Excerpt
Chronic pain is a pervasive health issue that adversely affects both the patient and society, including loss of productivity, decreased quality of life, and an increased burden on the health care system.1–4 The International Classification of Diseases (ICD) of the World Health Organization defines chronic pain as persistent or recurrent pain lasting longer than three months.5 Non-malignant (non-cancer) related types of chronic pain may include low back pain, osteoarthritis, rheumatoid arthritis, headache, neck pain, fibromyalgia, and irritable bowel syndrome.6 The prevalence of chronic pain is estimated to be 21% among the general Canadian population, a prevalence rate that has increased over time.2 Chronic pain has substantial economic implications and has been estimated to cost Canada over six billion dollars per year in direct health care costs and 37 billion per year in productivity costs (e.g., job loss, sick days).1,7,8 Given the prevalence and burden of chronic pain, a variety of treatment options have been explored to help patients manage their symptoms of pain, including pharmacological approaches (i.e., prescription or non-prescription drugs), physical therapy, exercise, surgery, psychological therapy, and complementary and alternative therapies.4 In order to decide what treatment is best for the patient, careful consideration should be given to the benefits and risks of the available treatment options.9 Medications, such as opioids, are commonly prescribed for pain, with approximately three to four percent of the adult population in the United States prescribed long-term opioid therapy.9,10 However, long-term opioid therapy presents some serious risks, including addiction, accidental overdose, hyperalgesia, and diversion for non-medical use.10 Mindfulness training is another potential treatment option for individuals who suffer from chronic pain.11 Mindfulness is defined as the intentional and non-judgmental conscious awareness of the present moment.12 A previous CADTH rapid response report that was published in 201211 examined the clinical effectiveness and evidence-based guidelines regarding the use of mindfulness training for chronic pain management in adults and found insufficient evidence to draw conclusions about its potential effectiveness. An update is needed to determine if the evidence surrounding mindfulness for chronic pain management is more conclusive to inform future policy decisions. The aim of this report is to summarize the evidence regarding both the clinical and cost-effectiveness, as well as guidelines for the use of mindfulness training for chronic non-malignant pain management.
Copyright © 2019 Canadian Agency for Drugs and Technologies in Health.
Sections
PMID: 31498576
