Interactions between analgesic drug therapy and mindfulness-based interventions for chronic pain in adults: protocol for a systematic scoping review

Rex Park; Mohammed Mohiuddin; Patricia Poulin; Tim Salomons; Robert Edwards; Howard Nathan; Chris Haley; Ian Gilron

doi:10.1097/PR9.0000000000000793

Interactions between analgesic drug therapy and mindfulness-based interventions for chronic pain in adults: protocol for a systematic scoping review

Pain Rep. 2019 Nov 21;4(6):e793. doi: 10.1097/PR9.0000000000000793. eCollection 2019 Nov-Dec.

Authors

Rex Park¹, Mohammed Mohiuddin¹, Patricia Poulin², Tim Salomons^{3

4}, Robert Edwards⁵, Howard Nathan², Chris Haley¹, Ian Gilron^{1

6

4

7}

Affiliations

¹ Department of Anesthesiology and Perioperative Medicine, Kingston General Hospital, Queen's University, Kingston, ON, Canada.
² Department of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, ON, Canada.
³ Department of Psychology, Queen's University, Kingston, ON, Canada.
⁴ Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada.
⁵ Department of Anesthesiology, Harvard University, Boston, MA, USA.
⁶ Department of Biomedical and Molecular Sciences.
⁷ School of Policy Studies, Queen's University, Kingston, ON, Canada.

Abstract

Introduction: Most current chronic pain treatment strategies have limitations in effectiveness and tolerability, and accumulating evidence points to the added benefits of rational combinations of different therapies. However, most published clinical trials of treatment combinations have involved combinations of 2 drugs, whereas very little research has been performed to characterize interactions between drug and nondrug interventions. Mindfulness-based interventions (MBIs) have been emerging as a safe and potentially effective treatment option in the management of chronic pain, but it is unclear how MBIs can and should be integrated with various other pain treatment interventions. Thus, we seek to review available clinical trials of MBIs for chronic pain to evaluate available evidence on the interactions between MBIs and various pharmacological treatments.

Methods: A detailed search of trials of MBIs for the treatment of chronic pain in adults will be conducted on the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, and PsycINFO from their inception until the date the searches are run to identify relevant randomized controlled trials. Primary outcomes will include the following: (1) what concomitant analgesic drug therapies (CADTs) were allowed; (2) if and how trials controlled for CADTs and analyzed their interaction; and (3) results of available analyses of interactions between the MBI and CADT.

Perspective: This review is expected to synthesize available evidence describing the interactions between MBIs and various studied drug therapies for chronic pain. Available evidence may help inform the rational integration of MBIs with drug therapy for chronic pain.

Keywords: Analgesic therapy; Chronic pain; Clinical trials; Meditation; Mindfulness; Systematic review.