Mindfulness-Based Stress Reduction for HIV Treatment Side Effects: A Randomized, Wait-List Controlled Trial

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• 作者：Larissa G. Duncan ; PhD^a ; Judith Tedlie Moskowitz ; PhD ; MPH^a ; Torsten B. Neilands ; PhD^b ; Samantha E. Dilworth ; MS^b ; Frederick M. Hecht ; MD^a ; Mallory O. Johnson ; PhD^b ; ^{Mallory.Johnson@ucsf.edu}
• 关键词：Mindfulness-Based Stress Reduction ; HIV ; antiretroviral therapy ; side effects ; symptoms ; adherence
• 刊名：Journal of Pain and Symptom Management
• 出版年：2012
• 出版时间：February 2012
• 年：2012
• 卷：43
• 期：2
• 页码：161-171
• 全文大小：457 K

文摘

Context

Advances in antiretroviral therapy (ART) for HIV offer life-extending benefit; however, the side effects associated with ART use negatively impact quality of life and medication adherence among people living with HIV.

Objectives

This study tested the efficacy of Mindfulness-Based Stress Reduction (MBSR) for reducing ART symptoms and bother/distress related to ART side effects. Secondary aims were to test the impact of MBSR on medication adherence and psychological functioning.

Methods

Seventy-six people living with HIV who were actively taking ART and reported distress from ART-related side effects were randomly assigned to an MBSR program or a wait-list control (WLC) standard care condition. We measured side effects, ART adherence, perceived stress, depression, positive and negative affect, and mindfulness at three time points: baseline, three-month follow-up, and six-month follow-up. Side effects and related distress were assessed separately from other symptoms.

Results

Compared with a WLC, participants in the MBSR condition experienced a reduction in the frequency of symptoms attributable to ARTs at three months post-intervention (mean difference = 0.33; 95 % confidence interval [CI] = 0.01, 0.66; t(132) = 2.04, P = 0.044) and six months post-intervention (mean difference = 0.38; 95 % CI = 0.05, 0.71; t(132) = 2.27, P = 0.025). MBSR participants also experienced a reduction in distress associated with those symptoms at three months post-intervention (mean difference = 0.47; 95 % CI = 0.003, 0.94; t(132) = 1.99, P = 0.048) compared with the WLC condition.

Conclusion

MBSR is a promising approach for reducing HIV treatment-related side effects.