Highlights
- •Mindfulness-based interventions (MBIs) are complex interventions.
- •The optimal MBI for people with multiple sclerosis (PwMS) is not known.
- •MBIs appear to be moderately effective in improving fatigue in PwMS.
- •Evidence for MBIs for relieving pain in PwMS is inconsistent.
Abstract
Background
Physical wellbeing is commonly impaired in people with multiple sclerosis (PwMS).
This study aims to update our previous systematic review (2014) and conduct a meta-analysis
on the efficacy of Mindfulness-based interventions (MBIs) for improving physical symptoms
in PwMS.
Methods
In November 2017 we carried out systematic searches for eligible randomised controlled
trials (RCTs) in seven major databases, updating our search in July 2018. We used
medical subject headings and key words. Two independent reviewers used pre-defined
criteria to screen, data extract, quality appraise, and analyse studies. The Cochrane
Collaboration risk of bias tool was used to determine study quality. Physical wellbeing
was the main outcome of interest. We used the random effects model for meta-analysis,
reporting effect sizes as Standardised Mean Difference (SMD). This study is registered
with PROSPERO: CRD42018093171.
Results
We identified 10 RCTs as eligible for inclusion in the systematic review (including
678 PwMS), whilst seven RCTs (555 PwMS) had data that could be used in our meta-analyses.
In general, comorbidity, disability, ethnicity and socio-economic status were poorly
reported. MBIs included manualised and tailored interventions, treatment duration
6-9 weeks, delivered face-to-face and online in groups and also individually. For
fatigue, against any comparator SMD was 0.24 (0.08 – 0.41), I2=0%; against active comparators only, SMD was 0.10 (-0.14 – 0.34), I2=0%. For pain SMD was 0.16 (-0.46 – 0.79), I2=77%. Three adverse events occurred across all studies.
Conclusions
MBIs appear to be an effective treatment for fatigue in PwMS. The optimal MBI in this
context remains unclear. Further research into MBI optimisation, cost- and comparative-effectiveness
is required.
Keywords
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Article info
Publication history
Published online: November 09, 2019
Accepted:
October 31,
2019
Received in revised form:
October 28,
2019
Received:
January 22,
2019
Identification
Copyright
© 2019 Elsevier B.V. All rights reserved.
