e-Therapies in England for stress, anxiety or depression: how are apps developed? A survey of NHS e-therapy developers

Abstract

ObjectiveTo document the quality of web and smartphone apps used and recommended for stress, anxiety or depression by examining the manner in which they were developed.DesignThe study was conducted using a survey sent to developers of National Health Service (NHS) e-therapies.Data sourcesData were collected via a survey sent out to NHS e-therapy developers during October 2015 and review of development company websites during October 2015.Data collection/extraction methodsData were compiled from responses to the survey and development company websites of the NHS e-therapies developers.ResultsA total of 36 (76.6%) out of the 48 app developers responded. One app was excluded due to its contact details and developer website being unidentifiable. Data from the missing 10 was determined from the app developer’s website. The results were that 12 out of 13 web apps and 20 out of 34 smartphone apps had clinical involvement in their development. Nine out of 13 web apps and nine out of 34 smartphone apps indicated academic involvement in their development. Twelve out of 13 web apps and nine out of 34 smartphone apps indicated published research evidence relating to their app. Ten out of 13 web apps and 10 out of 34 smartphone apps indicated having other evidence relating to their app. Nine out of 13 web apps and 19 out of 34 smartphone apps indicated having a psychological approach or theory behind their app.ConclusionsAs an increasing number of developers are looking to produce e-therapies for the NHS it is essential they apply clinical and academic best practices to ensure the creation of safe and effective apps.

Evaluation of a Mobile App to Enhance Relational Awareness and Change During Cognitive Analytic Therapy: Mixed Methods Case Series

“…“Technology push” also occurs when the commercial concerns of digital health care companies trump the wants/needs of patients and also challenges the values of clinicians [ 2 ]. The lack of sufficient depth of clinical and academic collaboration regarding electronic mental health innovation has been highlighted as a key feature of “technology push” [ 12 ]. The speed at which electronic mental health can be developed also threatens to ignore (or be ignorant of) robust methods for treatment development and associated evaluation [ 13 ].…”

“…The content of some electronic mental health apps has also been criticized for not being grounded in sufficient theory [ 14 ] and for the fact that the outcomes achieved during clinical trials are rarely replicated in routine service delivery settings [ 15 ]. Although a plethora of electronic mental health apps are readily available for the treatment of a variety of disorders and in a variety of contexts, questions can linger concerning a lack of evidence regarding feasibility, safety, clinical effectiveness, and efficacy [ 12 ]. The potential for technological innovations to outstrip the co-development of a sufficiently robust evidence base therefore risks a loss of confidence/trust from both clinicians and patients [ 16 ].…”

“…The electronic mental health field is currently also dominated by apps reflecting the changing methods of cognitive behavioral therapy (CBT), in part because of the ease with which those changing methods can be translated into app content [ 12 ]. For example, a recent review of CBT-based apps for the management of depression found that 31 apps were available [ 3 ].…”

Evaluation of a Mobile App to Enhance Relational Awareness and Change During Cognitive Analytic Therapy: Mixed Methods Case Series (Preprint)

“…"Technology push" also occurs when the commercial concerns of digital health care companies trump the wants/needs of patients and also challenges the values of clinicians [2]. The lack of sufficient depth of clinical and academic collaboration regarding electronic mental health innovation has been highlighted as a key feature of "technology push" [12]. The speed at which electronic mental health can be developed also threatens to ignore (or be ignorant of) robust methods for treatment development and associated evaluation [13].…”

“…The content of some electronic mental health apps has also been criticized for not being grounded in sufficient theory [14] and for the fact that the outcomes achieved during clinical trials are rarely replicated in routine service delivery settings [15]. Although a plethora of electronic mental health apps are readily available for the treatment of a variety of disorders and in a variety of contexts, questions can linger concerning a lack of evidence regarding feasibility, safety, clinical effectiveness, and efficacy [12]. The potential for technological innovations to outstrip the co-development of a sufficiently robust evidence base therefore risks a loss of confidence/trust from both clinicians and patients [16].…”