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Systematic Review and Meta-analysis: Mindfulness-Based Interventions for Rheumatoid Arthritis

  • Complementary and Alternative Medicine (S Kolasinski, Section Editor)
  • Published:
Current Rheumatology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

To determine the efficacy of mindfulness-based interventions (MBIs) on clinical and patient-reported outcomes in rheumatoid arthritis (RA).

Recent Findings

We identified randomized clinical trials from inception through April 2018 from MEDLINE, PsycINFO, EMBASE, CINAHL, Web of Science, the Cochrane Library, and hand searches. After screening 338 references, we included five trials with one post-hoc analysis that evaluated MBIs and collectively included 399 participants. Outcome instruments were heterogeneous across studies. Three studies evaluated RA clinical outcomes by a rheumatologist; one study found improvements in disease activity. A limited meta-analysis found no statistically significant difference in the levels of DAS28-CRP in the two studies that evaluated this metric (− 0.44 (− 0.99, 0.12); I2 0%). Four studies evaluated heterogeneous psychological outcomes, and all found improvements including depressive symptoms, psychological distress, and self-efficacy. A meta-analysis of pain Visual Analog Scale (VAS) levels post intervention from three included studies was not significantly different between MBI participants and control group (− 0.58 (− 1.26, 0.10); I2 0%) although other studies not included in meta-analysis found improvement.

Summary

There are few trials evaluating the effect of MBIs on outcomes in patients with RA. Preliminary findings suggest that MBIs may be a useful strategy to improve psychological distress in those with RA.

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Funding

Dr. DiRenzo is supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health under Award Number T32AR048522. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Authors and Affiliations

  1. Division of Rheumatology, Johns Hopkins University School of Medicine, 5200 Eastern Avenue, MFL Building, Center Tower, Suite 4100, Baltimore, MD, 21224, USA

    Dana DiRenzo, Monica Crespo-Bosque & Clifton O. Bingham III

  2. Department of Psychiatry and Behavioral Services, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Neda Gould & Patrick Finan

  3. Welch Medical Library, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Julie Nanavati

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  1. Dana DiRenzo
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  2. Monica Crespo-Bosque
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  3. Neda Gould
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  6. Clifton O. Bingham III
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Corresponding author

Correspondence to Dana DiRenzo.

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Conflicts of Interest

The authors declare that they have no conflict of interest. The protocol for this systematic review was registered at Prospero.org: 2018 CRD42018094717 (https://www.crd.york.ac.uk/prospero/).

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors

Additional information

This article is part of the Topical Collection on Complementary and Alternative Medicine

Appendix

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Table 4 Search Strategy
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Table 5 Risk of bias criteria
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DiRenzo, D., Crespo-Bosque, M., Gould, N. et al. Systematic Review and Meta-analysis: Mindfulness-Based Interventions for Rheumatoid Arthritis. Curr Rheumatol Rep 20, 75 (2018). https://doi.org/10.1007/s11926-018-0787-4

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