Mindfulness-oriented recovery enhancement ameliorates the impact of pain on self-reported psychological and physical function among opioid-using chronic pain patients.
BACKGROUND
Chronic pain impacts one-third of the U.S. population, and its effects are debilitating for individuals and costly to the medical system. Although opioids are commonly prescribed to address chronic pain, they confer risk for misuse and addiction in some patients and may not fully restore life function-particularly with regard to psychosocial factors. Because of the multiplicity of impacts that chronic pain may have on daily functioning, broad-spectrum behavioral interventions are needed.


OBJECTIVE
The purpose of this study was to conduct follow-up analyses from a pilot randomized controlled trial of Mindfulness-Oriented Recovery Enhancement (MORE) to assess specific effects of MORE on various biopsychosocial aspects of pain-related impairment.


METHODS
Chronic pain patients (N = 115; mean age, 48 ± 14 years; 68% female) were randomly assigned to either eight weeks of MORE or a support group. Domains of pain-related functional interference were measured with the Brief Pain Inventory at pre- and post-treatment and at a three-month follow-up. Treatment effects were analyzed with multivariate intention-to-treat models.


RESULTS
MORE participants reported significantly greater reductions in functional interference than support group participants at post-treatment across all domains, including general activity, mood, walking ability, normal work, relationships, sleep, and enjoyment of life. These effects were largely maintained by the three-month follow-up; however, general activity level and walking ability were no longer significant, indicating differential long-term effects between physiological and psychological functioning.


CONCLUSIONS
Findings demonstrate preliminary efficacy of MORE as a treatment for pain-related functional impairments and suggest that effects may be more pronounced and durable for aspects of psychological function.
Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA; College of Social Work, University of Utah, Salt Lake City, Utah, USA. Electronic address: elgarlan@gmail.com.
Eric L
EL
Garland
College of Social Work, University of Utah, Salt Lake City, Utah, USA.
Elizabeth
E
Thomas
School of Social Work, University of North Carolina, Chapel Hill, North Carolina, USA.
Matthew O
MO
Howard
D000701:Analgesics, Opioid / Q000627:therapeutic use*; D059350:Chronic Pain / Q000503:physiopathology / Q000523:psychology* / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D064866:Mindfulness / Q000379:methods*; D015999:Multivariate Analysis; D010147:Pain Measurement; D010865:Pilot Projects; D011788:Quality of Life; D057566:Self Report; D016896:Treatment Outcome
D000701:Analgesics, Opioid
Mindfulness; chronic pain; function; impairment; opioid; quality of life