Feasibility of a Mobile Electronic Mindfulness Therapy Service for Chronic Pancreatitis

Patients who meet diagnostic criteria for definite or suspected chronic pancreatitis and
have current symptoms over the past month will be considered for study enrollment. Potential
patients will be initially pre-screened by a patient chart review.

If not excluded during the pre-screening process, potential subjects will be mailed
questionnaires to fill out at home and speak with a member of the research team for an
intake interview. At that time, they will be asked to sign a consent form after its review.
Subjects will then be given instructions on how to participate in daily mindfulness therapy
for one-month via the phone messaging service with a research team member.

The total duration of the study intervention will be four weeks where enrolled patients will
be asked to perform daily mindfulness sessions through our electronic mobile mindfulness
therapy service.

Patients will be sent a daily automated text message or call reminder to their mobile phone
at a pre-determined time, selected by the patient at the intake interview. The text message
will prompt patients with a phone number to call to access the Mindfulness Therapy sessions.

When the patient is ready, s/he will call the provided phone number which is an automated
answering and voice messaging service, which will prompt the patient to select a mindfulness
therapy session of varying durations from 2 to 30 minutes. The session will lead the
patients through deep relaxation breathing exercise for the duration the patient selected
from the phone menu. Although the investigators will only ask patients to do one mindfulness
session a day, patients are free to do as many as they want a day. At the end of their
session, patients will leave a voice message with their name and current location such as
home or work. The investigators will track the mindfulness sessions the individual patient
participated in by obtaining their recorded voice messages in an inbox that correlates with
the duration of the mindfulness session that the patient participated in. The voice
messaging system will also provide information of the time the voice message was left, or
time of completion of the patient's mindfulness session. If the patient prematurely
terminated his/her session, got disconnected from his/her session or forgot to leave a
message, the patient may call the same provided phone number to leave a message with his/her
name, date of unrecorded session along with its duration and location of participation such
as home or work.

At the end of the study at four weeks, patients will be asked to complete an exit interview.
The patient will be asked to fill out questionnaires during this interview. The patient will
also be asked to participate in an informal exit interview with one of the research team
members. Patients will be asked of any new medications were added during the duration of the
study. They will also be asked regarding any changes in chronic pancreatitis strategies and
any new stressors.

Inclusion Criteria:

- For the study group: Patients with diagnosis of chronic pancreatitis with at least
two of the following features: clinical course consistent with chronic pancreatitis,
calcification in the pancreas on US/CT/EUS, ERCP showing ductal abnormalities
(Cambridge Classification), exocrine insufficiency, histology showing irregular
fibrosis, acinar cell loss, islet cell loss, and inflammatory cell infiltrates, or
other features suggestive of chronic pancreatitis (such as pancreatic pseudocyst).
The study group will also include patients with suspected chronic pancreatitis based
on history of documented pancreatitis with lingering symptoms or signs of early
chronic pancreatitis on imaging.

- For the control group: no history of chronic GI symptoms lasting greater than 8
weeks, no gastrointestinal disease or condition diagnosis, and not be currently
experiencing gastrointestinal symptoms.

- Age 18 to 80

- Willing to give informed consent

- Able to complete entire study

- Ability to speak and read English

- Regular menstrual cycles or menopause for at least 6 months

- Owns a mobile phone with texting capabilities

- Unlimited minutes and text messaging dataplan for mobile phone

- Physically and mentally capable of using a mobile phone

- Phone access

Exclusion Criteria:

- Red flags of concern: anemia, blood in stools, unexplained weight loss, unexplained
fevers

- Pregnant or nursing woman, or planning on becoming pregnant within next year

- Travel plans outside of the county over the study duration or a month prior

- Change in medications one month prior or during study

- Change in chronic pancreatitis management strategies one month prior or during study
such as dietary changes, exercise, counseling and behavioral therapies.

- Current co-morbid condition that might account for GI symptoms

- Current infectious diseases: HIV, Hepatitis A, B or C, other

- Psychiatric Conditions: moderate to severe depression (ECT, unable to work, disrupts
ADL's), moderate to severe anxiety (unable to work, disrupts ADL's), bipolar
disorder, schizophrenia, or history of psychosis, suicidal ideation or attempt,
substance abuse (alcohol and/or drugs in past year), dissociative disorder, dementia
related disorder

- Immunologic Diseases: systemic lupus, moderate to severe arthritis, scleroderma,
other

- Gastrointestinal Disorders: inflammatory bowel diseases (ulcerative colitis,
Crohn's), celiac disease,personal history of colon cancer or polyps, other unless
condition associated with chronic pancreatitis.

- Cardiovascular disorder, clinically significant in past 12 months

- Pain disorder, clinically significant (back pain, fibromyalgia)

- Recent surgery, during 6 months prior to study enrollment or during study period
(except minor surgeries such as wisdom teeth extraction, cataract surgery, corrective
lens surgery, and/or minor skin surgeries)

- Major stressor(s) in life 3 months prior to study or anticipated over the next month