The Functionality, Evidence, and Privacy Issues Around Smartphone Apps for the Top Neuropsychiatric Conditions

Minen, Mia T.; Gopal, Ariana; Sahyoun, Gabriella; Stieglitz, Eric J.; Torous, John

doi:10.1176/appi.neuropsych.19120353

Cited by 13 publications

(44 citation statements)

References 23 publications

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“…Many people with migraine are using smartphone apps. One 2018 study found that the top 15 migraine apps on the market in the Google Play and in the Apple Stores had an average of 72,440 ± 256,628 (100–1,000,000) downloads 23 . Research has demonstrated that patients with migraine are willing to track their symptoms and are interested in sharing their electronic headache diary data with their providers 24,25 .…”

Section: Discussionmentioning

confidence: 99%

“…One 2018 study found that the top 15 migraine apps on the market in the Google Play and in the Apple Stores had an average of 72,440 ± 256,628 (100-1,000,000) downloads. 23 Research has demonstrated that patients with migraine are willing to track their symptoms and are interested in sharing their electronic headache diary data with their providers. 24,25 Thus, going forward, studies may examine how providers can best digitally prescribe apps and, in turn, how they can efficiently review the patient-inputted data.…”

Section: Median Iqrmentioning

confidence: 99%

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Telehealth as a new care delivery model: The headache provider experience

et al. 2021

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Objective To assess telehealth practice for headache visits in the United States. Background The rapid roll out of telehealth during the COVID‐19 pandemic impacted headache specialists. Methods American Headache Society (AHS) members were emailed an anonymous survey (9/9/20–10/12/20) to complete if they had logged ≥2 months or 50+ headache visits via telehealth. Results Out of 1348 members, 225 (16.7%) responded. Most were female (59.8%; 113/189). Median age was 47 (interquartile range [IQR] 37–57) (N = 154). The majority were MD/DOs (83.7%; 159/190) or NP/PAs (14.7%; 28/190), and most (65.1%; 123/189) were in academia. Years in practice were 0–3: 28; 4–10: 58; 11–20: 42; 20+: 61. Median number of telehealth visits was 120 (IQR 77.5–250) in the prior 3 months. Respondents were “comfortable/very comfortable” treating via telehealth (a) new patient with a chief complaint of headache (median, IQR 4 [3–5]); (b) follow‐up for migraine (median, IQR 5 [5–5]); (c) follow‐up for secondary headache (median, IQR 4 [3–4]). About half (51.1%; 97/190) offer urgent telehealth. Beyond being unable to perform procedures, top barriers were conducting parts of the neurologic exam (157/189), absence of vital signs (117/189), and socioeconomic/technologic barriers (91/189). Top positive attributes were patient convenience (185/190), reducing patient travel stress (172/190), patient cost reduction (151/190), flexibility with personal matters (128/190), patient comfort at home (114/190), and patient medications nearby (103/190). Only 21.3% (33/155) of providers said telehealth visit length differed from in‐person visits, and 55.3% (105/190) believe that the no‐show rate improved. On a 1–5 Likert scale, providers were “interested”/“very interested” in digitally prescribing headache apps (median 4, IQR 3–5) and “interested”/“very interested” in remotely monitoring patient symptoms (median 4, IQR 3–5). Conclusions Respondents were comfortable treating patients with migraine via telehealth. They note positive attributes for patients and how access may be improved. Technology innovations (remote vital signs, digitally prescribing headache apps) and remote symptom monitoring are areas of interest and warrant future research.

