Practitioners should embrace, not ignore, health apps

Hickey, Eamonn; McMillan, Brian; Mitchell, Caroline

doi:10.1136/bmj.h2336

Cited by 21 publications

(24 citation statements)

References 1 publication

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“…35,36 Research has suggested that efficacy of apps is also dependent on long-term adherence to an app, otherwise the impact may be limited, and prompts where shown to increase effectiveness. 37 Far fewer than half of the investigated studies employed such strategies; eight studies prompted participant engagement by explicitly requesting input and only five studies sent intervention reminders based on adherence.…”

Section: Discussionmentioning

confidence: 99%

“…The development of digital mental health services should be user-driven and solution-focused, including app developers, researchers and clinicians in the process. 37,40–42 It is important to investigate app features and components, which make smartphone apps unique delivery modalities, such as context sensing, constant access and availability, high likelihood that prompts are received in daily life, and the combination possibilities with physiological assessments. The feature-driven approach could be helpful to understand working mechanisms of apps for mental health.…”

Section: Discussionmentioning

confidence: 99%

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Standalone smartphone apps for mental health—a systematic review and meta-analysis

et al. 2019

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While smartphone usage is ubiquitous, and the app market for smartphone apps targeted at mental health is growing rapidly, the evidence of standalone apps for treating mental health symptoms is still unclear. This meta-analysis investigated the efficacy of standalone smartphone apps for mental health. A comprehensive literature search was conducted in February 2018 on randomized controlled trials investigating the effects of standalone apps for mental health in adults with heightened symptom severity, compared to a control group. A random-effects model was employed. When insufficient comparisons were available, data was presented in a narrative synthesis. Outcomes included assessments of mental health disorder symptom severity specifically targeted at by the app. In total, 5945 records were identified and 165 full-text articles were screened for inclusion by two independent researchers. Nineteen trials with 3681 participants were included in the analysis: depression (k = 6), anxiety (k = 4), substance use (k = 5), self-injurious thoughts and behaviors (k = 4), PTSD (k = 2), and sleep problems (k = 2). Effects on depression (Hedges’ g = 0.33, 95%CI 0.10–0.57, P = 0.005, NNT = 5.43, I2 = 59%) and on smoking behavior (g = 0.39, 95%CI 0.21–0.57, NNT = 4.59, P ≤ 0.001, I2 = 0%) were significant. No significant pooled effects were found for anxiety, suicidal ideation, self-injury, or alcohol use (g = −0.14 to 0.18). Effect sizes for single trials ranged from g = −0.05 to 0.14 for PTSD and g = 0.72 to 0.84 for insomnia. Although some trials showed potential of apps targeting mental health symptoms, using smartphone apps as standalone psychological interventions cannot be recommended based on the current level of evidence.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Standalone smartphone apps for mental health—a systematic review and meta-analysis

et al. 2019

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“…The apps may be of particular benefit in primary care considering the heavy pressure on time and resources as well as the wide range of symptoms, diseases and patient groups involved [16]. The apps would seem ideal as support tools for physicians to use on specific patients in primary care, thus promoting health in the long term [17,18].…”

Section: Introductionmentioning

confidence: 99%

The use of health apps in primary care—results from a survey amongst general practitioners in Germany

Wangler

Jansky

2021

Wien Med Wochenschr

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SummaryMass availability and use of health apps raises the question as to how they might be integrated into healthcare systems towards improving prevention and therapy. This study has researched prevailing opinion on health apps amongst primary care physicians, potential application areas physicians have seen in their experience with these apps up to now, and situations suitable for using apps in patient care. A total of 2138 primary care physicians in the state of Baden-Württemberg, Germany, responded to an anonymised written survey between March and June 2020. Physicians with a positive opinion (36%) emphasised motivation and compliance as advantages, whereas sceptical respondents (43%) expressed suspicion regarding data privacy and reliability as well as legal issues and additional workload arising from using the apps. Even so, a clear majority accepted the potential benefit from sensible use of health apps with features providing prevention and lifestyle support (90/76%). With respect to patients using the apps, 54% of respondents saw a positive contribution to healthcare and/or recovery. Despite the perceived benefits of health apps, general practitioners are still reluctant to bring up or recommend health apps in their consultations. Many physicians do not feel capable of giving expert advice to patients on the apps available. Many general practitioners are aware of the potential that health apps may have in improving prevention and treatment. However, there are reservations and uncertainties regarding clarity, transparency, and privacy issues in these apps. More focus should be placed on these concerns to ensure ideal conditions for integrating health apps into primary care.

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“…This is also a problem in assuring the quality and effectiveness of mMH applications. The unsuccessful experience of the NHS approved apps library is a good example of how the need for regulation is recognized but difficult to address [14,15]. Issues around the Samaritans Radar app, initially launched in 2014 and now withdrawn, show that designing an app to support mental health can cause unanticipated problems.…”

Section: Introductionmentioning

confidence: 99%

Design for mobile mental health: an exploratory review

2018

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A large number of mobile mental health apps are available to the public but current knowledge about requirements of designing such solutions is scarce, especially from sociotechnical and user centred points of view. Due to the significant role of mobile apps in the mental health service models, identifying the design requirements of mobile mental health solutions is crucial. Some of those requirements have been addressed individually in the literature, but there are few research studies that show a comprehensive picture of this domain. This exploratory review aims to facilitate such holistic understanding. The main search keywords of the review were identified in a cross-disciplinary requirements workshop. The search was started by finding some core references in the healthcare databases. A wider range of references then has been explored using a snowball method. Findings showed that there is a good understanding of individual design requirements in current literature but there are few examples of implementing a combination of different design requirements in real world products. The design processes specifically developed for mobile mental health apps are also rare. Most studies on operational mobile mental health apps address major mental health issues while prevention and wellbeing areas are underdeveloped. In conclusion, the main recommendations for designing future mobile mental health solutions include: moving towards sociotechnical and open design strategies, understanding and creating shared value, recognizing all dimensions of efficacy, bridging design and medical research and development, and considering an ecosystem perspective.

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Practitioners should embrace, not ignore, health apps

Abstract: medical student, Brian McMillan academic clinical fellow in primary care, Caroline Mitchell senior clinical lecturer

Cited by 21 publications

References 1 publication

Standalone smartphone apps for mental health—a systematic review and meta-analysis

Standalone smartphone apps for mental health—a systematic review and meta-analysis

The use of health apps in primary care—results from a survey amongst general practitioners in Germany

Design for mobile mental health: an exploratory review

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