OP0280-PARE A MINDFULNESS PROGRAM DOSING STUDY TO EVALUATE IMPROVEMENT IN EMOTIONAL DISTRESS AMONG PEOPLE WITH RHEUMATIC DISEASE
Authors: J. Thompson, N. Parikh, K. Gavigan, S. Venkatachalam, W. B. Nowell
Journal: Annals of the Rheumatic Diseases (2021)

Background: Mindfulness-based interventions for chronic pain and emotional distress have increased in popularity as complementary therapies among people living with rheumatic and musculoskeletal disease (RMD). 1,2 Despite growing evidence that mindfulness meditation reduces pain and anxiety associated with RMD, more research is needed to specify the optimal duration of mindfulness training necessary to be effective for short- and long-term benefit. Objectives: To evaluate and compare the effectiveness of full-length versus brief mindfulness training programs for improving anxiety among people living with RMD. Methods: Adult US participants (pts) within the ArthritisPower registry were invited to participate in the Healthy Mind Healthy You study comparing the effectiveness of two online mindfulness training programs of different lengths accessed via the MoodNetwork platform. The full-length mindfulness based cognitive therapy program lasted 8 weeks, while the brief evidence-based mindfulness program lasted 3 weeks. Pts were randomized to one of the two programs and completed assessments every two weeks during the program and then every four weeks during the 12-week follow-up period. Assessments included World Health Organization-Five Well-Being Index (WHO-5), Five Facet Mindfulness Questionnaire (FFMQ), Perceived Stress Scale (PSS), and two measures of emotional distress, PROMIS Short Forms for Anxiety and Depression. Analyses compared demographic characteristics and assessment scores by program length. Results: 324 pts completed assessments at baseline and 70 pts completed them at week 8, an attrition rate of 78% in each of the program arms. The majority of pts were female, White, with 67% between the ages of 45-64 years. No statistically significant differences were observed at baseline between participants randomized to each of the two programs, and in their assessment scores at week 8 (Table 1); PROMIS Anxiety and Depression scores improved from baseline to week 8 for pts in both programs (Figure 1). Overall, mean (SD) PROMIS Depression scores improved from 58.4 (7.7) at baseline to 55.4 (7.2) at week 8 (p=0.018), a meaningfully important difference, among the 70 pts reporting scores at both time points. Table 1. Assessment Scores at Baseline and Week 8, Mean (SD) Baseline Week 8 All (n=324 ) 8-week course (n=163 ) 3-week course (n=161 ) p-value All (n=70 ) 8-week course (n=35 ) 3-week course (n=35 ) p-value WHO-5 b 10.6 (4.9) 10.4 (4.8) 10.9 (5.0) 0.378 12.0 (5.1) 12.5 (5.5) 11.6 (4.7) 0.488 FFMQ c 42.7 (6.1) 42.7 (6.1) 42.7 (6.1) 0.932 39.2 (5.7) 38.9 (6.1) 39.4 (5.3) 0.741 PSS d 18.7 (7.5) 19.2 (6.8) 18.3 (8.2) 0.304 16.6 (7.3) 15.7 (7.8) 17.6 (6.8) 0.291 PROMIS Depression e 56.5 (8.3) 57.3 (8.0) 55.7 (8.6) 0.097 55.1 (8.5) 54.8 (9.3) 55.5 (7.8) 0.735 PROMIS Anxiety f 58.7 (8.2) 59.0 (8.2) 58.4 (8.1) 0.470 55.4 (7.2) 54.6 (7.4) 56.1 (7.1) 0.404 a denotes use of Fisher’s Exact Test b Range 0 (worse) to 25 (better), c Range 3 (worse) to 15 (better), d Range 0 (better) to 40 (worse), e Range 24.7 (better) to 63.5 (worse), f Range 25.7 (better) to 62.0 (worse) Conclusion: People living with RMD who are part of a real-world US registry are willing to participate in an online mindfulness training program study, but may require additional support to remain engaged and adherent throughout the program and to participate to study conclusion. Participation in a mindfulness training program, whether full-length or brief, appears to improve symptoms of emotional distress among people with RMD. References: [1]Zhou, B. et al. Comp. Ther. in Clin. Prac. 2020; 39:1-7 [2]Reiner, K. et al. Pain Medicine. 2013; 14(2): 230-242 Acknowledgements: The authors would like to thank ArthritisPower members for participating in the study, and the Healthy Mind Healthy You study team at Massachusetts General Hospital (see MoodNetwork.org) for leading it. The study was funded by the Patient-Centered Outcomes Research Institute (XPPRN-1512-33786). Disclosure of Interests: Julia Thompson: None declared, Nupur Parikh: None declared, Kelly Gavigan: None declared, Shilpa Venkatachalam: None declared, W. Benjamin Nowell Grant/research support from: Full-time employee of Global Healthy Living Foundation, an independent nonprofit organization, which has received funding to conduct research; Principal Investigator for studies with grant support from AbbVie, Amgen and Eli Lilly.