Virtual Mindfulness Therapy for the Management of Endometriosis Chronic Pelvic Pain: A Novel Delivery Platform to Increase Access to Care.

Abstract

<h3>Study Objective</h3> The objective of this study was to assess the effectiveness of virtual mindfulness-based stress reduction (MBSR) program to improve quality of life and pain in people with endometriosis. <h3>Design</h3> Mixed-methods before and after study design. <h3>Setting</h3> Urban Canadian tertiary-care centre. <h3>Patients or Participants</h3> Fifteen adult patients with a clinical or surgical diagnosis of endometriosis were recruited to participate through an outpatient academic gynecology clinic. Sample size was limited to fifteen to facilitate participation in the MBSR program. <h3>Interventions</h3> Patients participated in a virtual eight-week MBSR program run by an experienced social worker. Participants completed the Endometriosis Health Profile (EHP), a validated survey tool, and a pain medication use questionnaire before and after the program. A focus group was held upon completion of the program to assess participants experiences using mindfulness for the management of endometriosis-related chronic pelvic pain. <h3>Measurements and Main Results</h3> 67% of people enrolled completed the MBSR course (10/15). Following the MBSR program participants had a statistically significant decrease in four components of the EHP: control and powerlessness (p = 0.12), emotional well-being (p = 0.048), social support (p = 0.030), and self-image (p = 0.014). There was no change in pain scores or pain medication use. Based on the thematic analysis the participants felt the program's benefits came from a sense of community, education about their condition, and application of mindfulness tools when approaching pain. Participants felt more comfortable with the virtual format over in-person sessions. <h3>Conclusion</h3> A virtual MBSR course can improve quality of life domains in people with endometriosis but does not impact pain. Participants felt more comfortable in a virtual format, which has the potential to decrease some geographic barriers to care. Further research should focus on assessing this MBSR program in a randomized control trial.