Mindfulness is a Cost-Effective Treatment for Fibromyalgia
By John M. de Castro, Ph.D.
“Mindfulness as a practice of conscious meditation affects brain activity, achieving, on the one hand, deactivating the areas of negative pain assessment and, on the other, activating those related to the healing and resilience processes. In this way, it helps calm the sympathetic nervous system, which usually leads to reduced stress levels, on the one hand, and also the sensation of perceived pain.” – Andres Martin
Fibromyalgia is a mysterious disorder whose causes are unknown. It is very common affecting over 5 million people in the U.S., about 2% of the population with about 7 times more women affected than men. It is characterized by widespread pain, abnormal pain processing, sleep disturbance, and fatigue that lead to psychological distress. Fibromyalgia may also have morning stiffness, tingling or numbness in hands and feet, headaches, including migraines, irritable bowel syndrome, sleep disturbances, thinking and memory problems, and painful menstrual periods. The symptoms are so severe and debilitating that about half the patients are unable to perform routine daily functions and about a third have to stop work. Although it is not itself fatal, suicide rates are higher in fibromyalgia sufferers. Clearly, fibromyalgia greatly reduces the quality of life of its’ sufferers.
There are no completely effective treatments for fibromyalgia. Symptoms are generally treated with pain relievers, antidepressant drugs and exercise. But these only reduce the severity of the symptoms and do not treat the disease directly. Mindfulness practices have also been shown to be effective in reducing pain from fibromyalgia. Some of the effects of mindfulness practices are to alter thought processes, changing what is thought about. In terms of pain, mindfulness training, by focusing attention on the present moment has been shown to reduce worry and catastrophizing. Pain is increased by worry about the pain and the expectation of greater pain in the future. So, mindfulness may reduce worry and catastrophizing and thereby reduce fibromyalgia pain and improve the quality of life.
The effectiveness of mindfulness training for the treatment of fibromyalgia pain has been established. But whether it is cost-effective relative to other treatments has not been investigated. In today’s Research News article “Cost-Utility of Mindfulness-Based Stress Reduction for Fibromyalgia versus a Multicomponent Intervention and Usual Care: A 12-Month Randomized Controlled Trial (EUDAIMON Study).” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6678679/), Pérez-Aranda and colleagues examine the cost-effectiveness of Mindfulness-Based Stress Reduction (MBSR) training for the treatment of fibromyalgia.
They recruited adult fibromyalgia patients and continued treatment as usual. The patients were then randomly assigned to receive once a week for 2 hours for 8 weeks either Mindfulness-Based Stress Reduction (MBSR) or relaxation and Fibromyalgia education, or were assigned to receive no additional treatment as. The MBSR program consisted of meditation, yoga, body scan, and discussion. The patients were also encouraged to practice at home. They were measured before and after the intervention and 12 months later for health-related quality of life, current health status, medications, and health services.
They found that over the year following treatment there were significant increases in the patient’s quality of life and their current health status for the Mindfulness-Based Stress Reduction (MBSR) group but not for the fibromyalgia education or treatment as usual groups. In addition, there was a significant reduction in total healthcare costs including the costs of the interventions for the MBSR group only. The largest reduction in costs for the MBSR group was in primary healthcare costs. So, MBSR training reduced treatment costs and increased the health-related quality of life of the fibromyalgia patients. Hence, MBSR training is a safe, effective, and very cost effective treatment for fibromyalgia.
So, mindfulness is a cost-effective treatment for fibromyalgia.
CMCS – Center for Mindfulness and Contemplative Studies
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Study Summary
Pérez-Aranda, A., D’Amico, F., Feliu-Soler, A., McCracken, L. M., Peñarrubia-María, M. T., Andrés-Rodríguez, L., … Luciano, J. V. (2019). Cost-Utility of Mindfulness-Based Stress Reduction for Fibromyalgia versus a Multicomponent Intervention and Usual Care: A 12-Month Randomized Controlled Trial (EUDAIMON Study). Journal of clinical medicine, 8(7), 1068. doi:10.3390/jcm8071068
Abstract
Fibromyalgia (FM) is a prevalent, chronic, disabling, pain syndrome that implies high healthcare costs. Economic evaluations of potentially effective treatments for FM are needed. The aim of this study was to analyze the cost–utility of Mindfulness-Based Stress Reduction (MBSR) as an add-on to treatment-as-usual (TAU) for patients with FM compared to an adjuvant multicomponent intervention (“FibroQoL”) and to TAU. We performed an economic evaluation alongside a 12 month, randomized, controlled trial; data from 204 (68 per study arm) of the 225 patients (90.1%) were included in the cost–utility analyses, which were conducted both under the government and the public healthcare system perspectives. The main outcome measures were the EuroQol (EQ-5D-5L) for assessing Quality-Adjusted Life Years (QALYs) and improvements in health-related quality of life, and the Client Service Receipt Inventory (CSRI) for estimating direct and indirect costs. Incremental cost-effectiveness ratios (ICERs) were also calculated. Two sensitivity analyses (intention-to-treat, ITT, and per protocol, PPA) were conducted. The results indicated that MBSR achieved a significant reduction in costs compared to the other study arms (p < 0.05 in the completers sample), especially in terms of indirect costs and primary healthcare services. It also produced a significant incremental effect compared to TAU in the ITT sample (ΔQALYs = 0.053, p < 0.05, where QALYs represents quality-adjusted life years). Overall, our findings support the efficiency of MBSR over FibroQoL and TAU specifically within a Spanish public healthcare context.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6678679/