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Section: Discussionmentioning

confidence: 99%

Section: Median Iqrmentioning

confidence: 99%

Telehealth as a new care delivery model: The headache provider experience

et al. 2021

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“…In our study, the main concern of participants was privacy. This has been previously discussed in the context of digital markers for psychiatric illness [20, 21] as well as several neuropsychiatric conditions [10]. Applications and devices that monitor behavior and physiology may be designed so that the device itself processes the information, with no transmission of sensitive data.…”

Section: Discussionmentioning

confidence: 99%

“…This study demonstrated that it may be possible to detect early signs of cognitive decline through Internet search terms. The current limitations of digital biomarkers are the lack of standardization of tools and established regulatory guidelines on privacy [10]. Importantly, there is a lack of understanding of the public's attitudes and acceptance to utilize these technologies, which we aim to address here.…”

Section: Introductionmentioning

confidence: 99%

Survey on Acceptance of Passive Technology Monitoring for Early Detection of Cognitive Impairment

et al. 2020

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Introduction: Digital biomarkers may act as a tool for early detection of changes in cognition. It is important to understand public perception of technologies focused on monitoring cognition to better guide the design of these tools and inform patients appropriately about the associated risks and benefits. Health care systems may also play a role in the clinical, legal, and financial implications of such technologies. Objective: To evaluate public opinion on the use of passive technology for monitoring cognition. Methods: This was a one-time, Internet-based survey conducted in English and Spanish. Results: Within the English survey distributed in the USA (n = 173), 58.1% of respondents would be highly likely to agree to passive monitoring of cognition via a smartphone application. Thirty-eight percent of those with a higher degree of experience with technology were likely to agree to monitoring versus 20% of those with less experience with technology (p = 0.003). Sixty-two percent of non-health-care professionals were likely to agree to monitoring versus 45% of health-care workers (p = 0.012). There were significant concerns regarding privacy (p < 0.01). We compared the surveys answered in Spanish in Costa Rica via logistic regression (n = 43, total n = 216), adjusting for age, education level, health-care profession, owning a smartphone, experience with technology, and perception of cognitive decline. Costa Rican/Spanish-speaking respondents were 7 times more likely to select a high probability of agreeing to such a technology (p < 0.01). English-speaking respondents from the USA were 5 times more likely to be concerned about the impact on health insurance (p = 0.001) and life insurance (p = 0.01). Conclusions: Understanding public perception and ethical implications should guide the design of digital biomarkers for cognition. Privacy and the health-care system in which the participants take part are 2 major factors to be considered. It is the responsibility of researchers to convey the ethical and legal implications of cognition monitoring.

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“…Mobile health (mHealth) apps have the potential to provide several advantages for delivering interdisciplinary care for headache management including increased accessibility, enhanced patient-provider communication, support of headache management and education, symptom monitoring, and potential reductions in health care costs (9)(10)(11)(12). Given that effective headache management requires a multimodal approach (13), mHealth apps have the potential to promote successful engagement in treatment.…”

Section: Introductionmentioning

confidence: 99%

A systematic evaluation of primary headache management apps leveraging behavior change techniques

et al. 2021

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Background Mobile health apps have the potential to promote adherence to headache management through the use of evidence-based behavior change techniques (e.g., self-monitoring). While many headache management apps exist, the extent to which these apps include behavior change techniques remains unknown. Thus, the present study systematically evaluated the content and quality of commercially available headache management apps. Methods Headache apps were identified using a systematic search in the Apple App and Google Play stores. A total of 55 apps were evaluated using the taxonomy of behavior change techniques and app quality using the Mobile App Rating Scale. Results Headache management apps included 0–14 behavior change techniques (Mean [M] = 5.89) and 0–8 headache management behavior change techniques (M = 4.29). App quality ranged from 2.84–4.67 (M = 3.73) out of 5.00. Three apps, Migraine Trainer, Easeday: Headache & Migraine, and PainScale, included the highest number of overall and headache management behavior change techniques along with good quality scores. Conclusions While randomized controlled trials are necessary to determine the efficacy of individual headache apps, most existing apps include evidence-based headache management behavior change techniques. Headache apps often focus on either self-monitoring or stress management via relaxation training, suggesting that patients’ needs should be used to inform app selection.

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The Functionality, Evidence, and Privacy Issues Around Smartphone Apps for the Top Neuropsychiatric Conditions

Cited by 13 publications

References 23 publications

Telehealth as a new care delivery model: The headache provider experience

Telehealth as a new care delivery model: The headache provider experience

Survey on Acceptance of Passive Technology Monitoring for Early Detection of Cognitive Impairment

A systematic evaluation of primary headache management apps leveraging behavior change techniques

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