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Mindfulness Meditation for Chronic Pain

其他書名	A Systematic Review
出版	RAND, 2016
URL	http://books.google.com.hk/books?id=rKhhnQAACAAJ&hl=&source=gbs_api

註釋RAND researchers conducted a systematic review that synthesized evidence from randomized controlled trials of mindfulness meditation interventions--used adjunctively or as monotherapy--to provide estimates of their efficacy and safety in alleviating chronic pain in adults. Outcomes of interest included changes in pain symptomatology, use of analgesics, functional status, health-related quality of life, functional impairment (disability measures), and adverse events. Meta-analyses for efficacy outcomes were conducted using the Hartung-Knapp-Sidik-Jonkman method for random-effects models. Quality of evidence was assessed using the Grades of Recommendation, Assessment, Development, and Evaluation (or GRADE) approach. In total, 28 studies met inclusion criteria. Mindfulness meditation was associated with a small effect of improved pain symptoms compared with control groups in a meta-analysis of 24 randomized controlled trials. However, there was evidence of substantial heterogeneity among studies, resulting in a low quality of evidence assessment for this outcome. We were unable to determine which patient subgroups or intervention characteristics were associated with greater efficacy. Mindfulness meditation statistically significantly improved depression and health-related quality of life. Adverse events were rare and not serious, but the vast majority of studies did not collect adverse event data. The low quality of evidence prevents any strong conclusions about mindfulness meditation for chronic pain. Additional trials with adequate power, greater efforts to prevent attrition, monitoring of adherence to meditation practice, active collection of adverse events, and better reporting of methods are suggested.