title: The Efficacy of Mindfulness-Based Interventions in Primary Care: A Meta-Analytic Review.
abstract: OBJECTIVE
  Positive effects have been reported after mindfulness-based interventions (MBIs) in diverse clinical and nonclinical populations. Primary care is a key health care setting for addressing common chronic conditions, and an effective MBI designed for this setting could benefit countless people worldwide. Meta-analyses of MBIs have become popular, but little is known about their efficacy in primary care. Our aim was to investigate the application and efficacy of MBIs that address primary care patients.
  
  
  METHODS
  We performed a meta-analytic review of randomized controlled trials addressing the effect of MBIs in adult patients recruited from primary care settings. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and Cochrane guidelines were followed. Effect sizes were calculated with the Hedges g in random effects models.
  
  
  RESULTS
  The meta-analyses were based on 6 trials having a total of 553 patients. The overall effect size of MBI compared with a control condition for improving general health was moderate (g = 0.48; P = .002), with moderate heterogeneity (I(2) = 59; P <.05). We found no indication of publication bias in the overall estimates. MBIs were efficacious for improving mental health (g = 0.56; P = .007), with a high heterogeneity (I(2) = 78; P <.01), and for improving quality of life (g = 0.29; P = .002), with a low heterogeneity (I(2) = 0; P >.05).
  
  
  CONCLUSIONS
  Although the number of randomized controlled trials applying MBIs in primary care is still limited, our results suggest that these interventions are promising for the mental health and quality of life of primary care patients. We discuss innovative approaches for implementing MBIs, such as complex intervention and stepped care.
authors.affiliation: Federal University of Sao Paulo (UNIFESP), "Mente Aberta" - Brazilian Center for Mindfulness and Health Promotion, Department of Preventive Medicine, Sao Paulo, Brazil.
authors.forename: Marcelo M P
authors.initials: MM
authors.lastname: Demarzo
authors.affiliation: Faculty of Health Sciences and Sports, University of Zaragoza, Huesca, Spain.
authors.forename: Jesús
authors.initials: J
authors.lastname: Montero-Marin
authors.affiliation: VU University Amsterdam, Department of Psychology, Amsterdam, Netherlands.
authors.forename: Pim
authors.initials: P
authors.lastname: Cuijpers
authors.affiliation: Institut Universitari d'Investigació en Atenció Primària (IDIAP) Jordi Gol, Barcelona, Spain.
authors.forename: Edurne
authors.initials: E
authors.lastname: Zabaleta-del-Olmo
authors.affiliation: Oxford University, Department of Primary Care, Oxford, United Kingdom.
authors.forename: Kamal R
authors.initials: KR
authors.lastname: Mahtani
authors.affiliation: National University of Ireland, Galway, Department of Primary Care, Galway, Ireland.
authors.forename: Akke
authors.initials: A
authors.lastname: Vellinga
authors.affiliation: Red de Investigación en Actividades Preventivas y Promoción de la Salud (redIAPP), Primary Care, Palma de Mallorca, Spain.
authors.forename: Caterina
authors.initials: C
authors.lastname: Vicens
authors.affiliation: Faculty of Health Sciences and Sports, University of Zaragoza, Huesca, Spain.
authors.forename: Yolanda
authors.initials: Y
authors.lastname: López-del-Hoyo
authors.affiliation: University of Zaragoza, Department of Psychiatry, Zaragoza, Spain jgarcamp@gmail.com.
authors.forename: Javier
authors.initials: J
authors.lastname: García-Campayo
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease / Q000523:psychology* / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D064866:Mindfulness / Q000379:methods*; D011320:Primary Health Care / Q000379:methods*; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
keywords: complex interventions; meta-analysis; mindfulness-based interventions; practice-base research; primary care; randomized controlled trials