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Effectiveness of Mindfulness- and Relaxation-Based eHealth Interventions for Patients with Medical Conditions: a Systematic Review and Synthesis

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Abstract

Purpose

This systematic review aims to summarize eHealth studies with mindfulness- and relaxation-based interventions for medical conditions and to determine whether eHealth interventions have positive effects on health.

Method

A comprehensive search of five databases was conducted for all available studies from 1990 to 2015. Studies were included if the intervention was mainly technology delivered and included a mindfulness- or relaxation-based intervention strategy and if patients with a medical condition were treated. Treatment effects were summarized for different outcomes.

Results

A total of 2383 records were identified, of which 17 studies with 1855 patients were included in this systematic review. These studies were conducted in patients with irritable bowel syndrome, chronic fatigue syndrome, cancer, chronic pain, surgery, and hypertension. All but one study were delivered online through a web-based platform; one study delivered the intervention with iPods. The studies indicate that mindfulness- and relaxation-based eHealth interventions can have positive effects on patients’ general health and psychological well-being. No effects were found for stress or mindfulness. Only five studies reported economic analyses of eHealth interventions without any clear conclusion.

Conclusion

There is some evidence that mindfulness- and relaxation-based eHealth interventions for medical conditions can have positive effects on health outcomes. Therefore, such interventions might be a useful addition to standard medical care. No app studies were retrieved, even though a vast number of smartphone apps exist which aim at increasing users’ health. Therefore, more studies investigating those health apps are needed.

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Acknowledgments

The authors acknowledge and thank for the contribution of Iara Meili, who supported the screening process.

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Authors and Affiliations

  1. Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Sonneggstrasse 6, 8091, Zurich, Switzerland

    Michael Mikolasek, Jonas Berg, Claudia M. Witt & Jürgen Barth

  2. Institute for Social Medicine, Epidemiology and Health Economics, Charité–Universitätsmedizin Berlin, Berlin, Germany

    Claudia M. Witt

  3. Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, MD, USA

    Claudia M. Witt

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  1. Michael Mikolasek
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Correspondence to Michael Mikolasek.

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Funding

This study was funded by the Swiss Cancer League (funding ID: KLS-3564-02-2015).

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The authors declare that they have no conflict of interest.

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This article does not contain any studies with human participants performed by any of the authors.

Appendix

Appendix

Search strategy for EBSCO (PsycINFO, CINAHL, AMED)

(

TI (app OR mobile OR web OR online OR internet OR phone OR smart-phone OR smartphone OR cellphone OR cell-phone OR computer)

OR

AB (app OR mobile OR web OR online OR internet OR phone OR smart-phone OR smartphone OR cellphone OR cell-phone OR computer)

)

AND

(

TI (mindfulness OR meditat* OR stress-reduc* OR stress-manag* OR mind-body* OR breath* OR relax*)

OR

AB (mindfulness OR meditat* OR stress-reduc* OR stress-manag* OR mind-body* OR breath* OR relax* OR mbsr OR kabat zinn)

)

AND

(

TI (intervention OR rct OR (random* N3 trial*) OR treatment OR training OR exerci* OR practice OR clinical trial*)

OR

AB (intervention OR rct OR (random* N3 trial*) OR treatment OR training OR exerci* OR practice OR clinical trial*)

)

NOT

(

TI (abuse OR alcohol OR addiction OR smok* OR carbon* OR (acute N2 respiratory) OR asthma)

ORAB (abuse OR alcohol OR addiction OR smok* OR carbon* OR (acute N2 respiratory) OR asthma)

)

Limiters:

Date: January 1, 1990–April 7, 2015, 22:00

Source type: academic journals, journals, dissertations

Number of hits, 924

Duplicates found by EBSCOhost, 69

Number of unique hits, 855

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Mikolasek, M., Berg, J., Witt, C.M. et al. Effectiveness of Mindfulness- and Relaxation-Based eHealth Interventions for Patients with Medical Conditions: a Systematic Review and Synthesis. Int.J. Behav. Med. 25, 1–16 (2018). https://doi.org/10.1007/s12529-017-9679-7

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