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Acceptance- and mindfulness-based interventions for the treatment of chronic pain: a meta-analytic review.

Cognitive behaviour therapy
January 1, 2016
M M Veehof et al. (4 authors)
Journal ArticleMeta-AnalysisReviewSystematic ReviewHuman Study
Study Details

Study Goal

The researchers aimed to update a systematic review and meta-analysis on the effects of acceptance- and mindfulness-based interventions (ACT, MBSR, MBCT) on mental and physical health outcomes in chronic pain patients.

Results Summary

The study found small to moderate effect sizes on pain intensity, depression, anxiety, pain interference, disability, and quality of life at post-treatment, with some effects persisting at follow-up. ACT showed significantly higher effects on depression and anxiety compared to MBSR and MBCT, but these interventions were not superior to traditional cognitive behavioral treatments.

Population

1,285 patients with chronic pain.

Effective Dosage

Not specified

Duration

Not specified

Interactions

None mentioned

Extracted Claims (13)
InterventionDirectionEndpointPopulationDosageImpactClaim #
acceptance- and mindfulness-based interventions
decrease
anxiety
patients with chronic pain
moderate
ranged from small to moderate
#1
acceptance- and mindfulness-based interventions
decrease
pain interference
patients with chronic pain
moderate
ranged from small to moderate
#2
acceptance- and mindfulness-based interventions
decrease
pain intensity
patients with chronic pain
small
ranged from small
#3
acceptance- and mindfulness-based interventions
decrease
depression
patients with chronic pain
small
ranged from small
#4
acceptance- and mindfulness-based interventions
decrease
disability
patients with chronic pain
small
ranged from small
#5
acceptance- and mindfulness-based interventions
increase
quality of life
patients with chronic pain
small
ranged from small
#6
acceptance- and mindfulness-based interventions
decrease
pain interference
patients with chronic pain
large
ranged from small to large
#7
acceptance- and mindfulness-based interventions
decrease
pain intensity
patients with chronic pain
small
ranged from small
#8
acceptance- and mindfulness-based interventions
decrease
disability
patients with chronic pain
small
ranged from small
#9
acceptance and commitment therapy (ACT)
decrease
depression
patients with chronic pain
-
showed significantly higher effects
#10
acceptance and commitment therapy (ACT)
decrease
anxiety
patients with chronic pain
-
showed significantly higher effects
#11
acceptance- and mindfulness-based interventions
no change
-
-
-
did not moderate the effects
#12
acceptance- and mindfulness-based interventions
neutral
-
-
-
can be good alternatives
#13
Abstract

The number of acceptance- and mindfulness-based interventions for chronic pain, such as acceptance and commitment therapy (ACT), mindfulness-based stress reduction (MBSR), and mindfulness-based cognitive therapy (MBCT), increased in recent years. Therefore an update is warranted of our former systematic review and meta-analysis of studies that reported effects on the mental and physical health of chronic pain patients. Pubmed, EMBASE, PsycInfo and Cochrane were searched for eligible studies. Current meta-analysis only included randomized controlled trials (RCTs). Studies were rated for quality. Mean quality did not improve in recent years. Pooled standardized mean differences using the random-effect model were calculated to represent the average intervention effect and, to perform subgroup analyses. Outcome measures were pain intensity, depression, anxiety, pain interference, disability and quality of life. Included were twenty-five RCTs totaling 1285 patients with chronic pain, in which we compared acceptance- and mindfulness-based interventions to the waitlist, (medical) treatment-as-usual, and education or support control groups. Effect sizes ranged from small (on all outcome measures except anxiety and pain interference) to moderate (on anxiety and pain interference) at post-treatment and from small (on pain intensity and disability) to large (on pain interference) at follow-up. ACT showed significantly higher effects on depression and anxiety than MBSR and MBCT. Studies' quality, attrition rate, type of pain and control group, did not moderate the effects of acceptance- and mindfulness-based interventions. Current acceptance- and mindfulness-based interventions, while not superior to traditional cognitive behavioral treatments, can be good alternatives.

Medical Subject Headings (MeSH)
Acceptance and Commitment TherapyChronic PainHumansMindfulnessTreatment Outcome
Study Links
Quality Scores
SafetyNot Assessed
Efficacy75/10
Quality85/10
Citation Metrics
Total Citations420
Citations/Year46.7
Relative Citation Ratio24.87
NIH Percentile99.6%
Research Impact Scores
APT Score0.95
Weight Score2.38
Normalized Score0.67
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