Mindfulness based interventions in multiple sclerosis - a systematic review

Simpson, R., Booth, J., Lawrence, M., Byrne, S., Mair, F. and Mercer, S. (2014) Mindfulness based interventions in multiple sclerosis - a systematic review. BMC Neurology, 14(15), (doi:10.1186/1471-2377-14-15)

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Publisher's URL: http://dx.doi.org/10.1186/1471-2377-14-15

Abstract

Background Multiple sclerosis (MS) is a stressful condition; depression, anxiety, pain and fatigue are all common problems. Mindfulness based interventions (MBIs) mitigate stress and prevent relapse in depression and are increasingly being used in healthcare. However, there are currently no systematic reviews of MBIs in people with MS. This review aims to evaluate the effectiveness of MBIs in people with MS.

Methods Systematic searches were carried out in seven major databases, using both subject headings and key words. Papers were screened, data extracted, quality appraised, and analysed by two reviewers independently, using predefined criteria. Study quality was assessed using the Cochrane Collaboration risk of bias tool. Perceived stress was the primary outcome. Secondary outcomes include mental health, physical health, quality of life, and health service utilisation. Statistical meta-analysis was not possible. Disagreements were adjudicated by a third party reviewer.

Results Three studies (n = 183 participants) were included in the final analysis. The studies were undertaken in Wales (n = 16, randomised controlled trial - (RCT)), Switzerland (n = 150, RCT), and the United States (n = 17, controlled trial). 146 (80%) participants were female; mean age (SD) was 48.6 (9.4) years. Relapsing remitting MS was the main diagnostic category (n = 123, 67%); 43 (26%) had secondary progressive disease; and the remainder were unspecified. MBIs lasted 6–8 weeks; attrition rates were variable (5-43%); all employed pre- post- measures; two had longer follow up; one at 3, and one at 6 months. Socio-economic status of participants was not made explicit; health service utilisation and costs were not reported. No study reported on perceived stress. All studies reported quality of life (QOL), mental health (anxiety and depression), physical (fatigue, standing balance, pain), and psychosocial measures. Statistically significant beneficial effects relating to QOL, mental health, and selected physical health measures were sustained at 3- and 6- month follow up.

Conclusion From the limited data available, MBIs may benefit some MS patients in terms of QOL, mental health, and some physical health measures. Further studies are needed to clarify how MBIs might best serve the MS population.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Mercer, Professor Stewart and Mair, Professor Frances and Simpson, Dr Robert and Byrne, Ms Sharon
Authors: Simpson, R., Booth, J., Lawrence, M., Byrne, S., Mair, F., and Mercer, S.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > General Practice and Primary Care
Journal Name:BMC Neurology
Publisher:BioMed Central
ISSN:1471-2377
ISSN (Online):1471-2377
Copyright Holders:Copyright © 2014 The Authors
First Published:First published in BMC Neurology 14(15)
Publisher Policy:Reproduced under a Creative Commons License

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