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Attrition Rates in Mindfulness-Based Interventions for Chronic Pain: A Meta-Analysis With Meta-Regression.

Michael Yufeng Wang1, M Prabhavi N Perera2,3, Paul B Fitzgerald2,3

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The Clinical Journal of Pain
|November 18, 2025
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Summary
This summary is machine-generated.

Mindfulness-based interventions for chronic pain have a 30.1% attrition rate. Stricter completion criteria, online delivery, and individual formats increase participant withdrawal from these pain management programs.

Keywords:
attritionmindfulnesspain

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Area of Science:

  • Pain Management
  • Behavioral Medicine
  • Psychological Interventions

Background:

  • Mindfulness-based interventions (MBIs) show promise for chronic pain management.
  • High attrition rates and concerns about acceptability limit MBI effectiveness.
  • Substantial time commitments are often required for MBIs.

Purpose of the Study:

  • To evaluate attrition rates in MBIs for chronic pain.
  • To identify moderators contributing to participant withdrawal in MBIs for pain.
  • To assess the impact of program characteristics on MBI adherence.

Main Methods:

  • Systematic review and meta-analysis following PRISMA guidelines.
  • Inclusion of randomized controlled trials, controlled trials, and quasi-experimental studies reporting attrition data.
  • Random-effects meta-analyses of proportions, meta-regression, and sensitivity analyses were performed.

Main Results:

  • The pooled attrition rate for MBIs in chronic pain was 30.1% across 44 studies.
  • Higher attrition was linked to stricter completion thresholds (49.7% for >6 sessions vs. 18.0% for 3-4 sessions).
  • Online delivery (51.0%) and individual formats (higher attrition) showed greater withdrawal than in-person (25.6%) and group formats.

Conclusions:

  • Attrition rates in MBIs for chronic pain are substantial and variable.
  • Optimizing MBI program structure is crucial for improving adherence and pain management outcomes.
  • Factors such as delivery format and completion requirements significantly influence participant retention.