Smartphone-Based Meditation for Myeloproliferative Neoplasm Patients: Feasibility Study to Inform Future Trials
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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), depression (P=.09; d=-0.29), sleep disturbance (P=.002; d=-0.47), physical health (P=.005; d=0.44), total symptom burden (P=.13; d=-0.27), and fatigue (P=.13; d=-0.27). Educational control participants (n=61) did not have effects on any patient-reported outcome except for a moderate effect on physical health (P<.001; d=0.77). CONCLUSIONS: Delivering meditation via the Calm app is feasible and scored higher in terms of feasibility when compared with the 10% Happier app. The Calm app will be used to implement a randomized controlled trial, testing the effects of meditation on symptom burden in MPNs. TRIAL REGISTRATION: ClinicalTrials.gov NCT03726944; https://clinicaltrials.gov/ct2/show/NCT03726944 (Archived by WebCite at http://www.webcitation.org/77MVdFJwM).
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The Ten Percent Happier app has been shown in previous studies to be an effective intervention to increase mindfulness and decrease anxiety and depressive symptoms.
“Among the many mindfulness apps available in the market, we chose this app because it has been shown to be an effective intervention to increase mindfulness and decrease anxiety and depressive symptoms in previous studies [60-62].”
From App-Based Mindfulness Meditation for People of Color Who Experience Race-Related Stress: Protocol for a Randomized Controlled Trial (2022) · cites this paper as [62]
The Results > Feasibility Outcomes (page unavailable) report significant reductions in anxiety and depression from baseline after four weeks of 10% Happier use in patients with myeloproliferative neoplasms. The paper does not report an increase in mindfulness, and its limited efficacy testing does not establish that the app caused the symptom reductions. This source is one study, not evidence of multiple previous studies. (LLM, conf=0.88)
Experimental — accuracy not yet measuredSamples in previous studies of the Ten Percent Happier app were almost exclusively non-Latinx White.
“It is important to note that samples in these studies were almost exclusively non-Latinx White.”
From App-Based Mindfulness Meditation for People of Color Who Experience Race-Related Stress: Protocol for a Randomized Controlled Trial (2022) · cites this paper as [62]
The Results (Recruitment and Enrollment; page unavailable) report that 123 of 128 participants were White, supporting the description of this study’s sample as almost exclusively White. The paper does not report whether those participants were non-Latinx, and this source describes one study rather than establishing the demographics of all the studies mentioned. (LLM, conf=0.85)
Experimental — accuracy not yet measuredOverall, the program was rated as acceptable, with the percentage of affirmative satisfaction ratings pertaining to comprehensibility and interest well above acceptability thresholds of 70% used in comparable app feasibility studies.
“Overall, the program was rated as acceptable, with the percentage of affirmative satisfaction ratings pertaining to comprehensibility and interest well above acceptability thresholds of 70% used in comparable app feasibility studies, for example, the study by Huberty et al [38].”
From An Acceptance and Commitment Therapy Prototype Mobile Program for Individuals with a Visible Difference: Mixed Methods Feasibility Study (2022) · cites this paper as [38]
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- Authors
- Huberty, J., Eckert, R., Larkey, L., Kurka, J., Rodríguez De Jesús, S. A., Yoo, W., & Mesa, R.
- Affiliations
- Arizona State University (US)
- Mays Cancer Center at UT Health San Antonio (US)
- Corresponding author
- Huberty, Jennifer
- ORCID
- Venue
- JMIR Formative Research
- Publisher
- JMIR Publications Inc.
- Published
- 2019-04-29
- Volume
- 3
- Issue
- 2
- Pages
- e12662
- ISSN
- 2561-326X (ISSN-L)
- PMC
- PMC6658299
- OpenAlex
- W2943601327
- Cited by
- 67
- References
- 45
- Citations by year
- 2026: 3 · 2025: 7 · 2024: 6 · 2023: 9 · 2022: 17 · 2021: 13 · 2020: 9 · 2019: 3
- FWCI
- 12.26
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- JMIR Formative Research (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- National Cancer Institute (P30CA054174)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Keywords
- myeloproliferative neoplasms, digital mental health interventions, feasibility, symptom burden, depression, anxiety, sleep disorders, quality of life, patient acceptability, sexual function, pain intensity, global health
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