Randomized, wait-list–controlled pilot study of app-delivered mindfulness for patients reporting chronic pain

Abstract

Introduction: Chronic pain creates economic burden and exerts profound individual and societal harm. Mobile application (app)delivered mindfulness meditation may be an important approach to self-management of chronic pain. Objectives: We examined the feasibility, acceptability, and impact of app-delivered mindfulness meditation on pain cognition and daily functioning among patients reporting chronic pain. Methods: We used a longitudinal, randomized, and wait-list-controlled design (NCT03495726) to evaluate changes in selfreported pain severity, pain catastrophizing, and social and physical functioning among participants randomized to 6 weeks of appdelivered mindfulness meditation, compared with participants randomized to a wait-list control group. Results: Although most participants randomized to the mindfulness group used the app at least once, fewer than half adhered to the instructed program. Participants who did not use the app scored higher on the helplessness component of pain catastrophizing at the start of the study and were less likely to have completed 4 years of college. Participants who reported feeling pressured to enroll in the study were also less likely to adhere to the intervention. Compared with participants randomized to wait-list, those in the mindfulness group reported significant improvements in social functioning, even after controlling for pain severity. Participants randomized to the mindfulness intervention also reported significant improvements in helplessness. App usage was not significantly correlated with changes in social functioning or helplessness scores. Conclusions: These results suggest that app-delivered mindfulness meditation is beneficial to patients with chronic pain. Identifying characteristics of patients who were adherent highlights important considerations for clinical settings.

Examining the interrelationships between mindfulness‐based interventions, depression, inflammation, and cancer survival

“…Still, there may be a role for app‐delivered MBIs in pain reduction. Mascaro et al 65 conducted an RCT to evaluate the effects of 6 weeks of self‐guided, informal mindfulness app use on pain severity and pain catastrophizing. Participants who used the app reported significantly less helplessness (on a subscale of pain catastrophizing) 65 .…”

“…Mascaro et al 65 conducted an RCT to evaluate the effects of 6 weeks of self‐guided, informal mindfulness app use on pain severity and pain catastrophizing. Participants who used the app reported significantly less helplessness (on a subscale of pain catastrophizing) 65 . There was no significant change in pain severity scores in the mindfulness group, which could have been because of poor adherence to recommended app use duration and frequency.…”

“…There was no significant change in pain severity scores in the mindfulness group, which could have been because of poor adherence to recommended app use duration and frequency. However, an interesting finding was that the mindfulness group reported deterioration in physical functioning but improved social functioning 65 . The authors suggest that mindfulness allows people to be more engaged with their social lives despite their pain 65 …”

“…However, an interesting finding was that the mindfulness group reported deterioration in physical functioning but improved social functioning 65 . The authors suggest that mindfulness allows people to be more engaged with their social lives despite their pain 65 …”

“…MBAs have also shown modest potential as modalities for pain and perceived social support, two factors associated with inflammation and possibly survival (Table 4). 39,[64][65][66][67] Ngamkham et al 39 conducted a systematic review and found that MBIs resulted in a statistically significant improvement in pain severity in four of six studies included. The authors propose that mindfulness helps to turn attention away from unpleasant symptoms, thereby improving pain tolerance.…”