Mindfulness Group Visits for Chronic Low Back Pain in Primary Care: The OPTIMUM Pragmatic Clinical Trial
Natalia E. Morone, Tra Nguyen, Keturah R Faurot, Susan A Gaylord, Kathleen McTigue, Kristina Astone, Janice M Weinberg, Carol M. Greco
Innovation in Aging December 1, 2025 DOI: 10.1093/geroni/igaf122.2126 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 451 |
| Population | Primary care patients with chronic low back pain across three sites; mean age 52.1 years, 70% female, 39% Black, 45% White |
| Intervention | usual medical care |
| Duration | 8-session program; follow-up at week 8 and 6 and 12 months |
| Measures | PEG (Pain intensity, Enjoyment, General Activity) |
| Topics | Meditation |
| Key findings | The OPTIMUM trial reports that it successfully enrolled and retained primary care patients with chronic low back pain in a telehealth group mindfulness program, with 89% retention at 12-month follow-up. The authors state the program holds promise for integration into routine primary care medicine. |
Abstract
Abstract Mindfulness is recommended as a first-line non-pharmacologic treatment for chronic low back pain (cLBP). However, accessibility is challenging. The OPTIMUM trial (Optimizing Pain Treatment In Medical settings Using Mindfulness) compared a telehealth-delivered group mindfulness program for primary care patients with cLBP to usual care. Here we describe the methods of this investigation, and report on baseline sample characteristics, intervention acceptability, and retention. The intervention is an 8-session program based upon Mindfulness-Based Stress Reduction (MBSR) led by an experienced MBSR instructor and co-led by a primary care provider who participated in sessions and met briefly with each participant. 451 adults with cLBP were randomized to the intervention or to usual medical care, across three sites. The primary outcome was the PEG (Pain intensity, Enjoyment, General Activity). Participants also completed measures of physical and psychological function, medications, and healthcare utilization, at baseline, week-8, and 6- and 12-months. Participants’ mean age=52.1 years (SD 14.7), 315 (70%) female, 176 (39%) are Black, 202 (45%) White, 253 (56%) not employed, 140 (31%) income < $25,000, 332 (74%) have pain ≥ 5 years duration. Participants’ pain intensity/pain interference was moderate at baseline, with PEG score=6 (SD 2.4). Retention was 89% at 12-month follow-up. OPTIMUM successfully enrolled and retained primary care patients with cLBP into a telehealth group mindfulness program. The program holds promise for integration into routine primary care medicine.
Comparable studies
Other randomized controlled trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Alterations in Brain and Immune Function Produced by Mindfulness Meditation Healthy employees in a work environment | 2003 | Randomized controlled trial | n = 41 |
| Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Recovered recurrently depressed patients | 2000 | Randomized controlled trial | n = 145 |
| Open hearts build lives: Positive emotions, induced through loving-kindness meditation, build consequential personal resources. Working adults | 2008 | Randomized controlled trial | n = 139 |
| Short-term meditation training improves attention and self-regulation Undergraduate Chinese students | 2007 | Randomized controlled trial | n = 40 |
| Mindfulness-Based Cognitive Therapy for Depression: Replication and Exploration of Differential Relapse Prevention Effects. Recovered recurrently depressed patients | 2004 | Randomized controlled trial | n = 73 |