Telehealth Mindfulness Program Improves Outcomes in Chronic Low Back Pain: JAMA
USA: Researchers have found in a randomized clinical trial that a telehealth-delivered mindfulness group medical visit program for individuals with chronic low back pain (CLBP) led to significant improvements in pain intensity and pain interference compared with usual care. However, the improvements did not reach the prespecified minimum clinically important difference (MCID) of 1 point between groups.
The program, which incorporated primary care clinicians, was accessible and demonstrated potential as a scalable, nonpharmacologic treatment approach for managing chronic low back pain.
The findings, published in JAMA Internal Medicine, were led by Natalia E. Morone from the Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, and colleagues.
Chronic low back pain is one of the leading causes of disability worldwide and remains a common reason for primary care visits. Although mindfulness-based interventions have shown promise in reducing chronic pain, their use in routine clinical practice has been limited because they are rarely integrated into standard primary care. To address this gap, researchers evaluated whether delivering a structured mindfulness program through telehealth as part of routine primary care could improve pain outcomes in patients with chronic low back pain.
The Optimizing Pain Treatment in Medical Settings Using Mindfulness (OPTIMUM) trial was conducted between May 2021 and November 2024 across primary care clinics in Massachusetts, Pennsylvania, and North Carolina. A total of 451 adults with chronic low back pain were enrolled and randomly assigned to either an 8-week telehealth-delivered mindfulness group medical visit program integrated into primary care (224 participants) or to receive usual care (227 participants). All participants reported moderate pain interference at the start of the study.
Key findings
- At 6 months, participants in the mindfulness group experienced a significantly greater improvement in Pain, Enjoyment of Life, and General Activity (PEG) scores than those receiving usual care (between-group difference: −0.62).
- Significant improvements were also observed at 8 weeks (between-group difference: −0.89) and 12 months (between-group difference: −0.74).
- Despite these statistically significant reductions in pain intensity and pain interference, the intervention did not achieve the prespecified minimum clinically important difference (MCID) of 1 point between groups at any assessment.
- The program was successfully delivered through telehealth within primary care settings, supporting its feasibility and accessibility for patients with chronic low back pain.
The researchers concluded that a telehealth-delivered mindfulness group medical visit program integrated into primary care can significantly improve pain intensity and pain interference in people with chronic low back pain compared with usual care. Although the magnitude of improvement did not meet the predefined threshold for clinical importance, the findings suggest that this accessible, nonpharmacologic intervention could serve as a practical and scalable option to complement existing approaches for chronic low back pain management.
Reference:
Morone NE, Faurot KR, Weinberg J, et al. Mindfulness-Based Group Medical Visits for Persons With Chronic Low Back Pain: A Randomized Clinical Trial. JAMA Intern Med. Published online June 29, 2026. doi:10.1001/jamainternmed.2026.2186
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