Excerpt
Chronic pain involves persistent or recurrent pain lasting longer than three months.1 It is a global health issue that is common in both developed and developing countries.2 For example, nearly one in four Canadian adults has a chronic pain condition.3,4 Medications, such as opioids, are frequently prescribed for patients experiencing chronic non-malignant (i.e., non-cancer) pain to alleviate their symptoms. Given the side effects of their use (e.g., nausea, constipation, respiratory depression), potential for addiction and misuse, and uncertainty in their long-term effectiveness for treating chronic non-malignant pain, alternative strategies should be explored.5 Complementary and alternative medicine therapies, such as mindfulness training and yoga, are potential treatment options for individuals who have chronic non-malignant pain.6,7 Mindfulness is defined as the intentional and non-judgmental conscious awareness of the present moment.7 Yoga is a mind-body practice with three main components: physical poses/postures, breathing control, and meditation/relaxation.8 Most recently, two CADTH Rapid Response reports examined the clinical effectiveness, cost-effectiveness, and evidence-based guidelines regarding the use of mindfulness training (published in June 2019)9 and yoga (published in July 2019)10 for chronic pain management in adults. The report on mindfulness found insufficient evidence to draw conclusions about its potential clinical effectiveness.9 The report on yoga found evidence from one randomized study suggesting that yoga plus conventional treatment with analgesics was effective for reducing chronic pelvic pain, while conventional treatment with analgesics alone was not.10 No economic evaluations were identified in either report.9,10 Notably, both reviews focused on comparing mindfulness or yoga with or without pharmacotherapy to pharmacotherapy alone (e.g., opioids, nonsteroidal anti-inflammatory drugs, acetaminophen).9,10 To inform policy decisions, further exploration of mindfulness or yoga compared with no treatment may provide additional insight on the clinical and cost-effectiveness of these complementary and alternative medicine therapies for management of chronic non-malignant pain. The aim of this report is to summarize the evidence regarding both the clinical effectiveness and cost-effectiveness of the use of mindfulness training or yoga for the management of chronic non-malignant pain.
Copyright © 2019 Canadian Agency for Drugs and Technologies in Health.
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