University Press |
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This pilot trial compared the feasibility, tolerability, acceptability, and effects of group-delivered mindfulness meditation (MM),... This pilot trial compared the feasibility, tolerability, acceptability, and effects of group-delivered mindfulness meditation (MM), cognitive therapy (CT), and... Objective. This pilot trial compared the feasibility, tolerability, acceptability, and effects of group-delivered mindfulness meditation (MM), cognitive... Objective This pilot trial compared the feasibility, tolerability, acceptability, and effects of group-delivered mindfulness meditation (MM), cognitive therapy... |
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| SubjectTerms | Back pain Care and treatment Clinical trials Cognitive ability Cognitive therapy Comparative analysis Low back pain Meditation Mindfulness Mindfulness meditation Opioids Patient outcomes |
| Title | A Pilot Randomized Controlled Trial Comparing Mindfulness Meditation, Cognitive Therapy, and Mindfulness-Based Cognitive Therapy for Chronic Low Back Pain |
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