Aleksandra E Zgierska1, Cindy A Burzinski1, Jennifer Cox1, John Kloke2, Janice Singles3, Shilagh Mirgain3, Aaron Stegner4,5, Dane B Cook4,5, Miroslav Bačkonja6,7. 1. 1 Department of Family Medicine and Community Health, University of Wisconsin-Madison , School of Medicine and Public Health, Madison, WI. 2. 2 Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison , School of Medicine and Public Health, Madison, WI. 3. 3 Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison , School of Medicine and Public Health, Madison, WI. 4. 4 Research Service, William S. Middleton Memorial Veterans Hospital, Madison, WI. 5. 5 Department of Kinesiology, University of Wisconsin-Madison , School of Education, Madison, WI. 6. 6 Department of Neurology, University of Wisconsin-Madison , School of Medicine and Public Health, Madison, WI. 7. 7 PRAHS Clinical Research Company Lifetree , Salt Lake City, UT.
Abstract
OBJECTIVE: Although mindfulness meditation (MM) is increasingly used for chronic pain treatment, limited evidence supports its clinical application for opioid-treated chronic low back pain (CLBP). The goal of this study was to determine feasibility, acceptability, and safety of an MM-based intervention in patients with CLBP requiring daily opioid therapy. DESIGN: 26-week pilot randomized controlled trial comparing MM-based intervention, combined with usual care, to usual care alone. SETTING: Outpatient. PATIENTS: Adults with CLBP treated with ≥30 mg ofmorphine-equivalent dose (MED) per day for 3 months or longer. INTERVENTIONS: Targeted MM-based intervention consisted of eight weekly 2-hour group sessions and home practice (30 minutes/d, 6 days/wk) during the study. "Usual care" for opioid-treated CLBP was provided to participants by their regular clinicians. OUTCOME MEASURES: Feasibility and acceptability of the MM intervention were assessed by adherence to intervention protocol and treatment satisfaction among experimental participants. Safety was evaluated by inquiry about side effects/adverse events and opioid dose among all study participants. RESULTS:Thirty-five participants enrolled during the 10-week recruitment period. The mean age (±standard deviation) was 51.8 ± 9.7 years; the patients were predominantly female, with substantial CLBP-related pain and disability, and treated with 148.3 ± 129.2 mg of MED per day. All participants completed baseline assessments; none missed both follow-up assessments or withdrew. Among experimental participants (n = 21), 19 attended 1 or more intervention sessions and 14 attended 4 or more. They reported, on average, 164.0 ± 122.1 minutes of formal practice per week during the 26-week study and 103.5 ± 111.5 minutes of brief, informal practice per week. Seventeen patients evaluated the intervention, indicating satisfaction; their qualitative responses described the course as useful for pain management (n = 10) and for improving pain coping skills (n = 8). No serious adverse events or safety concerns occurred among the study participants. CONCLUSIONS:MM-based intervention is feasible, acceptable, and safe in opioid-treated CLBP.
RCT Entities:
OBJECTIVE: Although mindfulness meditation (MM) is increasingly used for chronic pain treatment, limited evidence supports its clinical application for opioid-treated chronic low back pain (CLBP). The goal of this study was to determine feasibility, acceptability, and safety of an MM-based intervention in patients with CLBP requiring daily opioid therapy. DESIGN: 26-week pilot randomized controlled trial comparing MM-based intervention, combined with usual care, to usual care alone. SETTING:Outpatient. PATIENTS: Adults with CLBP treated with ≥30 mg of morphine-equivalent dose (MED) per day for 3 months or longer. INTERVENTIONS: Targeted MM-based intervention consisted of eight weekly 2-hour group sessions and home practice (30 minutes/d, 6 days/wk) during the study. "Usual care" for opioid-treated CLBP was provided to participants by their regular clinicians. OUTCOME MEASURES: Feasibility and acceptability of the MM intervention were assessed by adherence to intervention protocol and treatment satisfaction among experimental participants. Safety was evaluated by inquiry about side effects/adverse events and opioid dose among all study participants. RESULTS: Thirty-five participants enrolled during the 10-week recruitment period. The mean age (±standard deviation) was 51.8 ± 9.7 years; the patients were predominantly female, with substantial CLBP-related pain and disability, and treated with 148.3 ± 129.2 mg of MED per day. All participants completed baseline assessments; none missed both follow-up assessments or withdrew. Among experimental participants (n = 21), 19 attended 1 or more intervention sessions and 14 attended 4 or more. They reported, on average, 164.0 ± 122.1 minutes of formal practice per week during the 26-week study and 103.5 ± 111.5 minutes of brief, informal practice per week. Seventeen patients evaluated the intervention, indicating satisfaction; their qualitative responses described the course as useful for pain management (n = 10) and for improving pain coping skills (n = 8). No serious adverse events or safety concerns occurred among the study participants. CONCLUSIONS: MM-based intervention is feasible, acceptable, and safe in opioid-treated CLBP.
Authors: Aleksandra Zgierska; David Rabago; Megan Zuelsdorff; Christopher Coe; Michael Miller; Michael Fleming Journal: J Addict Med Date: 2008-09 Impact factor: 3.702
Authors: Roger Chou; Gilbert J Fanciullo; Perry G Fine; Jeremy A Adler; Jane C Ballantyne; Pamela Davies; Marilee I Donovan; David A Fishbain; Kathy M Foley; Jeffrey Fudin; Aaron M Gilson; Alexander Kelter; Alexander Mauskop; Patrick G O'Connor; Steven D Passik; Gavril W Pasternak; Russell K Portenoy; Ben A Rich; Richard G Roberts; Knox H Todd; Christine Miaskowski Journal: J Pain Date: 2009-02 Impact factor: 5.820
Authors: Eric L Garland; Eron G Manusov; Brett Froeliger; Amber Kelly; Jaclyn M Williams; Matthew O Howard Journal: J Consult Clin Psychol Date: 2014-02-03
Authors: Alexandra Dima; George T Lewith; Paul Little; Rona Moss-Morris; Nadine E Foster; Felicity L Bishop Journal: Br J Gen Pract Date: 2013-07 Impact factor: 5.386
Authors: Aleksandra E Zgierska; Cindy A Burzinski; Marlon P Mundt; Andrew S McClintock; Jennifer Cox; Christopher L Coe; Michael M Miller; Michael F Fleming Journal: J Subst Abuse Treat Date: 2019-01-17
Authors: Vivien P Nichols; Francine Toye; Sam Eldabe; Harbinder Kaur Sandhu; Martin Underwood; Kate Seers Journal: BMJ Open Date: 2020-02-18 Impact factor: 2.692
Authors: Nicholas Avery; Amy G McNeilage; Fiona Stanaway; Claire E Ashton-James; Fiona M Blyth; Rebecca Martin; Ali Gholamrezaei; Paul Glare Journal: BMJ Date: 2022-04-04
Authors: Abhimanyu Sud; Michelle L A Nelson; Darren K Cheng; Alana Armas; Kirk Foat; Michelle Greiver; Fardous Hosseiny; Joel Katz; Rahim Moineddin; Benoit H Mulsant; Ronnie I Newman; Leon Rivlin; Akshya Vasudev; Ross Upshur Journal: Trials Date: 2020-04-07 Impact factor: 2.279