Adv Mind Body Med. 2022;36(1):4-12.
Preexisting patient characteristics may influence the outcome of mindfulness training, and a composite predictive index may be most informative in predicting outcome.
To develop a predictive index from baseline patient characteristics to determine which characteristics are associated with improvement following mindfulness-based stress reduction (MBSR) vs health education and to examine whether intreatment variables-reflecting adherence to the mindfulness intervention-predicted clinical outcome.
In a secondary data analysis, a composite moderator statistical approach created a predictive index from baseline participant characteristics that were associated with clinical global impressions improvement following intervention.
Data come from a 2-site, randomized controlled trial which took place in medical centers in St Louis, Missouri, and San Diego, California.
Included 103 older adults with anxiety and/or depressive disorders randomized to either 8 sessions of MBSR or health education classes.
MBSR was delivered in 8 sessions of 2 hours each by credentialed health care providers. The control condition consisted of health education classes designed to match the length and timing of the MBSR sessions.
The Clinical Global Impressions-Improvement scale was used to measure symptom improvement and was assigned by a blind rater.
The combined moderator approach generated a predictive index with a moderate effect size (0.46; 95% CI: 0.35, 0.57). Individuals who demonstrated improvement on the scale following MBSR were more likely to be younger, female, with lower psychological symptom severity, and less likely to have a diagnosis of depression or to be taking selective serotonin reuptake inhibitors.
Baseline characteristics predicted clinical response with MBSR in older adults. These predictive factors, if replicated and validated, could determine which patients are most likely to benefit from mindfulness training and lead to personalized strategies to maximize outcomes. The study was registered on ClinicalTrials.gov (identifier: NCT01693874).
患者的既往特征可能会影响正念训练的结果，而综合预测指标可能最能有效地预测结果。
从基线患者特征中构建一个预测指标，以确定哪些特征与正念减压（MBSR）与健康教育相比的改善相关，并检验治疗中反映对正念干预的依从性的变量是否预测临床结果。
在二次数据分析中，采用综合调节变量统计方法，从与干预后临床总体印象改善相关的基线参与者特征中构建一个预测指标。
数据来自于在密苏里州圣路易斯和加利福尼亚州圣地亚哥的两个医学中心进行的 2 个地点、随机对照试验。
包括 103 名患有焦虑和/或抑郁障碍的老年患者，随机分配至 8 节 MBSR 或健康教育课程。
由合格的医疗保健提供者提供 8 节 2 小时的 MBSR。对照组由旨在匹配 MBSR 课程时长和时间的健康教育课程组成。
使用临床总体印象-改善量表来衡量症状改善，并由盲法评估者进行评估。
综合调节方法产生了一个具有中等效应大小（0.46；95%CI：0.35，0.57）的预测指标。在 MBSR 后表现出改善的个体更有可能年轻、女性、心理症状严重程度较低，且不太可能被诊断为抑郁症或正在服用选择性 5-羟色胺再摄取抑制剂。
基线特征预测了老年患者接受 MBSR 的临床反应。如果这些预测因素得到复制和验证，它们可以确定哪些患者最有可能从正念训练中受益，并制定出最大化结果的个性化策略。该研究在 ClinicalTrials.gov 上注册（标识符：NCT01693874）。
