Evaluating distance education of a mindfulness-based meditation programme for chronic pain management

Abstract

Patients with chronic pain were recruited from two large urban hospitals and from rural hospitals in Ontario. Patients on the waiting list served as controls. The intervention was a Mindfulness-Based Chronic Pain Management course, delivered to patients for two hours per week for 10 weeks. Pre- and postcourse measures of quality of life, pain catastrophizing and usual pain ratings were collected over a period of two years. Patients received the course via traditional face-to-face, in-person teaching (Present site group) or via videoconferencing at their local hospital site (Distant site group). In all, there were 99 Present site participants, 57 at Distant sites and 59 waitlist controls. Patients at Present and Distant sites achieved similar gains in mental health (P < 0.01) and pain catastrophizing levels (P < 0.01) relative to controls. However, the Present site group obtained significantly higher scores on the physical dimension of quality of life (P < 0.01) and lower usual-pain ratings (P < 0.05) than the Distant site group. The results suggest that videoconferencing is an effective mode of delivery for the Mindfulness course and may represent a new way of helping chronic pain patients in rural areas manage their suffering.

Digital Characteristics and Dissemination Indicators to Optimize Delivery of Internet-Supported Mindfulness-Based Interventions for People With a Chronic Condition: Systematic Review (Preprint)

“…a primary outcome was feasibility, but sample size was calculated with adequate power to reducing mood disturbance (secondary outcome) OCD = Obsessive compulsive disorder; QE = Quasi-Experimental, QoL = Quality of Life; FU = follow up Studies were published from 2008 and conducted in Sweden (n=3); [43,44,49], Canada (n=2); [41,45], the United States (n=2) [42,46], the Netherlands (n=1); [36], Ireland (n=1); [47] and Germany (n=1); [48]. Eight studies were RCTs [36,[42][43][44][45][47][48][49], and two were quasi experimental design [41,46]. Most studies involved female participants with an overall mean of 74.8%, ranging between 46.3% [36] and 98% [42].…”

“…The overall mean age of participants was 45 years (mean age range: 36 -57.6 years). Three studies comprised active comparison groups, including the same MBI delivered in person [41], a web-based behavioural activation condition [44], and a progressive muscle relaxation program [48]. Control conditions were attention control (n=1) [42], online discussion forum (n=2) [43,49], psychoeducational (n=1) [47], wait-list (n=2) [41,45] or usual care (n=2) [36,46].…”

“…Control conditions were attention control (n=1) [42], online discussion forum (n=2) [43,49], psychoeducational (n=1) [47], wait-list (n=2) [41,45] or usual care (n=2) [36,46]. One study involved two comparison groups [41].…”

Research Findings Using Mindfulness-Based Interventions for Chronic Pain

“…A literature search was conducted and 9 randomized controlled trials (RCTs), 5 clinical controlled trials (CCTs) without randomization, and 8 uncontrolled studies were selected for analysis out of the 1121 reviewed. The RCTs followed by the CCTs had the best quality scores measuring research strength [27]- [29] [31]- [35] [37]- [40]. RCTs and CCTs demonstrated small yet significant improvements in pain and depression.…”

From Retreat Center to Clinic to Boardroom? Perils and Promises of the Modern Mindfulness Movement

“…Using a secular approach, and eschewing any appeals to the Buddha or other spiritual claims to authority, these programs have been sufficiently sanitized to be offered by publically-funded clinical institutions. In addition to MBSR, specialized variants of the 8 week program have been created to deal with issues such as vulnerability to depression [41], recovery from addiction [42,43], and chronic pain [44], among others. While this paper will focus primarily on MBSR as a clinical prototype for MSMT, similar issues are apparent in these other training programs.…”