geoffrey modest medical blogs

  A recent study compared mindfulness training and cognitive behavioral therapy in patients who had chronic low back pain and were being treated with opiates, finding improved back pain symptoms with decreased opiate doses in both cohorts at both 6 months and 12 months (see  lbp opioids mindfulness and CBT helps JAMA2025  in dropbox, or doi:10.1001/jamanetworkopen.2025.3204)   Details : -- 770 patients were enrolled in this community partner-informed, partially masked, multisite, randomized controlled trial with participants from primary and specialty care clinics and community settings who were randomly assigned to mindfulness-based therapy (MBT) or cognitive behavioral therapy (CBT) -- participants had never had either MBT or CBT previously, had moderate-to-severe chronic low back pain (CLBP) (score of at least 3 on the Brief Pain Inventory (BPI)), functional limitations (score at least 20 on the Oswestry Disability Index (ODI)), and were treated with opiates ...

A recent systematic review and network meta-analysis found exercise and cognitive behavioral therapy were superior to meds in treating depression in patients with heart failure (see  depression in heart failure CBT jpsychres2019 in dropbox, or doi.org/10.1016/j.jpsychires.2018.10.007 Details:   -- 21 RCTs were identified with 4563 heart failure patients assessing depression treatment with exercise therapy (ET), cognitive behavioral therapy (CBT), or antidepressant medications (AD)     -- 1989 patients received an active intervention versus 1826 controls           -- 15 RCTs with 3309 patients compared ET with usual care           -- 4 RCTs with 390 patients compared CBT with usual care           -- 3 RCTs with 878 patients compared AD with placebo   -- mean age 63 years, 61% men. 47% from North America/4...