NEW YORK (Reuters Health)—Mindfulness-based stress reduction (MBSR) is more effective than treatment as usual for improving function and other outcomes in patients with fibromyalgia, according to a new randomized trial.
MBSR is an extension of cognitive-behavioral therapy (CBT) intended to help patients change the way they experience symptoms, Dr. Albert Feliu-Soler of the Institut de Recerca Sant Joan de Deu in Esplugues de Llobregat, Spain, and colleagues write.
The intervention “aims to fundamentally alter how symptoms, as well as stressful thoughts and feelings, are experienced, so that they are addressed with greater awareness and acceptance rather than with ignoring and resistance,” the authors write in Pain, online July 11.1
Dr. Jon Kabat-Zinn originally developed MBSR to treat patients with chronic stress-related illness, and several studies have found it improves some core symptoms of fibromyalgia.
For their 12-month study, Dr. Feliu-Soler and his team randomly assigned 225 fibromyalgia patients to receive either usual care alone, or usual care plus MBSR or FibroQoL.
MBSR consisted of eight weekly two-hour sessions and an optional half-day of silent retreat. FibroQoL, a multicomponent intervention for fibromyalgia, has a similar structure and format to the MBSR. Members of both treatment groups attended five to six sessions, on average, while retention rates were similar across all three conditions post-treatment and at 12 months.
The MBSR group had significantly greater improvements in Revised Fibromyalgia Impact Questionnaire (FIQR) scores after treatment (large effect size) and at one year compared with the control group (medium to large effect size).
MBSR was also superior to Fibro-QoL in improving FIQR scores after treatment, but the effects of the two treatments were similar at follow-up.
The relative loss of MSBR efficacy at one year could be related to the difficulty of maintaining a meditation practice at home, the authors note.
“Participants generally admitted having practiced meditation intermittently and not very often, although this was not formally analyzed,” they write. “A main focus for future research should be how to enhance the frequency and quality of mindfulness practice, not only during the intervention but especially once it is over.”
Dr. Feliu-Soler was not available for an interview by press time.
Reference
- Pérez-Aranda A, Feliu-Soler A, Montero-Marín J, et al. A randomized controlled efficacy trial of mindfulness-based stress reduction compared to an active control group and usual care for fibromyalgia: The EUDAIMON study. Pain. 2019 Jul 11. [Epub ahead of print]