How effective is mindfulness meditation programs in improving stress-related outcomes among patients with stress-related chronic disease diagnosis.
Date of publication of the systematic review: March 2014
Design
Systematic review of 47 randomized controlled trials (RCTs).
Participants
3320 adults (mean age range: not reported, male % range: not reported) with clinical (medical or psychiatric) diagnosis of any chronic condition (e.g. high blood pressure, anxiety) as a stressor.
Intervention
Mindfulness meditation programs including mindfulness-based programs (Mindfulness-Based Stress Reduction, Mindfulness-Based Cognitive Therapy, Vipassana, Zen, and other mindfulness meditation) or mantra-based programs (Transcendental Meditation and other mantra meditation) or other meditation programs.
Comparator
Comparison 1: Mindfulness meditation programs versus non-specific active control (education and attention control).
Major Outcomes
Outcome 1: Anxiety, measured at 8 weeks and 3-6 months;
Outcome 2: Depression, measured at 8 weeks and 3-6 months;
Outcome 3: Pain. The reviewers did not state the time of measurement.
Settings
The reviewers did not specify whether the included studies were conducted in inpatient or outpatient settings.
Comparison    Mindfulness meditation programs versus non-specific active control
Main Results
Mindfulness meditation programs had shown significant impact on reducing anxiety (at 8 week, effect size: 0.38, 95% Cl: 0.12 to 0.64; at 3-6 months, effect size: 0.22, 95% Cl: 0.02 to 0.43), depression (at 8 week, effect size:0.30, 95% Cl: 0.00 to 0.59; at 3-6 months, effect size: 0.23, 95% Cl: 0.05 to 0.42) and pain (effect size: 0.33, 95% Cl: 0.03 to 0.62) among patients with stress related to a chronic disease diagnosis.
Comparison 1: Mindfulness meditation programs versus non-specific active control in patients with stress-related chronic disease
Outcomes No. of studies (Total no. of participants) Mean score/ No. of participants Heterogeneity test (I2) Effect size (95% CI) Overall quality of evidence*
Intervention Comparator
1 11 (884) Not reported Not reported Not reported 8 week: 0.38 (0.12 to 0.64) 3-6 months: 0.22 (0.02 to 0.43) High
2 15 (1246) Not reported Not reported Not reported 8 week: 0.30 (0.00 to 0.59) 3-6 months: 0.23 (0.05 to 0.42) High
3 5 (364) Not reported Not reported Not reported 0.33 (0.03 to 0.62) Moderate
Keys: CI: confidence interval.
Comparison    Mindfulness meditation programs versus non-specific active control
Main Results
Mindfulness meditation programs had shown significant impact on reducing anxiety (at 8 week, effect size: 0.38, 95% Cl: 0.12 to 0.64; at 3-6 months, effect size: 0.22, 95% Cl: 0.02 to 0.43), depression (at 8 week, effect size:0.30, 95% Cl: 0.00 to 0.59; at 3-6 months, effect size: 0.23, 95% Cl: 0.05 to 0.42) and pain (effect size: 0.33, 95% Cl: 0.03 to 0.62) among patients with stress related to a chronic disease diagnosis.
Comparison 1: Mindfulness meditation programs versus non-specific active control in patients with stress-related chronic disease
Outcomes 1 2 3
No. of studies (Total no. of participants) 11 (884) 15 (1246) 5 (364)
Mean score/ No. of participants Intervention Not reported Not reported Not reported
Comparator Not reported Not reported Not reported
Effect size (95% CI) 8 week: 0.38 (0.12 to 0.64) 3-6 months: 0.22 (0.02 to 0.43) 8 week: 0.30 (0.00 to 0.59) 3-6 months: 0.23 (0.05 to 0.42) 0.33 (0.03 to 0.62)
Overall quality of evidence* High High Moderate
Keys: CI: confidence interval.
Conclusion
Benefits
Mindfulness meditation programs significantly improve anxiety, depression and pain in patients with clinically diagnosed stressor, compared to non-specific active control programs. For Outcome 1, the the overall quality of evidence is high. Further research is unlikely to have an important impact on our confidence in this estimate of effect. For Outcome 2, the the overall quality of evidence is high. Further research is unlikely to have an important impact on our confidence in this estimate of effect. For Outcome 3, the overall quality of evidence is moderate. Further research is fairly likely to have an important impact on our confidence in this estimate of effect.
Harms
No adverse events were reported.
Link to Original Article
https://www.ncbi.nlm.nih.gov/pubmed/24395196
The synopsis is based on the following article:
Goyal M, Singh S, Sibinga EM, Gould NF, Rowland-Seymour A, Sharma R, et al. Meditation programs for psychological stress and well-being: a systematic review and meta-analysis. JAMA Internal Medicine. 2014 Mar 1;174(3):357-68.


* Interpretation of quality assessment results:
• Very low: Further research is most likely to have an important impact on our confidence in this estimate of effect.
• Low: Further research is likely to have an important impact on our confidence in this estimate of effect.
• Moderate: Further research is fairly likely to have an important impact on our confidence in this estimate of effect.
• High: Further research is unlikely to have an important impact on our confidence in this estimate of effect.
• Very high: Further research is most unlikely to have an important impact on our confidence in this estimate of effect.

Details of assessment method can be found at Chung VC, Wu XY, Ziea ET, Ng BF, Wong SY, Wu JC. Assessing internal validity of clinical evidence on effectiveness of CHinese and integrative medicine: Proposed framework for a CHinese and Integrative Medicine Evidence RAting System (CHIMERAS). European Journal of Integrative Medicine. 2015 Aug 31;7(4):332-41.