A systematic review of the barriers and facilitators to adherence to mindfulness‐based cognitive therapy for those with chronic conditions. Issue 2 (31st October 2022)

• Record Type: Journal Article
• Authors: Marks, Eleanor; Moghaddam, Nima; De Boos, Danielle; Malins, Sam
• Is Part Of: British journal of health psychology. Volume 28:Issue 2(2023)
• Page Start: 338
• Page End: 365
• Publication Date: 2022-10-31
• Subjects: adherence -- barriers -- chronic conditions -- facilitators -- Mindfulness‐based cognitive therapy; Clinical health psychology -- Periodicals; 613.019
• DOI: 10.1111/bjhp.12628
• Languages: English
• ISSNs: 1359-107X

Abstract

Abstract: Purpose: Mindfulness‐Based Cognitive Therapy (MBCT) can improve the lives of those with a chronic condition and psychological distress, however, high drop‐out rates limit benefits. MBCT might be a candidate treatment for this population if nonadherence can be overcome. This review explores the existing literature on the barriers and facilitators to adherence to MBCT for those with chronic conditions. Method: Databases MEDLINE, PsycINFO, CINAHL and Scopus were searched between 28 th May and 11th June 2021. We included empirical papers that identified barriers and/or facilitators to MBCT adherence in patients with chronic conditions—excluding non‐English and grey literature. Papers were screened and duplicates removed. Extracted data included: setting, design, aim, sample‐size, population and identified barriers/facilitators to MBCT adherence. The Mixed Methods Appraisal Tool (MMAT) was adapted and used to appraise the quality of studies Results: Twenty papers were eligible for review. Synthesis identified six themes (in prevalence order): (1) Practical Factors (e.g., time and other commitments), (2) Motivation (e.g., change‐readiness), (3) Patient clinical and demographic characteristics (e.g., current physical health), (4) Connection with Others (facilitators and group members), (5) Credibility (perception of the intervention) and (6) Content difficulty (intervention accessibility). Findings highlight potential adaptations to implementation (e.g., clear treatment rationale, preference matching, and eliciting and responding to individual concerns or obstructive assumptions) that could address barriers and harness facilitators. Conclusion: This review contributes a higher order understanding of factors that may support/obstruct client adherence to MBCT with implications for future implementation in research and practice. Future research should prioritize open exploration of barriers/facilitators.