Mindfulness-based telehealth program improves chronic pain

Key takeaways:

• Both a group and self-paced telehealth interventions improved pain-related function in participants.
• Mindfulness interventions also improved outcomes like pain intensity, depression and fatigue.

U.S. veterans who participated in a mindfulness-based telehealth intervention experienced significant improvements in pain and pain-related function, results from a randomized controlled trial showed.

“Although mindfulness interventions are evidence-based treatment for chronic pain and conditions that often accompany pain, like anxiety and depression, many [mindfulness-based interventions (MBIs)] are difficult to implement at scale in health care systems. They require trained mindfulness instructors, dedicated space and pose barriers to patients due to the time commitment involved,” Diana J. Burgess, PhD, a professor in the department of medicine at the University of Minnesota, said in a press release. “We wanted to develop MBIs that were relatively low resource, scalable and more accessible for patients.”

In the Learning to Apply Mindfulness to Pain study, the researchers compared usual care with two different types of two telehealth MBIs — a self-paced MBI and a group MBI — among 811 veterans with moderate to severe chronic pain across three Veterans Affairs facilities.

The self-paced MBI consisted of eight, 30- to 60-minute weekly sessions using the same content as the other intervention, only without group interaction, Burgess and colleagues explained.

“Content focused on providing participants with opportunities and resources to develop their mindfulness and pain self-management capabilities and motivations,” they wrote in JAMA Internal Medicine. “This included mindfulness-related knowledge and skills in regulating attention and emotions, establishing body awareness, and shifting self-perceptions, considered essential content of MBIs.”

Pain-related function served as the study’s primary outcome measurement. Researchers assessed this measurement at 10 weeks, 6 months, and 1 year using the Brief Pain Inventory interference scale. The study also had several secondary outcomes, including pain intensity and depression.

Overall, 694 participants completed the trial.

Across all three time points, researchers reported significantly lower pain interference scores for the group MBI (difference = 0.4; 95% CI, 0.7 to 0.2) and self-paced MBI (difference = 0.4 [95%CI, 0.7 to 0.2]) vs. usual care.

Both MBI arms also had significantly better scores in patient global impression of change, social roles and activities, pain intensity, depression, physical function, fatigue, sleep disturbance and PTSD.

The researchers noted that the two MBI arms did not differ significantly from each other.

Additionally, compared with the usual care group, they noted greater probability of 30% improvement from baseline for the group MBI at 10 weeks and 6 months, and at all three time points for the self-paced MBI.

Burgess and colleagues noted high engagement in tandem with safely administered mindfulness exercises during the study, “with fewer physical and mental health symptoms reported relative to usual care, suggesting the MBIs may have protective effects,” they wrote. “The viability and similarity of both these approaches for delivering MBIs increase patient options for meeting their individual needs and could help accelerate and improve the implementation of nonpharmacological pain treatment in health care systems.”

References:

• Burgess D, et al. JAMA Intern Med. 2024;doi:10.1001/jamainternmed.2024.3940.
• New research finds scalable mindfulness interventions delivered via telehealth improve pain and well-being for veterans with chronic pain. Available at: https://med.umn.edu/news/new-research-finds-scalable-mindfulness-interventions-delivered-telehealth-improve-pain-and-well-being-veterans-chronic-pain. Published Aug. 19, 2024. Accessed Aug. 21, 2024.