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针对成瘾行为、精神困扰和慢性疼痛的正念导向康复强化:随机对照试验的多层次荟萃分析

Mindfulness-Oriented Recovery Enhancement for Addictive Behavior, Psychiatric Distress, and Chronic Pain: A Multilevel Meta-Analysis of Randomized Controlled Trials.

作者信息

Parisi Anna, Roberts R Lynae, Hanley Adam W, Garland Eric L

机构信息

Center On Mindfulness and Integrative Health Intervention Development, University of Utah, 395 South, 1500 East, Salt Lake City, UT 84112 USA.

Veterans Health Care Administration VISN 19 Whole Health Flagship Site Located at the VA Salt Lake City Health Care System, Salt Lake City, UT USA.

出版信息

Mindfulness (N Y). 2022;13(10):2396-2412. doi: 10.1007/s12671-022-01964-x. Epub 2022 Sep 15.

Abstract

OBJECTIVES

Mindfulness-Oriented Recovery Enhancement (MORE) is an integrative intervention designed to ameliorate addiction, chronic pain, and psychiatric symptoms. Although multiple randomized controlled trials (RCTs) have examined the clinical efficacy of MORE, no study has quantitatively synthesized this body of research. Thus, we conducted a meta-analysis of RCTs examining the effects of MORE on addictive behaviors, craving, opioid dose, pain, and psychiatric symptoms.

METHODS

Relevant manuscripts were identified through comprehensive searches of four bibliographic databases. Two- and three-level random-effects models were used to generate synthesized effect size estimates, and meta-regressions were performed to examine whether study and sample characteristics influenced the magnitude of aggregate effect sizes.

RESULTS

Our search identified 16 manuscripts reporting data from eight RCTs ( = 816). Moderate to small effects in favor of MORE were observed for addictive behaviors (SMC =  - .54,  = .007), craving (SMC =  - .42,  = .010), opioid dose (MC =  - 17.95,  < .001), chronic pain (SMC =  - .60,  < .001), and psychiatric symptoms (SMC =  - .34,  < .001). MORE's effects on psychiatric symptoms and craving were not moderated by participant race, gender, age, or income.

CONCLUSIONS

Study findings provide empirical evidence of MORE's efficacy for a wide diversity of individuals, and as such, MORE should now be disseminated broadly throughout the healthcare system.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s12671-022-01964-x.

摘要

目的

以正念为导向的康复强化疗法(MORE)是一种综合干预措施,旨在改善成瘾、慢性疼痛和精神症状。尽管多项随机对照试验(RCT)已对MORE的临床疗效进行了研究,但尚无研究对这一系列研究进行定量综合分析。因此,我们对RCT进行了荟萃分析,以研究MORE对成瘾行为、渴望、阿片类药物剂量、疼痛和精神症状的影响。

方法

通过全面检索四个文献数据库确定相关手稿。采用二级和三级随机效应模型生成综合效应量估计值,并进行荟萃回归分析,以检验研究和样本特征是否影响总体效应量的大小。

结果

我们的检索确定了16篇手稿,报告了来自8项RCT的数据(n = 816)。在成瘾行为(标准化均数差[SMC] = -0.54,P = 0.007)、渴望(SMC = -0.42,P = 0.010)、阿片类药物剂量(均数差[MC] = -17.95,P < 0.001)、慢性疼痛(SMC = -0.60,P < 0.001)和精神症状(SMC = -0.34,P < 0.001)方面,观察到有利于MORE的中度至小效应。MORE对精神症状和渴望的影响不受参与者种族、性别、年龄或收入的调节。

结论

研究结果为MORE对广泛个体的疗效提供了实证证据,因此,MORE现在应在整个医疗系统中广泛传播。

补充信息

在线版本包含可在10.1007/s12671-022-01964-x获取的补充材料。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b6bf/9476401/33e064024c89/12671_2022_1964_Fig1_HTML.jpg

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