Digital Technology Adoption in Psychiatric Care: an Overview of the Contemporary Shift from Technology to Opportunity

Hategan, Ana; Giroux, Caroline; Bourgeois, James A.

doi:10.1007/s41347-019-00086-x

Cited by 16 publications

(7 citation statements)

References 14 publications

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“…In contrast, two of these apps—Headspace and MoodGYM—were used in other studies, where they produced significant positive changes in depressive symptoms [ 31 , 53 , 64 , 65 , 68 , 69 ]. These mixed findings support the notion that while mental health apps may have a future in telemedicine and psychological settings [ 89 , 108 ], more research is needed to understand which mental health app features are integral to improving mental health symptoms. From there, these facets can be properly implemented as a methodologically reliable therapeutic technique.…”

Section: Discussionmentioning

confidence: 60%

Examining the Effectiveness of Gamification in Mental Health Apps for Depression: Systematic Review and Meta-analysis

Six¹,

Byrne²,

Tibbett³

et al. 2021

JMIR Ment Health

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Background Previous research showed that computerized cognitive behavioral therapy can effectively reduce depressive symptoms. Some mental health apps incorporate gamification into their app design, yet it is unclear whether features differ in their effectiveness to reduce depressive symptoms over and above mental health apps without gamification. Objective The aim of this study was to determine whether mental health apps with gamification elements differ in their effectiveness to reduce depressive symptoms when compared to those that lack these elements. Methods A meta-analysis of studies that examined the effect of app-based therapy, including cognitive behavioral therapy, acceptance and commitment therapy, and mindfulness, on depressive symptoms was performed. A total of 5597 articles were identified via five databases. After screening, 38 studies (n=8110 participants) remained for data extraction. From these studies, 50 total comparisons between postintervention mental health app intervention groups and control groups were included in the meta-analysis. Results A random effects model was performed to examine the effect of mental health apps on depressive symptoms compared to controls. The number of gamification elements within the apps was included as a moderator. Results indicated a small to moderate effect size across all mental health apps in which the mental health app intervention effectively reduced depressive symptoms compared to controls (Hedges g=–0.27, 95% CI –0.36 to –0.17; P<.001). The gamification moderator was not a significant predictor of depressive symptoms (β=–0.03, SE=0.03; P=.38), demonstrating no significant difference in effectiveness between mental health apps with and without gamification features. A separate meta-regression also did not show an effect of gamification elements on intervention adherence (β=–1.93, SE=2.28; P=.40). Conclusions The results show that both mental health apps with and without gamification elements were effective in reducing depressive symptoms. There was no significant difference in the effectiveness of mental health apps with gamification elements on depressive symptoms or adherence. This research has important clinical implications for understanding how gamification elements influence the effectiveness of mental health apps on depressive symptoms.

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Section: Discussionmentioning

confidence: 60%

Examining the Effectiveness of Gamification in Mental Health Apps for Depression: Systematic Review and Meta-analysis

Six¹,

Byrne²,

Tibbett³

et al. 2021

JMIR Ment Health

View full text Add to dashboard Cite

show abstract

“…In light of the importance of accurate estimation of adherence for informed medical decisions, new methods of unequivocal adherence detection are needed, such as digital adherence technologies being developed. 19,35 Implementation of these improved medication adherence assessment tools will also allow development of novel innovative interventions to improve therapy adherence as part of MS care.…”

Section: Discussionmentioning

confidence: 99%

Mobile phone-based e-diary for assessment and enhancement of medications adherence among patients with multiple sclerosis

