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Burgess DJ, Evans R, Calvert C, Campbell EM, Branson M, Allen KD, Bangerter A, Bronfort G, Cross LJ, Ferguson JE, Friedman JK, Haley AC, Mahaffey M, Mattias MS, Meis LA, Polusny MA, Serpa JG, Taylor SL, Taylor BC. Results from the Learning to Apply Mindfulness to Pain Study: A Pragmatic Clinical Trial. [Abstract]. Journal of Pain. 2024 Apr 12; 25(4):37, https://doi.org/10.1016/j.jpain.2024.01.172 Get rights and content.
Mindfulness-Based Interventions (MBIs) are evidence-based nonpharmacological treatments for pain. However, many MBIs have features that pose significant implementation barriers. This study compares two scalable approaches for delivering MBIs that address key patient- and system-level implementation barriers. Randomized pragmatic clinical trial with 12-month follow-up of 811 patients with moderate to severe chronic pain, recruited from three Veterans Affairs facilities. Mobile+Group Learning to Apply Mindfulness to Pain (LAMP) was delivered via videoconferencing and consisted of pre-recorded modules by a mindfulness instructor in a group setting, interspersed with discussions led by a facilitator. Mobile+Calls LAMP consisted of the same modules, was completed asynchronously by patients, and was supplemented by three individual facilitator calls. Both interventions were 8 weeks long and compared to Usual Care. The primary outcome was change in the Brief Pain Inventory interference score from baseline to 12 months (assessed at baseline, 10 weeks, 6 and 12 months). Secondary outcomes were changes in pain intensity, global improvement in pain, physical function, symptoms of anxiety, depression, and post-traumatic stress disorder, fatigue, sleep disturbance, participation in social roles/activities, and percentage reaching at least 30% improvement in pain interference. Both LAMP interventions resulted in significant reductions in pain interference compared to Usual Care over 12 months; similar results were observed for secondary outcomes. The two interventions performed similarly, except the Mobile+Calls group showed greater improvement on pain interference. Two novel, scalable approaches to delivering MBIs significantly reduced pain and biopsychosocial outcomes over the long-term in Veterans. Funding: Department of Defense, W81XWH-18-2-0003, ClinicalTrials.gov, #NCT04526158.
