A systematic review and meta-analysis exploring the efficacy of mindfulness-based interventions on quality of life in people with multiple sclerosis

Abstract

Background Quality of life (QoL) is commonly impaired among people with multiple sclerosis (PwMS). The aim of this study was to evaluate via meta-analysis the efficacy of Mindfulness-based interventions (MBIs) for improving QoL in PwMS. Methods Eligible randomized controlled trials (RCTs) were identified via searching six major electronic databases (MEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, AMED, and PsycINFO) in April 2022. The primary outcome was QoL. Study quality was determined using the Cochrane Collaboration risk of bias tool. Meta-analysis using a random effects model was undertaken. Effect sizes are reported as Standardized Mean Difference (SMD). Prospero ID: 139835. Results From a total of 1312 individual studies, 14 RCTs were eligible for inclusion in the meta-analysis, total participant n = 937. Most studies included PwMS who remained ambulatory. Cognitively impaired PwMS were largely excluded. Comorbidities were inconsistently reported. Most MBIs were delivered face-to face in group format, but five were online. Eight studies (n = 8) measured MS-specific QoL. In meta-analysis, overall effect size (SMD) for any QoL measure (n = 14) was 0.40 (0.18–0.61), p = 0.0003, I2 = 52%. SMD for MS-specific QoL measures (n = 8) was 0.39 (0.21–0.57), p < 0.0001, I2 = 0%. MBI effect was largest on subscale measures of mental QoL (n = 8), SMD 0.70 (0.33–1.06), p = 0.0002, I2 = 63%. Adverse events were infrequently reported. Conclusions MBIs effectively improve QoL in PwMS. The greatest benefits are on mental health-related QoL. However, more research is needed to characterize optimal formatting, mechanisms of action, and effects in PwMS with more diverse social, educational, and clinical backgrounds.

Improved quality of life and psychological symptoms following mindfulness and cognitive rehabilitation in multiple sclerosis and their mediating role for cognition: a randomized controlled trial

“…This study shows that MBCT reduced a wide variety of self-reported psychological symptoms directly following treatment completion, including depressive symptoms, fatigue and brooding, of which the latter is a central target of mindfulness interventions. These small-to-moderate effects are in accordance with previous mindfulness-based studies [13], but we extend these findings by revealing the feasibility and effectiveness of MBCT within a sample that encompasses cognitively impaired patients. Patients with cognitive impairments are generally not included in previous studies [13], whereas our sample included 57% of these patients.…”

Mindfulness, Gut‐Brain Axis and Health Related Quality of Life: The Paradigm of IBD Patients

“…Firstly, among healthy participants, there is a moderate correlation between HRQoL and mindfulness, indicating that individuals with higher levels of mindfulness tend to report better overall well-being. This aligns with previous research demonstrating the positive impact of mindfulness on various aspects of health and quality of life [36][37][38]. Similarly, the low correlation between HRQoL and adherence to the Mediterranean Diet suggests that while diet may influence certain dimensions of well-being, its association with overall quality of life may be less pronounced.…”

Esclerose múltipla e qualidade de vida: abordagens para a inclusão do bem-estar

“…Já as intervenções baseadas em mindfulness, ou terapias de mindfulness, auxiliam na saúde mental dos pacientes, principalmente no quesito depressão, uma vez que é trabalhado e desenvolvido nos pacientes portadores de EM a aceitação, autoeficácia e autocompaixão (SIMPSON et al, 2023).…”