The development and feasibility of a personal health-optimization system for people with bipolar disorder

Eiring, Øystein; Nytrøen, Kari; Kienlin, Simone; Khodambashi, Soudabeh; Nylenna, Magne

doi:10.1186/s12911-017-0481-x

Cited by 20 publications

(9 citation statements)

References 37 publications

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“…The current literature reports advances in development of BD biomarkers and evidence on alternative treatments such as circadian‐based therapies, vagus nerve stimulation, and omega‐3 fatty acid supplementation . New evidence is available on BD‐specific psychological interventions, psychoeducation and individualized treatmentoptimized by E‐health applications and stage‐appropriate interventions . A range of guidelines and practical algorithms have been produced for pharmacological treatment of BD, although none have been broadly adopted in the USA.…”

Section: Discussionmentioning

confidence: 99%

Systemic challenges in bipolar disorder management: A patient‐centered approach

Nestsiarovich

Hurwitz²,

Nelson

et al. 2017

Bipolar Disorders

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ObjectivesAs part of a series of Patient‐Centered Outcomes Research Institute‐funded large‐scale retrospective observational studies on bipolar disorder (BD) treatments and outcomes, we sought the input of patients with BD and their family members to develop research questions. We aimed to identify systemic root causes of patient‐reported challenges with BD management in order to guide subsequent studies and initiatives.MethodsThree focus groups were conducted where patients and their family members (total n = 34) formulated questions around the central theme, “What do you wish you had known in advance or over the course of treatment for BD?” In an affinity mapping exercise, participants clustered their questions and ranked the resulting categories by importance. The research team and members of our patient partner advisory council further rated the questions by expected impact on patients. Using a Theory of Constraints systems thinking approach, several causal models of BD management challenges and their potential solution were developed with patients using the focus group data.ResultsA total of 369 research questions were mapped to 33 categories revealing 10 broad themes. The top priorities for patient stakeholders involved pharmacotherapy and treatment alternatives. Analysis of causal relationships underlying 47 patient concerns revealed two core conflicts: for patients, whether or not to take pharmacotherapy, and for mental health services, the dilemma of care quality vs quantity.ConclusionsTo alleviate the core conflicts identified, BD management requires a coordinated multidisciplinary approach including: improved access to mental health services, objective diagnostics, sufficient provider visit time, evidence‐based individualized treatment, and psychosocial support.

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Section: Discussionmentioning

confidence: 99%

Systemic challenges in bipolar disorder management: A patient‐centered approach

Nestsiarovich

Hurwitz²,

Nelson

et al. 2017

Bipolar Disorders

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“…Software systems have been designed to identify specific clinical conditions and assist physicians to diagnose and monitor chronic diseases taking into account relevant quality attributes [ 22 – 25 ]. For example, Pesl et al (2016) [ 26 ] present the architecture and initial usability results of an insulin bolus calculator for diabetes.…”

Section: Introductionmentioning

confidence: 99%

Design and evaluation of a mobile application to assist the self-monitoring of the chronic kidney disease in developing countries

Sobrinho

Silva

Perkusich

et al. 2018

BMC Med Inform Decis Mak

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BackgroundThe chronic kidney disease (CKD) is a worldwide critical problem, especially in developing countries. CKD patients usually begin their treatment in advanced stages, which requires dialysis and kidney transplantation, and consequently, affects mortality rates. This issue is faced by a mobile health (mHealth) application (app) that aims to assist the early diagnosis and self-monitoring of the disease progression.MethodsA user-centered design (UCD) approach involving health professionals (nurse and nephrologists) and target users guided the development process of the app between 2012 and 2016. In-depth interviews and prototyping were conducted along with healthcare professionals throughout the requirements elicitation process. Elicited requirements were translated into a native mHealth app targeting the Android platform. Afterward, the Cohen’s Kappa coefficient statistics was applied to evaluate the agreement between the app and three nephrologists who analyzed test results collected from 60 medical records. Finally, eight users tested the app and were interviewed about usability and user perceptions.ResultsA mHealth app was designed to assist the CKD early diagnosis and self-monitoring considering quality attributes such as safety, effectiveness, and usability. A global Kappa value of 0.7119 showed a substantial degree of agreement between the app and three nephrologists. Results of face-to-face interviews with target users indicated a good user satisfaction. However, the task of CKD self-monitoring proved difficult because most of the users did not fully understand the meaning of specific biomarkers (e.g., creatinine).ConclusionThe UCD approach provided mechanisms to develop the app based on the real needs of users. Even with no perfect Kappa degree of agreement, results are satisfactory because it aims to refer patients to nephrologists in early stages, where they may confirm the CKD diagnosis.

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“…While political guidance in the national health-care strategy in Norway is quite supportive with regard to implementation of SDM, [7][8][9]18 there might still be a pronounced need to better balance emphasis between decision aids and HCP SDM trainings. The increasing number of patient decision aids both internationally and in Norway [33][34][35] should be complemented by a national effort to systematically implement SDM training. 18 As we continue to develop the "Ready for SDM" training, we will consider designing further studies in accordance with the complex intervention framework and the Kirkpatrick's model.…”

Section: Results In Contextmentioning

confidence: 99%

Ready for shared decision making: Pretesting a training module for health professionals on sharing decisions with their patients

Kienlin

Nytrøen

Stacey

et al. 2020

Evaluation Clinical Practice

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Introduction While shared decision‐making (SDM) training programmes for health professionals have been developed in several countries, few have been evaluated. In Norway, a comprehensive curriculum, “klar for samvalg” (ready for SDM), for interprofessional health‐care teams was created using generic didactic methods and guidance to tailor training to various contexts. The programmes adapted didactic methods from an evidence‐based German training programmes (doktormitSDM). The overall aim was to evaluate two particular SDM modules on facilitating SDM implementation into clinical practice. Method A descriptive mixed methods study using questionnaires and a focus group guided by the Medical Research Council Complex Interventions Framework. The training was provided as two different applications (module AB [introduction and SDM‐basics] and module ABC [introduction, SDM‐basics and interactive training]) with differing learning objectives, extent of interactivity, and duration (1 vs 2 hours). Groups of participants were recruited consecutively based on requests for health professional SDM training in university/college‐ and hospital‐settings. By a focus group and a self‐administered questionnaire comprehensibility, relevance and acceptance were assessed and qualitative feedback collected after the training. Data passed descriptive and content analysis, respectively. Knowledge was assessed twice using five multiple‐choice items and analysed using paired t‐tests. Results In 11 (six AB and five ABC) training sessions, 357/429 (296 AB and 133 ABC) eligible nurses, physicians and health professional students with varying clinical backgrounds and previous levels of SDM‐knowledge participated. SDM‐knowledge increased from 25‐78% (range pretest) to 85‐95% (range post‐test) (P ≤ .001). The training was rated easy to understand, acceptable and relevant for practice. Findings to improve the education suggest higher emphasis on interprofessional teaching methods. Conclusions The two SDM training modules met the basic requirements for use in a broader SDM implementation strategy and can even improve knowledge.

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The development and feasibility of a personal health-optimization system for people with bipolar disorder

Cited by 20 publications

References 37 publications

Systemic challenges in bipolar disorder management: A patient‐centered approach

Systemic challenges in bipolar disorder management: A patient‐centered approach

Design and evaluation of a mobile application to assist the self-monitoring of the chronic kidney disease in developing countries

Ready for shared decision making: Pretesting a training module for health professionals on sharing decisions with their patients

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