Dana DiRenzo1, Monica Crespo-Bosque2, Neda Gould3, Patrick Finan3, Julie Nanavati4, Clifton O Bingham2. 1. Division of Rheumatology, Johns Hopkins University School of Medicine, 5200 Eastern Avenue, MFL Building, Center Tower, Suite 4100, Baltimore, MD, 21224, USA. ddirenz1@jhmi.edu. 2. Division of Rheumatology, Johns Hopkins University School of Medicine, 5200 Eastern Avenue, MFL Building, Center Tower, Suite 4100, Baltimore, MD, 21224, USA. 3. Department of Psychiatry and Behavioral Services, Johns Hopkins University School of Medicine, Baltimore, MD, USA. 4. Welch Medical Library, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Abstract
PURPOSE OF REVIEW: To determine the efficacy of mindfulness-based interventions (MBIs) on clinical and patient-reported outcomes in rheumatoid arthritis (RA). RECENT FINDINGS: We identified randomized clinical trials from inception through April 2018 from MEDLINE, PsycINFO, EMBASE, CINAHL, Web of Science, the Cochrane Library, and hand searches. After screening 338 references, we included five trials with one post-hoc analysis that evaluated MBIs and collectively included 399 participants. Outcome instruments were heterogeneous across studies. Three studies evaluated RA clinical outcomes by a rheumatologist; one study found improvements in disease activity. A limited meta-analysis found no statistically significant difference in the levels of DAS28-CRP in the two studies that evaluated this metric (- 0.44 (- 0.99, 0.12); I2 0%). Four studies evaluated heterogeneous psychological outcomes, and all found improvements including depressive symptoms, psychological distress, and self-efficacy. A meta-analysis of pain Visual Analog Scale (VAS) levels post intervention from three included studies was not significantly different between MBI participants and control group (- 0.58 (- 1.26, 0.10); I2 0%) although other studies not included in meta-analysis found improvement. There are few trials evaluating the effect of MBIs on outcomes in patients with RA. Preliminary findings suggest that MBIs may be a useful strategy to improve psychological distress in those with RA.
PURPOSE OF REVIEW: To determine the efficacy of mindfulness-based interventions (MBIs) on clinical and patient-reported outcomes in rheumatoid arthritis (RA). RECENT FINDINGS: We identified randomized clinical trials from inception through April 2018 from MEDLINE, PsycINFO, EMBASE, CINAHL, Web of Science, the Cochrane Library, and hand searches. After screening 338 references, we included five trials with one post-hoc analysis that evaluated MBIs and collectively included 399 participants. Outcome instruments were heterogeneous across studies. Three studies evaluated RA clinical outcomes by a rheumatologist; one study found improvements in disease activity. A limited meta-analysis found no statistically significant difference in the levels of DAS28-CRP in the two studies that evaluated this metric (- 0.44 (- 0.99, 0.12); I2 0%). Four studies evaluated heterogeneous psychological outcomes, and all found improvements including depressive symptoms, psychological distress, and self-efficacy. A meta-analysis of pain Visual Analog Scale (VAS) levels post intervention from three included studies was not significantly different between MBI participants and control group (- 0.58 (- 1.26, 0.10); I2 0%) although other studies not included in meta-analysis found improvement. There are few trials evaluating the effect of MBIs on outcomes in patients with RA. Preliminary findings suggest that MBIs may be a useful strategy to improve psychological distress in those with RA.
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