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      • Record: found
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      A systematic review and meta-analysis exploring the efficacy of mindfulness-based interventions on quality of life in people with multiple sclerosis

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          Abstract

          Background

          Quality of life (QoL) is commonly impaired among people with multiple sclerosis (PwMS). The aim of this study was to evaluate via meta-analysis the efficacy of Mindfulness-based interventions (MBIs) for improving QoL in PwMS.

          Methods

          Eligible randomized controlled trials (RCTs) were identified via searching six major electronic databases (MEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, AMED, and PsycINFO) in April 2022. The primary outcome was QoL. Study quality was determined using the Cochrane Collaboration risk of bias tool. Meta-analysis using a random effects model was undertaken. Effect sizes are reported as Standardized Mean Difference (SMD). Prospero ID: 139835.

          Results

          From a total of 1312 individual studies, 14 RCTs were eligible for inclusion in the meta-analysis, total participant n = 937. Most studies included PwMS who remained ambulatory. Cognitively impaired PwMS were largely excluded. Comorbidities were inconsistently reported. Most MBIs were delivered face-to face in group format, but five were online. Eight studies ( n = 8) measured MS-specific QoL. In meta-analysis, overall effect size (SMD) for any QoL measure ( n = 14) was 0.40 (0.18–0.61), p = 0.0003, I 2 = 52%. SMD for MS-specific QoL measures ( n = 8) was 0.39 (0.21–0.57), p < 0.0001, I 2 = 0%. MBI effect was largest on subscale measures of mental QoL ( n = 8), SMD 0.70 (0.33–1.06), p = 0.0002, I 2 = 63%. Adverse events were infrequently reported.

          Conclusions

          MBIs effectively improve QoL in PwMS. The greatest benefits are on mental health-related QoL. However, more research is needed to characterize optimal formatting, mechanisms of action, and effects in PwMS with more diverse social, educational, and clinical backgrounds.

          Supplementary Information

          The online version contains supplementary material available at 10.1007/s00415-022-11451-x.

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          Most cited references70

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          Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.

          David Moher, Alessandro Liberati, Jennifer Tetzlaff … (2009)
          Article 0 comments Cited 7634 times – based on 0 reviews     Review now
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            Multiple sclerosis

            Alastair Compston, Alasdair Coles (2008)
            The Lancet, 372(9648), 1502-1517
            Article 0 comments Cited 601 times – based on 0 reviews     Review now
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              Meditation programs for psychological stress and well-being: a systematic review and meta-analysis.

              P Ranasinghe, S. Saha, D Maron … (2014)
              Many people meditate to reduce psychological stress and stress-related health problems. To counsel people appropriately, clinicians need to know what the evidence says about the health benefits of meditation. To determine the efficacy of meditation programs in improving stress-related outcomes (anxiety, depression, stress/distress, positive mood, mental health-related quality of life, attention, substance use, eating habits, sleep, pain, and weight) in diverse adult clinical populations. We identified randomized clinical trials with active controls for placebo effects through November 2012 from MEDLINE, PsycINFO, EMBASE, PsycArticles, Scopus, CINAHL, AMED, the Cochrane Library, and hand searches. Two independent reviewers screened citations and extracted data. We graded the strength of evidence using 4 domains (risk of bias, precision, directness, and consistency) and determined the magnitude and direction of effect by calculating the relative difference between groups in change from baseline. When possible, we conducted meta-analyses using standardized mean differences to obtain aggregate estimates of effect size with 95% confidence intervals. After reviewing 18 753 citations, we included 47 trials with 3515 participants. Mindfulness meditation programs had moderate evidence of improved anxiety (effect size, 0.38 [95% CI, 0.12-0.64] at 8 weeks and 0.22 [0.02-0.43] at 3-6 months), depression (0.30 [0.00-0.59] at 8 weeks and 0.23 [0.05-0.42] at 3-6 months), and pain (0.33 [0.03- 0.62]) and low evidence of improved stress/distress and mental health-related quality of life. We found low evidence of no effect or insufficient evidence of any effect of meditation programs on positive mood, attention, substance use, eating habits, sleep, and weight. We found no evidence that meditation programs were better than any active treatment (ie, drugs, exercise, and other behavioral therapies). Clinicians should be aware that meditation programs can result in small to moderate reductions of multiple negative dimensions of psychological stress. Thus, clinicians should be prepared to talk with their patients about the role that a meditation program could have in addressing psychological stress. Stronger study designs are needed to determine the effects of meditation programs in improving the positive dimensions of mental health and stress-related behavior.
              Article 0 comments Cited 341 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Robert Simpson:
                ORCID: http://orcid.org/0000-0002-7107-8679
                robert.simpson@uhn.ca
                Journal
                Journal ID (nlm-ta): J Neurol
                Journal ID (iso-abbrev): J Neurol
                Title: Journal of Neurology
                Publisher: Springer Berlin Heidelberg (Berlin/Heidelberg )
                ISSN (Print): 0340-5354
                ISSN (Electronic): 1432-1459
                Publication date (Electronic): 9 November 2022
                Publication date PMC-release: 9 November 2022
                Pages: 1-20
                Affiliations
                [1 ]GRID grid.17063.33, ISNI 0000 0001 2157 2938, Toronto Rehabilitation Institute, , University of Toronto, ; Toronto, Canada
                [2 ]GRID grid.8756.c, ISNI 0000 0001 2193 314X, University of Glasgow, ; Glasgow, UK
                [3 ]GRID grid.5214.2, ISNI 0000 0001 0669 8188, Glasgow Caledonian University, ; Glasgow, UK
                [4 ]GRID grid.4305.2, ISNI 0000 0004 1936 7988, University of Edinburgh, ; Edinburgh, UK
                Author information
                http://orcid.org/0000-0002-7107-8679
                Article
                Publisher ID: 11451
                DOI: 10.1007/s00415-022-11451-x
                PMC ID: 9643979
                PubMed ID: 36348069
                SO-VID: 06e43657-d04b-4eba-956f-3969adc95a8e
                Copyright © © The Author(s) 2022
                License:

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                Date received : 19 September 2022
                Date revision received : 20 October 2022
                Date accepted : 21 October 2022
                Categories
                Subject: Review

                ScienceOpen disciplines: Neurology
                Keywords: mindfulness,multiple sclerosis,systematic review,meta-analysis,quality of life
                Data availability:
                ScienceOpen disciplines: Neurology
                Keywords: mindfulness, multiple sclerosis, systematic review, meta-analysis, quality of life

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