A systematic review and meta-analysis exploring the efficacy of mindfulness-based interventions on quality of life in people with multiple sclerosis

Author: Robert Simpson1,2, Stephanie Posa3, Laura Langer3, Tania Bruno3, Sharon Simpson4, Maggie Lawrence5, Jo Booth5, Stewart W Mercer6, Anthony Feinstein3, Mark Bayley3
1 Toronto Rehabilitation Institute, University of Toronto, Toronto, Canada. robert.simpson@uhn.ca.
2 University of Glasgow, Glasgow, UK. robert.simpson@uhn.ca.
3 Toronto Rehabilitation Institute, University of Toronto, Toronto, Canada.
4 University of Glasgow, Glasgow, UK.
5 Glasgow Caledonian University, Glasgow, UK.
6 University of Edinburgh, Edinburgh, UK.
Conference/Journal: J Neurol
Date published: 2022 Nov 9
Other: Special Notes: doi: 10.1007/s00415-022-11451-x. , Word Count: 254

Quality of life (QoL) is commonly impaired among people with multiple sclerosis (PwMS). The aim of this study was to evaluate via meta-analysis the efficacy of Mindfulness-based interventions (MBIs) for improving QoL in PwMS.

Eligible randomized controlled trials (RCTs) were identified via searching six major electronic databases (MEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, AMED, and PsycINFO) in April 2022. The primary outcome was QoL. Study quality was determined using the Cochrane Collaboration risk of bias tool. Meta-analysis using a random effects model was undertaken. Effect sizes are reported as Standardized Mean Difference (SMD). Prospero ID: 139835.

From a total of 1312 individual studies, 14 RCTs were eligible for inclusion in the meta-analysis, total participant n = 937. Most studies included PwMS who remained ambulatory. Cognitively impaired PwMS were largely excluded. Comorbidities were inconsistently reported. Most MBIs were delivered face-to face in group format, but five were online. Eight studies (n = 8) measured MS-specific QoL. In meta-analysis, overall effect size (SMD) for any QoL measure (n = 14) was 0.40 (0.18-0.61), p = 0.0003, I2 = 52%. SMD for MS-specific QoL measures (n = 8) was 0.39 (0.21-0.57), p < 0.0001, I2 = 0%. MBI effect was largest on subscale measures of mental QoL (n = 8), SMD 0.70 (0.33-1.06), p = 0.0002, I2 = 63%. Adverse events were infrequently reported.

MBIs effectively improve QoL in PwMS. The greatest benefits are on mental health-related QoL. However, more research is needed to characterize optimal formatting, mechanisms of action, and effects in PwMS with more diverse social, educational, and clinical backgrounds.

Keywords: Meta-analysis; Mindfulness; Multiple sclerosis; Quality of life; Systematic review.

PMID: 36348069 DOI: 10.1007/s00415-022-11451-x