The effect of meditation-based interventions on patients with fatigue symptoms: a systematic review and meta-analysis.

Fatigue constitutes an important symptom in several diseases. Often, fatigue is not effectively alleviated by pharmaceutical treatments. Meditation could be an alternative non-pharmacological intervention. This review synthetizes data from randomized control trials (RCTs) that explored the effect of meditation-based interventions (MeBI) on fatigue in pathological conditions and provides quantitative estimates of the reported effects. Eight databases were systematically searched for eligible studies from inception to April 2020. Thirty-four RCTs met eligibility criteria, with 32 included in a meta-analysis. For the meta-analysis, we ran an analysis without any moderator. Then, we looked at the potential effect of three moderators: kind of control group, pathology, and MeBI type. The primary meta-analysis, without moderators, showed an effect in favor of MeBI compared to control groups (g=0.62, see Forest plot). The analyses on each moderator indicate that MeBI significantly reduced fatigue compared to passive, but not active control groups. When the effect of each modality of a moderator is assessed separately, we still notice an effect by comparison to the passive control group (g=0.87). However, there is now a significant effect of mindfulness interventions (g=0.80), but not of compassion or remoted-delivered interventions; and positive effect of MeBI was observed on fatigue in cancer patients (g=0.75) and to a lesser extent in multiple sclerosis (g=0.29). In conclusion, MeBI seem to reduce fatigue. However, it remains to identify which aspects of the treatment are the most effective and to assess its specific effects on different types of fatigue (i.e., physical and mental).