Table 2. Limitations of Existing Studies of MBTs and Suggestions for Future Research in this Area.
Limitations of Existing Studies | Suggestions for Future Research |
---|---|
Insufficient reporting of opioid dosing outcomes | Record the type of opioid agent prescribed, the dose per unit, the dose form, dose frequency, and duration of opioid use |
Outcomes for opioid-using subgroups were not analyzed separately in the results | Conduct a priori subgroup analyses for opioid users in future clinical trials |
High levels of intervention heterogeneity preclude examination of effect modifiers, including intervention dosage and delivery format | Increase the number of studies of each type of MBT of various dosages (brief vs multiweek MBT) and delivery formats (delivered in person by practitioner vs audio recording or internet); randomly assign participants to different MBT dosages and delivery formats |
High levels of heterogeneity in study design preclude determinations of the durability of treatment effects | Use standardized and consistent assessment points and outcome measures to facilitate meta-analytic comparisons across studies |
Some studies have small sample sizes | Increase sample size to ensure full power to detect treatment effects |
Some studies had risk of bias because of a lack of blinding of participants, personnel, and assessors | Blind participants, personnel, and assessors, as well as use double-blind or active placebo-controlled designs whenever possible |
Some studies had risk of bias because of a lack of intent-to-treat analysis | Use intent-to-treat analyses to assess primary and secondary outcomes |
Some studies relied on self-report of opioid dosing or opioid misuse–related outcomes | Triangulate data from self-reports, practitioner evaluation, PDMPs, and urine toxicologic screenings via modeling strategies capable of analyzing latent dependent variables composed of multiple observed indicators (eg, structural equation modeling); use psychophysiologic testing to detect addictive tendencies toward opioids |
Abbreviations: MBT, mind-body therapy; PDMPs, prescription drug monitoring plans.