A Systematic Review of the Adherence to Home-Practice Meditation Exercises in Patients with Chronic Pain

Author: Alberto Barceló-Soler1,2,3, Héctor Morillo-Sarto3,4, Selene Fernández-Martínez1,5, Alicia Monreal-Bartolomé1,3,4, Maria José Chambel6, Paula Gardiner7,8, Yolanda López-Del-Hoyo1,3,4, Javier García-Campayo1,3,5, Adrián Pérez-Aranda1,9
1 Institute of Health Research of Aragon (IIS), 50009 Zaragoza, Spain.
2 Navarra Medical Research Institute (IdiSNA), 31008 Pamplona, Spain.
3 Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), 50009 Zaragoza, Spain.
4 Department of Psychology and Sociology, University of Zaragoza, 50009 Zaragoza, Spain.
5 Department of Psychiatry, University of Zaragoza, 50009 Zaragoza, Spain.
6 CicPsi, Faculdade de Psicologia, Universidade de Lisboa, 1649-004 Lisbon, Portugal.
7 Center for Mindfulness and Compassion, Cambridge Health Alliance, Cambridge, MA 02141, USA.
8 Department of Family Medicine, Medical School, University of Massachusetts, Worcester, MA 01655, USA.
9 Department of Basic, Developmental and Educational Psychology, 08193 Cerdanyola del Vallès, Spain.
Conference/Journal: Int J Environ Res Public Health
Date published: 2023 Mar 2
Other: Volume ID: 20 , Issue ID: 5 , Pages: 4438 , Special Notes: doi: 10.3390/ijerph20054438. , Word Count: 212

Mindfulness-, compassion-, and acceptance-based (i.e., "third wave") psychotherapies are effective for treating chronic pain conditions. Many of these programs require that patients engage in the systematic home practice of meditation experiences so they can develop meditation skills. This systematic review aimed at evaluating the frequency, duration, and effects of home practice in patients with chronic pain undergoing a "third wave" psychotherapy. A comprehensive database search for quantitative studies was conducted in PubMed, Embase, and Web of Sciences Core Collection; 31 studies fulfilled the inclusion criteria. The reviewed studies tended to indicate a pattern of moderately frequent practice (around four days/week), with very high variability in terms of time invested; most studies observed significant associations between the amount of practice and positive health outcomes. Mindfulness-Based Stress Reduction and Mindfulness-Based Cognitive Therapy were the most common interventions and presented low levels of adherence to home practice (39.6% of the recommended time). Some studies were conducted on samples of adolescents, who practiced very few minutes, and a few tested eHealth interventions with heterogeneous adherence levels. In conclusion, some adaptations may be required so that patients with chronic pain can engage more easily and, thus, effectively in home meditation practices.

Keywords: adherence; chronic pain; home practice; meditation; mindfulness; systematic review; third wave psychotherapy.

PMID: 36901448 DOI: 10.3390/ijerph20054438