Smartphone-Based Meditation for Myeloproliferative Neoplasm Patients: Feasibility Study to Inform Future Trials

Abstract

Background Myeloproliferative neoplasm (MPN) patients often report high symptom burden that persists despite the best available pharmacologic therapy. Meditation has gained popularity in recent decades as a way to manage cancer patient symptoms. Objective The aim of this study was to examine the feasibility of 2 different consumer-based meditation smartphone apps in MPN patients and to examine the limited efficacy of smartphone-based meditation on symptoms compared with an educational control group. Methods Patients (n=128) were recruited nationally through organizational partners and social media. Eligible and consented patients were enrolled into 1 of 4 groups, 2 of which received varying orders of 2 consumer-based apps (10% Happier and Calm ) and 2 that received one of the apps alone for the second 4 weeks of the 8-week intervention after an educational control condition. Participants were asked to perform 10 min of meditation per day irrespective of the app and the order in which they received the apps. Feasibility outcomes were measured at weeks 5 and 9 with a Web-based survey. Feasibility outcomes were acceptability, demand, and limited efficacy for depression, anxiety, pain intensity, sleep disturbance, sexual function, quality of life, global health, and total symptom burden. Results A total of 128 patients were enrolled across all 4 groups, with 73.4% (94/128) patients completing the intervention. Of the participants who completed the 10% Happier app, 61% (46/76) enjoyed it, 66% (50/76) were satisfied with the content, and 77% (59/76) would recommend to others. Of those who completed the Calm app, 83% (56/68) enjoyed it, 84% (57/68) were satisfied with the content, and 97% (66/68) would recommend to others. Of those who completed the educational control, 91% (56/61) read it, 87% (53/61) enjoyed it, and 71% (43/61) learned something. Participants who completed the 10% Happier app averaged 31 (SD 33) min/week; patients completing the Calm app averaged 71 (SD 74) min/week. 10% Happier app participants saw small effects on anxiety ( P <.001 d =−0.43), depression ( P =.02; d =−0.38), sleep disturbance ( P =.01; d =−0.40), total symptom burden ( P =.13; d =−0.27), and fatigue ( P =.06; d =−0.30), and moderate effects on physical health ( P <.001; d =0.52). Calm app participants saw small effects on anxiety ( P =.29; d =−0.22...

Experiences of Using a Consumer-Based Mobile Meditation App to Improve Fatigue in Myeloproliferative Patients: Qualitative Study

“…In addition, both of these apps have a free option with limited accessibility, as well as a paid option with full accessibility. The findings and a detailed overview of the methods from the feasibility study are reported elsewhere in the parent paper [12] (ClinicalTrials.gov, NCT03726944). Briefly, participants were randomly assigned to 1 of 4 different groups that each comprised 2 different conditions lasting 4 weeks each.…”

“…Mindfulness meditation is the practice of moment-to-moment awareness, in which the person purposefully focuses on the present moment, without judgement [9,10]. However, there has been minimal research investigating the effects of mindfulness meditation as a complementary therapy in hematological cancer patients, and more specifically, only 1 small feasibility study has been conducted in MPN patients [11,12].…”

“…In a 2018 survey of 631 cancer patients, 74.0% (467/631) of the patients reported regular use of a mobile phone, and 38.9% (246/631) of the patients expressed an interest in supportive care information via mobile apps [22]. In a pilot study conducted by Huberty and colleagues, 96.9% (308/318) of MPN patients indicated that they owned a mobile phone and were willing to download a mobile app to participate in app-based meditation [12]. There are approximately 300 cancer-specific apps available across the major mobile phone platforms (eg, iPhone, Android); however, a majority of available apps have limited evidence to demonstrate their effectiveness and utility, and the evidence of the clinical benefits of commercially available apps for cancer patients is in its infancy [20,23].…”

“…The features, functionality, and experience desired by users of mobile phone-based meditation apps have yet to be thoroughly investigated and reported. A recently published study, Huberty et al [12], investigating the feasibility of mobile phone-based meditation via the Calm app and the 10% Happier app among MPN patients demonstrated the Calm app to be more feasible to implement because of higher demand and acceptability. In addition, this study demonstrated limited efficacy, with small effects observed in both apps on anxiety, depression, sleep disturbance, and total symptom burden.…”

A Novel Educational Control Group Mobile App for Meditation Interventions: Single-Group Feasibility Trial

“…Meditation apps have become quite popular in recent years [ 4 , 10 ] and have been used to improve mental and physical health in a range of healthy [ 7 , 11 - 15 ] and health-compromised populations [ 16 , 17 ]. However, few mobile app meditation studies have used active, time-matched, and attention-matched comparators [ 7 , 13 , 14 , 18 ] even when the study primarily aimed to determine effectiveness or efficacy.…”