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

• Type of Material: Article
• Authors: Jennifer Mascaro, Emory University; Vinita Singh, Emory University; Kathryn Wehrmeyer, Emory University; Benjamin Scott, Emory University; Justin Juan, Emory University; Anne McKenzie-Brown, Emory University; Olabisi Lane, Emory University; Carla Haack, Emory University
• Language: English
• Date: 2021-04-02
• Publisher: Lippincott, Williams & Wilkins
• Publication Version: Final Published Version
• Copyright Statement: © 2021 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The International Association for the Study of Pain.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1097/PR9.0000000000000924
• Title of Journal or Parent Work: PAIN Reports
• Volume: 6
• Issue: 1
• Keywords: Mindfulness; Mobile Health; Meditation; Chronic pain
• Research Categories: Health Sciences, Medicine and Surgery; Health Sciences, Public Health

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 self-reported pain severity, pain catastrophizing, and social and physical functioning among participants randomized to 6 weeks of app-delivered 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.