Grand Rounds September 12, 2025: Initial Outcomes of the Optimizing Pain Treatment in Medical Settings Using Mindfulness (OPTIMUM) Pragmatic Trial (Natalia E. Morone, MD, MS; Carol M. Greco, PhD; Kim Faurot, PhD, MPH, PA)

Posted on by Sophia Ramirez

Speakers

Natalia E. Morone, MD, MS
Associate Professor
Boston Medical Center/Boston University

Carol M. Greco, PhD
Associate Professor
University of Pittsburgh

Kim Faurot, PhD, MPH, PA
Associate Professor
University of North Carolina at Chapel Hill

Keywords

Pain; Low Back Pain; Mindfulness; Virtual; Group-Based; OPTIMUM

Key Points

  • OPTIMUM, an NIH Collaboratory trial, tested the effect of a virtual, group-based mindfulness intervention on levels of low back pain, life enjoyment, and activity. 451 participants with chronic low back pain were randomized to receive either the 8-week mindfulness-based stress reduction (MBSR) program or usual care.
  • The Zoom-based program integrated mindfulness instructors with primary care providers in a group medical visit format. The researchers found that patients in the mindfulness group had significantly lower scores (i.e., less pain) on the Pain, Enjoyment of Life, and General Activity (PEG) Scale from Week 8 through Month 12.
  • Once the intervention was complete, researchers conducted interviews with each participant. There were 6 emergent themes: ease, level of support, struggle, comfort, social demands at home, and sharing personal spaces.

Discussion Themes

The research team developed a tool to assess participant fidelity. Their measurements indicated that the essential elements of MBSR were maintained in a virtual format with high participant engagement. High participant retention was attributed to a culture of kindness among staff as well as proactive outreach, including monthly check-in calls.

The research team gained support from busy primary care clinics by keeping the ask light, avoiding extra workload for front-desk staff and using EMR-integrated tools.

It’s possible that the results reflect volunteer bias; i.e., individuals who agree to participate in a mindfulness study may differ significantly from the general patient population.

While specific pain scales are important, global impression of change often shows higher satisfaction – possibly because mindfulness provides general wellness benefits beyond physical pain reduction.