JMIR Publications

ABSTRACT

Background:

Myeloproliferative neoplasm patients often report a high symptom burden that persists despite best available pharmacologic therapy. Meditation has gained popularity in recent decades as a way to manage symptoms in cancer patients.

Objective:

The purpose of this study was to examine the feasibility of the use of two different consumer-based meditation smartphone applications (i.e., apps) in myeloproliferative neoplasm patients. Findings will inform the choice of an app to be used for a larger randomized controlled trial.

Methods:

Patients (n=128) were recruited nationally through organizational partners and social media. Elibigle and consented patients were enrolled into one of four groups, two of which received varying orders of two consumer-based apps (unnamed consumer-based [CB] app and Calm App) and two that received one of the apps alone for the second four weeks of the eight week intervention after an educational control condition. Participants were asked to perform 10 min/day of smartphone-based meditation irrespective of the app and/or the order in which they received the apps. Feasibility outcomes were measured at week five and nine with an online 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 four groups, with 94/128 (27% dropout rate) patients completing the intervention. Of the patients that completed the CB app (n=76), 61% enjoyed it, 66% were satisfied with the content, and 77% would recommend to others. Of those who completed the Calm app (n=68), 83% enjoyed it, 84% were satisfied with the content and 97% would recommend to others. Of those who completed the educational control (n=61), 91% read it, 87% enjoyed it, and 71% learned something. Patients that completed the CB app averaged 31±33 min/wk; patients that completed the Calm app averaged 71±74 min/wk. CB app participants saw small effects on anxiety (d=-0.43), depression (d=-0.38), sleep disturbance (d=-0.40), total symptom burden (d=-0.27), and fatigue (d=-0.30) as well as moderate effects on physical health (d=0.52). Calm app participants saw small effects on anxiety (d=-0.22), depression (d=-0.29), sleep disturbance (d=-0.47), physical health (d=0.44), total symptom burden (d=-0.27), and fatigue (d=-0.27). Educational control participants (n=61) did not have small, moderate, or large effects on any patient-reported outcome except for a moderate effect on physical health (d=0.77).

Conclusions:

Delivering meditation via the Calm app is feasible and scored higher in terms of feasibility when compared to the CB app. Future randomized controlled trials are needed examining the Calm app and its effects on myeloproliferative neoplasms. Clinical Trial: ClinicalTrials.gov, NCT03726944.