Moderators of the Effects of Telehealth Mindfulness-Based Interventions for Chronic Pain: a Randomized Controlled Trial

Calvert C, Campbell EH, Cross L, Bangerter A, Allen K, Bronfort G, Evans R, Meis L, Haley A, Matthias M, Polusny M, Taylor B, Taylor SL, Ferguson J, Burggess D. Moderators of the Effects of Telehealth Mindfulness-Based Interventions for Chronic Pain: a Randomized Controlled Trial. Journal of Pain. 2025 Apr 1; 29(105044):DOI:10.1016/j.jpain.2025.105044.

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• RCS 23-082 – HSR&D Research Career Scientist Award

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Abstract:

Little is known about who benefits most from Mindfulness-Based Interventions (MBIs), and whether certain groups differentially benefit from different types of MBI formats (group-based versus non-group based). The present study uses data from a three-arm randomized controlled trial of two MBIs (self-paced and group) to test for moderating effects by gender and diagnoses of three mental health conditions (depression, anxiety, and post-traumatic stress disorder).The sample consisted of 811 veterans with moderate to severe chronic pain, recruited from three Veterans Affairs (VA) sites from 2020 to 2022. Survey data were collected at baseline and three follow-up timepoints (10 weeks, 6 months, and 12 months). Outcomes were indicators of 30% or greater improvement from baseline in pain interference, pain intensity, anxiety, depression, PTSD, fatigue, sleep disturbance, physical function, and social functioning. A difference of 10 percentage points in intervention effect across moderator subgroups was deemed as a potentially meaningful difference.The group MBI and self-paced MBI arms had higher rates of improvement in all outcomes compared to usual care. Potentially meaningful differences were found for gender and anxiety diagnosis. In the group MBI, women had greater improvement in pain severity and depression than men, and those with anxiety diagnoses had less improvement in PTSD than those without anxiety. In the self-paced arm, those with anxiety had greater improvement in depression than those without anxiety.Certain subgroups of veterans differentially benefitted from different types of MBIs. Further research is needed to more systematically determine whether MBIs can be optimized for key subgroups