Comparative evaluation of group-based mindfulness-based stress reduction and cognitive behavioural therapy for the treatment and management of chronic pain: A systematic review and network meta-analysis.


Journal

Evidence-based mental health
ISSN: 1468-960X
Titre abrégé: Evid Based Ment Health
Pays: England
ID NLM: 100883413

Informations de publication

Date de publication:
02 2019
Historique:
received: 13 09 2018
revised: 14 12 2018
accepted: 20 12 2018
entrez: 2 2 2019
pubmed: 2 2 2019
medline: 18 12 2019
Statut: ppublish

Résumé

This review compares mindfulness-based stress reduction (MBSR) to cognitive-behavioural therapy (CBT) in its ability to improve physical functioning and reduce pain intensity and distress in patients with chronic pain (CP), when evaluated against control conditions. Ovid MEDLINE, EmbaseClassic+Embase, PsycINFO and the Cochrane Library were searched to identify randomised controlled trials. The primary outcome measure was physical functioning. Secondary outcomes were pain intensity and depression symptoms. We used random and fixed effects (RE and FE) network meta-analyses (NMA) to compare MBSR, CBT and control interventions on the standardised mean difference scale. Twenty-one studies were included: 13 CBT vs control (n=1095), 7 MBSR vs control (n=545) and 1 MBSR vs CBT vs control (n=341). Of the 21 articles, 12 were determined to be of fair or good quality. Findings from RE NMA for change in physical functioning, pain intensity and depression revealed clinically important advantages relative to control for MBSR and CBT, but no evidence of an important difference between MBSR and CBT was found. This review suggests that MBSR offers another potentially helpful intervention for CP management. Additional research using consistent measures is required to guide decisions about providing CBT or MBSR.

Identifiants

pubmed: 30705039
pii: ebmental-2018-300062
doi: 10.1136/ebmental-2018-300062
pmc: PMC10270397
doi:

Types de publication

Comparative Study Evaluation Study Journal Article Meta-Analysis Research Support, Non-U.S. Gov't Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

26-35

Subventions

Organisme : CIHR
Pays : Canada

Informations de copyright

© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

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Auteurs

Eve-Ling Khoo (EL)

Clinical Epidemiology, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada.

Rebecca Small (R)

Clinical Epidemiology, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
Faculty of Medicine, Memorial University of Newfoundland, Newfoundland and Labrador, Canada.

Wei Cheng (W)

Clinical Epidemiology, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.

Taylor Hatchard (T)

School of Psychology, University of Ottawa, Ottawa, Ontario, Canada.

Brittany Glynn (B)

Clinical Epidemiology, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.

Danielle B Rice (DB)

Clinical Epidemiology, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
Department of Psychology, McGill University, Montreal, Canada.

Becky Skidmore (B)

Independent Information Specialist Consultant, Ottawa, Ontario, Canada.

Samantha Kenny (S)

Clinical Epidemiology, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
Department of Educational & Counselling Psychology, McGill University, Montreal, Quebec, Canada.

Brian Hutton (B)

Clinical Epidemiology, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.

Patricia A Poulin (PA)

Clinical Epidemiology, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
Department of Psychology, The Ottawa Hospital, Ottawa, Ontario, Canada.
Department of Anesthesia and Pain Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.

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