Mindfulness Meditation-Based Intervention Is Feasible, Acceptable, and Safe for Chronic Low Back Pain Requiring Long-Term Daily Opioid Therapy.
OBJECTIVE
Although mindfulness meditation (MM) is increasingly used for chronic pain treatment, limited evidence supports its clinical application for opioid-treated chronic low back pain (CLBP). The goal of this study was to determine feasibility, acceptability, and safety of an MM-based intervention in patients with CLBP requiring daily opioid therapy.


METHODS
26-week pilot randomized controlled trial comparing MM-based intervention, combined with usual care, to usual care alone.


METHODS
Outpatient.


METHODS
Adults with CLBP treated with ≥30 mg of morphine-equivalent dose (MED) per day for 3 months or longer.


METHODS
Targeted MM-based intervention consisted of eight weekly 2-hour group sessions and home practice (30 minutes/d, 6 days/wk) during the study. "Usual care" for opioid-treated CLBP was provided to participants by their regular clinicians.


METHODS
Feasibility and acceptability of the MM intervention were assessed by adherence to intervention protocol and treatment satisfaction among experimental participants. Safety was evaluated by inquiry about side effects/adverse events and opioid dose among all study participants.


RESULTS
Thirty-five participants enrolled during the 10-week recruitment period. The mean age (±standard deviation) was 51.8 ± 9.7 years; the patients were predominantly female, with substantial CLBP-related pain and disability, and treated with 148.3 ± 129.2 mg of MED per day. All participants completed baseline assessments; none missed both follow-up assessments or withdrew. Among experimental participants (n = 21), 19 attended 1 or more intervention sessions and 14 attended 4 or more. They reported, on average, 164.0 ± 122.1 minutes of formal practice per week during the 26-week study and 103.5 ± 111.5 minutes of brief, informal practice per week. Seventeen patients evaluated the intervention, indicating satisfaction; their qualitative responses described the course as useful for pain management (n = 10) and for improving pain coping skills (n = 8). No serious adverse events or safety concerns occurred among the study participants.


CONCLUSIONS
MM-based intervention is feasible, acceptable, and safe in opioid-treated CLBP.
1 Department of Family Medicine and Community Health, University of Wisconsin-Madison , School of Medicine and Public Health, Madison, WI.
Aleksandra E
AE
Zgierska
1 Department of Family Medicine and Community Health, University of Wisconsin-Madison , School of Medicine and Public Health, Madison, WI.
Cindy A
CA
Burzinski
1 Department of Family Medicine and Community Health, University of Wisconsin-Madison , School of Medicine and Public Health, Madison, WI.
Jennifer
J
Cox
2 Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison , School of Medicine and Public Health, Madison, WI.
John
J
Kloke
3 Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison , School of Medicine and Public Health, Madison, WI.
Janice
J
Singles
3 Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison , School of Medicine and Public Health, Madison, WI.
Shilagh
S
Mirgain
4 Research Service, William S. Middleton Memorial Veterans Hospital, Madison, WI.|5 Department of Kinesiology, University of Wisconsin-Madison , School of Education, Madison, WI.
Aaron
A
Stegner
4 Research Service, William S. Middleton Memorial Veterans Hospital, Madison, WI.|5 Department of Kinesiology, University of Wisconsin-Madison , School of Education, Madison, WI.
Dane B
DB
Cook
6 Department of Neurology, University of Wisconsin-Madison , School of Medicine and Public Health, Madison, WI.|7 PRAHS Clinical Research Company Lifetree , Salt Lake City, UT.
Miroslav
M
Bačkonja
D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use*; D059350:Chronic Pain / Q000628:therapy*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000628:therapy*; D008297:Male; D019122:Meditation; D008875:Middle Aged; D064866:Mindfulness; D010147:Pain Measurement
D000701:Analgesics, Opioid