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Garland EL;Baker AK;Larsen P;Riquino MR;Priddy SE; Randomized Controlled Trial of Brief Mindfulness Training and Hypnotic Suggestion for Acute Pain Relief in the Hospital Setting. J Gen Intern Med. 2017 Jul 12. doi: 10.1007/s11606-017-4116-9.
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Psychologist 7 / 7
Physician 5 / 7
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Abstract

BACKGROUND: Medical management of acute pain among hospital inpatients may be enhanced by mind-body interventions.

OBJECTIVE: We hypothesized that a single, scripted session of mindfulness training focused on acceptance of pain or hypnotic suggestion focused on changing pain sensations through imagery would significantly reduce acute pain intensity and unpleasantness compared to a psychoeducation pain coping control. We also hypothesized that mindfulness and suggestion would produce significant improvements in secondary outcomes including relaxation, pleasant body sensations, anxiety, and desire for opioids, compared to the control condition.

METHODS: This three-arm, parallel-group randomized controlled trial conducted at a university-based hospital examined the acute effects of 15-min psychosocial interventions (mindfulness, hypnotic suggestion, psychoeducation) on adult inpatients reporting "intolerable pain" or "inadequate pain control." Participants (N = 244) were assigned to one of three intervention conditions: mindfulness (n = 86), suggestion (n = 73), or psychoeducation (n = 85).

KEY RESULTS: Participants in the mind-body interventions reported significantly lower baseline-adjusted pain intensity post-intervention than those assigned to psychoeducation (p < 0.001, percentage pain reduction: mindfulness = 23%, suggestion = 29%, education = 9%), and lower baseline-adjusted pain unpleasantness (p < 0.001). Intervention conditions differed significantly with regard to relaxation (p < 0.001), pleasurable body sensations (p = 0.001), and desire for opioids (p = 0.015), but all three interventions were associated with a significant reduction in anxiety (p < 0.001).

CONCLUSIONS: Brief, single-session mind-body interventions delivered by hospital social workers led to clinically significant improvements in pain and related outcomes, suggesting that such interventions may be useful adjuncts to medical pain management.

TRIAL REGISTRATION: Trial Registry: ClinicalTrials.gov ; registration ID number: NCT02590029 URL: https://clinicaltrials.gov/ct2/show/NCT02590029.

Comments from MORE raters

Physician rater

These are interesting result, but not yet ready for broad implementation. This inpatient intervention would need to be replicated in another setting, and clinicians would also want to know that such as brief intervention has some persistence. The current study only examined immediate benefit.

Psychologist rater

As a clinical/rehabilitation psychologist working with individuals suffering from pain, this article proposes techniques (mindfulness) which even when administered for a brief period of time, 15 minutes, and without a great deal of training of the counsellors, were effective in controlling pain when given directions as to how to relax, reframe their perception of the event (pain). Evidently, more research is needed, but undoubtedly this may have a positive impact on reducing pain medication and in patient's quality of life.
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