Mindfulness-Based Group Medical Visits for Persons With Chronic Low Back Pain: A Randomized Clinical Trial.

Area of Science:

• Integrative Medicine
• Behavioral Medicine
• Clinical Trial Research

Background:

• Chronic low back pain (CLBP) is a prevalent and costly condition in primary care.
• Current treatments for CLBP often yield inadequate relief.
• Mindfulness interventions show promise for CLBP but are underutilized in outpatient settings.

Purpose of the Study:

• To evaluate the effectiveness of a telehealth-delivered mindfulness group medical visit intervention for CLBP.
• To compare pain intensity and interference in CLBP patients receiving mindfulness intervention versus usual care.

Main Methods:

• A pragmatic randomized clinical trial (OPTIMUM) involving adults with CLBP.
• Participants were randomized to an 8-week telehealth mindfulness group medical visit or usual care.
• The primary outcome was the change in the Pain, Enjoyment of Life and General Activity (PEG) scale score at 6 months.

Main Results:

• The mindfulness intervention group showed statistically significant improvements in PEG scores at 8 weeks, 6 months, and 12 months compared to the usual care group.
• Between-group differences in PEG score improvements were -0.62 at 6 months (P=.002), -0.89 at 8 weeks (P<.001), and -0.74 at 12 months (P<.001).
• The prespecified minimal clinically important difference (MCID) of 1 point was not met at any time point.

Conclusions:

• A telehealth mindfulness group medical visit program significantly reduced pain intensity and interference in CLBP patients.
• While statistically significant, the observed improvements did not reach the MCID, indicating a need for further optimization.
• The accessible and scalable nature of this nonpharmacologic intervention warrants consideration for CLBP management.