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

Simpson, R., Posa, S., Langer, L., Bruno, T., Simpson, S., Lawrence, M., Booth, J., Mercer, S. W., Feinstein, A. and Bayley, M. (2023) A systematic review and meta-analysis exploring the efficacy of mindfulness-based interventions on quality of life in people with multiple sclerosis. Journal of Neurology, 270(2), pp. 726-745. (doi: 10.1007/s00415-022-11451-x) (PMID:36348069) (PMCID:PMC9643979)

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, I2 = 52%. SMD for MS-specific QoL measures (n = 8) was 0.39 (0.21–0.57), p < 0.0001, I2 = 0%. MBI effect was largest on subscale measures of mental QoL (n = 8), SMD 0.70 (0.33–1.06), p = 0.0002, I2 = 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.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Simpson, Dr Robert and Simpson, Mrs Sharon
• Authors: Simpson, R., Posa, S., Langer, L., Bruno, T., Simpson, S., Lawrence, M., Booth, J., Mercer, S. W., Feinstein, A., and Bayley, M.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care
• Journal Name: Journal of Neurology
• Publisher: Springer
• ISSN: 0340-5354
• ISSN (Online): 1432-1459
• Published Online: 09 November 2022
• Copyright Holders: Copyright © 2022 The Authors
• First Published: First published in Journal of Neurology 270(2): 726-745
• Publisher Policy: Reproduced under a Creative Commons License