Psych Outpatients Happy to Monitor Mood Via Smartphone Apps

Megan Brooks

May 03, 2014

NEW YORK ― Most psychiatry outpatients own smartphones and are open to using them to monitor their mental health, potentially offering clinicians the opportunity to track their patients' mood in real time, preliminary research suggests.

"Mood tracking is mostly done only at appointments and is less often done outside the clinic. When it is done, it is often still with paper and pencil," study presenter John Torous, MD, of Harvard University and Beth Israel Deaconness Medical Center in Boston, Massachusetts, told Medscape Medical News.

"This is both inconvenient and risks not being accurate if the user 'back fills in' data at a later time. A smartphone application is a much easier tool because it can remind you when to fill out a survey, administer the survey, and automatically time stamp the survey, and securely deliver or store it, all without carrying around anything extra," he added.

Dr. Torous and colleagues assessed smartphone use among patients attending 5 outpatient mental health clinics ― 2 in Massachusetts and 1 each in Louisiana, Wisconsin, and California.

Initial results of 100 patients at 1 site in Massachusetts revealed that 70% owned a smartphone and more than 50% were willing to download a mobile app to monitor their mental health.

"Unfortunately, we do not have data in from all the study sites, but our initial results suggest that psychiatry patients both own smartphones and are interested in using them to monitor their mental health," Dr. Torous said. The patients expressed more interest in using a mobile app than text messaging for mental health monitoring.

What prompted this research project? "Being repeatedly told that conducting studies of smartphone apps for psychiatric illnesses was unfeasible because these patients probably did not have smartphones or want to use their smartphones to monitor their mental health," said Dr. Torous.

"Looking at the staggering number of mental health–related apps already on the iTunes store and drawing on personal experience with patients, I felt otherwise, and this project was created to obtain the data to better understand the smartphone ownership and interest in use by patients with psychiatric illness," he added.

Rapidly Expanding Field

Commenting on the study for Medscape Medical News, Adam C. Powell, PhD, who was not involved in the study, said it "provides evidence suggesting that many patients receiving treatment for mental health issues may be willing and able to consider using mobile applications to augment their treatment.

"That being said, the study does not provide any information about actual uptake or persistence of use," said Dr. Powell, president of Payer+Provider Syndicate, a Boston-based consulting firm specializing in operational challenges faced by health insurance companies and hospitals.

"For applications that perform longitudinal functions like mood tracking to be useful, they must be used on a regular basis. Experience has shown that many mobile applications are abandoned after a brief period of usage," Dr. Powell added.

Dr. Torous noted that most of the apps currently available to track mood have never been studied or tested in clinical studies with patients. His team has created an app called "Mindful Moods" and is in the process of conducting a small study using the app in patients suffering from depression to determine how results of daily mood tracking on a smartphone compare with standard assessments.

"The whole field of smartphone app research seems to be rapidly expanding, and there is a push to build a greater evidence base around this," Dr. Torous said.

Dr. Powell said several things need to happen for clinicians and patients to embrace mental health mobile applications.

"People will need to be assured that the information is stored securely, that it is easy for clinicians and patients to access and process, and that the mobile applications are designed in a way that encourages continued use," he explained.

Dr. Powell is coauthor of an article on mobile health apps that was published March 24 in JAMA.

The researchers have disclosed no relevant financial relationships. Dr. Powell has received personal fees from mHealthCoach and Verbal Applications, companies that offer app-based solutions for care coordination and patient-clinician communication.

American Psychiatric Association's 2014 Annual Meeting. Abstract NR1-53. Presented May 3, 2014.

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