Web- and Mindfulness-Based Intervention to Prevent Chronic Pain After Cardiac Surgery: Protocol for a Pilot Randomized Controlled Trial.
Geraldine Martorella, Adam W. Hanley, Scott M. Pickett, Céline Gelinas
JMIR Research Protocols August 30, 2021 DOI: 10.2196/30951 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial protocol Double-blind Peer reviewed |
|---|---|
| Sample size | 32 |
| Population | Adults aged 18 years or older undergoing first-time elective cardiac surgery via median sternotomy, with worst pain in the past week of at least 4/10, able to complete questionnaires in English and use an electronic device |
| Interventions | Mindfulness-based cognitive therapy (MBCT) web-based educational session |
| Duration | 4-week intervention; 6-month follow-up after surgery |
| Topics | Meditation |
| Keywords | Cardiac surgery Chronic pain Mobile phone Postoperative pain Web-based |
| Key findings | The protocol proposes that a 4-week web-based MBCT intervention is feasible and acceptable for adults recovering from cardiac surgery and may show preliminary effects on pain intensity, pain interference, opioid use, pain acceptance, and catastrophic thoughts over 6 months. The authors state this is the first study to assess MBCT for preventing chronic postsurgical pain after cardiac surgery during the recovery phase. |
Abstract
Cardiac surgery is a frequently performed procedure. However, pain after cardiac surgery may become chronic (lasting >3 months) in adults. Once discharged from the hospital, patients are at greater risk of developing chronic postsurgical pain (CPSP) and of prolonged opioid use, as they need to self-manage their pain. Psychological risk and protective factors such as pain-related catastrophic thoughts and pain acceptance determine their ability to cope and their use of opioids, which is crucial for self-management of pain. Studies on mindfulness-based cognitive therapy (MBCT) have multiplied their potential effects on pain acceptance and catastrophic thoughts. However, web-based MBCT for the prevention of CPSP has not yet been examined. The aim of this study is to pilot test a 4-week-long web-based MBCT intervention for adults following discharge from the hospital by assessing the acceptability or feasibility of the intervention and examining preliminary effects on pain intensity, pain interference with activities and opioid use, and pain acceptance and catastrophic thoughts in the 6 months following surgery. A double-blinded pilot randomized controlled trial will be used to assess a web-based MBCT intervention. Patients will be selected according to the following criteria: age ≥18 years; first-time elective cardiac surgery via a median sternotomy; worst pain in the past week score ≥4/10; ability to understand and complete questionnaires in English; and ability to use an electronic device such as a smartphone, computer, or tablet. After baseline measures, 32 participants will be randomized into two groups: one receiving both the brief, 4-week-long web-based MBCT intervention and usual care (experimental group) and the other receiving only one standardized, web-based educational session with weekly reminders and usual care (attention control group). Peer-reviewed competitive funding was received from Florida State University's Council on Research & Creativity in January 2021, as well as research ethics approval from Florida State University's institutional review board. Recruitment began in June 2021. Unfortunately, because of the current COVID-19 pandemic, recruitment is not progressing as expected. Recruitment strategies are constantly monitored and updated according to latest data and restrictions surrounding the pandemic. This research is significant because it targets the trajectory of CPSP, a leading cause of disability and opioid misuse. This is the first study to assess MBCT for the prevention of CPSP after cardiac surgery in the recovery phase. This approach is innovative because it promotes self-management of pain through the modulation of individual factors. If successful, the intervention could be expanded to numerous populations at risk of chronic pain. DERR1-10.2196/30951.
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 |
Citations in the library
Cited by 3
- Meditation for the primary and secondary prevention of cardiovascular disease. Cochrane Database of Systematic Reviews February 15, 2024
- Mindful breathing for cancer pain: efficacy of a single 20-minute session - a randomised controlled study. BMJ Supportive & Palliative Care August 20, 2024
- Online Mindfulness-Based Cognitive Therapy for People with Parkinson's Disease and Their Caregivers: a Pilot Study. Journal of Technology in Behavioral Science 2022
Cites 14
- Meditation Programs for Psychological Stress and Well-being JAMA Internal Medicine January 6, 2014
- To be mindful of the breath or pain: Comparing two brief preoperative mindfulness techniques for total joint arthroplasty patients. Journal of Consulting and Clinical Psychology June 24, 2021
- The efficacy of mindfulness-based interventions in acute pain: a systematic review and meta-analysis Pain August 1, 2020
- A Pilot Randomized Controlled Trial Comparing Mindfulness Meditation, Cognitive Therapy, and Mindfulness-Based Cognitive Therapy for Chronic Low Back Pain Pain Medicine November 1, 2019
- Brief Mindfulness-Based Interventions for Acute and Chronic Pain: A Systematic Review The Journal of Alternative and Complementary Medicine March 1, 2019
and 9 more in the library