title: Mindfulness-based stress reduction (MBSR) as sole intervention for non-somatisation chronic non-cancer pain (CNCP): protocol for a systematic review and meta-analysis of randomised controlled trials.
abstract: BACKGROUND
  Chronic non-cancer pain (CNCP) affects up to 50% of the world's population. It impacts negatively on quality of life; entailing high costs on our medical systems, and translates to economic burden due to work loss. Aetiology of CNCP is complex and multifactorial, embracing the somatosensory, cognitive and affective domains. Opioid analgesia and other invasive interventions are often inadequate for clinical management of CNCP. Recently, mindfulness-based stress reduction (MBSR) has become a popular therapy for various medical conditions, including CNCP. However, studies reported varying efficacies, and relevant systematic reviews have included clinical trials with inherent heterogeneity either in study conditions or types of interventions used. Our study aims to provide an updated and more critical evaluation of the efficacy of MBSR as the intervention for non-somatisation CNCP.
  
  
  METHODS
  A systematic review with meta-analysis of randomised controlled trials published in English will be performed in accordance with the Preferred Reporting Items for Systematic reviews and Meta-analyses (PRISMA) guidelines and the Cochrane Collaboration format. MEDLINE, EMBASE, PsychINFO, and the Cochrane Central Register of Controlled Trials Intervention, will be searched independently by reviewers using defined MeSH terms. Studies with full texts using MBSR as the main intervention on patients with non-somatising CNCP will be included. Outcome measures include pain scores and disability assessment scales. Continuous data will be meta-analysed using the RevMan 5 Review Manager programme. Primary analysis will adopt the random effects model in view of heterogeneity between trials. The standardised mean difference will be expressed as the effect size with 95% CIs. Forest plots, funnel plots, the I(2) statistic and the Cochrane Risks of Bias Assessment table will be included.
  
  
  BACKGROUND
  No ethics approval is deemed necessary. Results of this study will be disseminated via peer-reviewed publications and scientific meetings.
  
  
  BACKGROUND
  PROSPERO CRD42014015568.
authors.affiliation: Department of Family Medicine, Queen's University, Kingston, Ontario, Canada Centre of Studies in Primary Care, Queen's University, Kingston, Ontario, Canada School of Medicine, Queen's University, Kingston, Ontario, Canada.
authors.forename: Lawrence
authors.initials: L
authors.lastname: Leung
authors.affiliation: Centre of Studies in Primary Care, Queen's University, Kingston, Ontario, Canada.
authors.forename: Han
authors.initials: H
authors.lastname: Han
authors.affiliation: Centre of Studies in Primary Care, Queen's University, Kingston, Ontario, Canada.
authors.forename: Mary
authors.initials: M
authors.lastname: Martin
authors.affiliation: Centre of Studies in Primary Care, Queen's University, Kingston, Ontario, Canada.
authors.forename: Jyoti
authors.identifier: http://orcid.org/0000-0002-0804-4345
authors.initials: J
authors.lastname: Kotecha
mesh_terms: D059350:Chronic Pain / Q000523:psychology / Q000628:therapy*; D002985:Clinical Protocols; D006801:Humans; D064866:Mindfulness / Q000379:methods*; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D013315:Stress, Psychological / Q000209:etiology / Q000517:prevention & control*; D000078202:Systematic Reviews as Topic; D015201:Meta-Analysis as Topic
keywords: COMPLEMENTARY MEDICINE; PAIN MANAGEMENT; PRIMARY CARE