Golan

Sagiv

Glass-Marmor³

et al. 2020

Multiple Sclerosis Journal - Experimental, Translational and Cl

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Background Adherence to multiple sclerosis (MS) disease-modifying drugs (DMDs) is essential for realization of their optimal effectiveness and benefits. Objective To evaluate the usefulness and validity of a smartphone-based e-diary as a tool for adherence assessment as well as its effectiveness as a promoter of adherence to DMDs. Methods An MS tailored e-diary (MyMS&Me) reminded patients to take their DMDs on time. DMD intake was self-recorded in the e-diary by the participants. Three methods of adherence evaluation were compared: e-diary derived, retrospective self-reported, and the medication possession rate (MPR). The proportion of patients with poor adherence to DMDs (defined as MPR <80%) among e-diary users was compared with a control group without intervention. Results Sixty-two patients downloaded the e-diary (Female: 41 (66%), Expanded Disability Status Scale 3.2 ± 2.2) and 55 controls were enrolled. The median difference between e-diary-derived adherence and the MPR was –3% (95% limits of agreement: −53% to 12%). The median difference between retrospective self-reported adherence and the MPR was 0.3% (95% limits of agreement: −20% to 42%). The proportion of participants with poor adherence to DMDs was similar in the e-diary and control groups (10% vs. 13%, p = 0.6). Conclusions Substantial and clinically important disagreement between methods of medication adherence evaluation was noted. Smartphone reminders did not significantly improve the MPR of DMDs.

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“…The American Psychiatric Association (APA) App Evaluation framework offers a useful tool to guide informed decision making around apps. Supported by evidence [ 13 , 14 ], international stakeholders [ 15 ], and frequently cited in research [ 16 , 17 ] on app evaluation, the framework offers a simple and ethically grounded approach that first considers access, then in sequence privacy/safety, evidence, usability, and finally clinical integration. The hierarchical nature of the framework ensures consideration of factors frequently overlooked by many other app evaluation tools, such as privacy and safety [ 14 ].…”

Section: Methodsmentioning

confidence: 99%

Technology Evaluation and Assessment Criteria for Health Apps (TEACH-Apps): Pilot Study

et al. 2020

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Background Despite the emergence of app evaluation tools, there remains no well-defined process receptive to diverse local needs, rigorous standards, and current content. The need for such a process to assist in the implementation of app evaluation across all medical fields is evident. Such a process has the potential to increase stakeholder engagement and catalyze interest and engagement with present-day app evaluation models. Objective This study aimed to develop and pilot test the Technology Evaluation and Assessment Criteria for Health apps (TEACH-apps). Methods Tailoring a well-known implementation framework, Replicating Effective Programs, we present a new process to approach the challenges faced in implementing app evaluation tools today. As a culmination of our experience implementing this process and feedback from stakeholders, we present the four-part process to aid the implementation of mobile health technology. This paper outlines the theory, evidence, and initial versions of the process. Results The TEACH-apps process is designed to be broadly usable and widely applicable across all fields of health. The process comprises four parts: (1) preconditions (eg, gathering apps and considering local needs), (2) preimplementation (eg, customizing criteria and offering digital skills training), (3) implementation (eg, evaluating apps and creating educational handouts), and (4) maintenance and evolution (eg, repeating the process every 90 days and updating content). TEACH-apps has been tested internally at our hospital, and there is growing interest in partnering health care facilities to test the system at their sites. Conclusions This implementation framework introduces a process that equips stakeholders, clinicians, and users with the foundational tools to make informed decisions around app use and increase app evaluation engagement. The application of this process may lead to the selection of more culturally appropriate and clinically relevant tools in health care.

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Digital Technology Adoption in Psychiatric Care: an Overview of the Contemporary Shift from Technology to Opportunity

Cited by 16 publications

References 14 publications

Examining the Effectiveness of Gamification in Mental Health Apps for Depression: Systematic Review and Meta-analysis

Examining the Effectiveness of Gamification in Mental Health Apps for Depression: Systematic Review and Meta-analysis

Mobile phone-based e-diary for assessment and enhancement of medications adherence among patients with multiple sclerosis

Technology Evaluation and Assessment Criteria for Health Apps (TEACH-Apps): Pilot Study

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