Managing Pain with Alternative Therapies
Aug 24, 2018
Published in: Evidence Map of Mindfulness, VA-ESP Project no. 05-226 / Susanne Hempel et al. (Washington, DC: Department of Veterans Affairs, Oct. 2014), 36 p
Posted on RAND.org on July 06, 2015
This evidence map provides an overview of "mindfulness" intervention research and describes its volume and focus. It summarizes patient outcomes as reported in systematic reviews of randomized controlled trial evidence. We searched 10 electronic databases to February 2014, screened reviews of reviews, and consulted topic experts. We used a bubble plot as a visual overview of the distribution of evidence and synthesized results narratively in an executive summary. In total, 81 systematic reviews met inclusion criteria and the largest review included 109 mindfulness RCTs. Most research is available for general overviews on health benefits or psychological wellbeing. Reviews on chronic illness, depression, substance use, somatization, distress, and mental illness included 10 or more RCTs. Reviews suggest differential effects of mindfulness-based stress reduction (MBSR), mindfulness-based cognitive therapy (MBCT), and other mindfulness-based interventions, and definitions of "mindfulness-based" varied. The most consistent effect was reported for depression but published meta-analyses also indicated effects compared to passive control of MBSR on overall health, chronic illness, and psychological variables; MBCT for mental illness; and mindfulness interventions for somatization disorders. Limited evidence is also available for mindfulness interventions for pain, anxiety, and psychosis compared to passive control groups. More detail is provided for priority areas post-traumatic stress disorder, stress, depression, and wellness. The evidence map provides a broad overview (not detailed or definitive effectiveness evidence) over the existing research to help interpret the state of the evidence to inform policy and clinical decision making.
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