Acceptability Study of “Ascenso”: An Online Program for Monitoring and Supporting Patients with Depression in Chile

Espinosa, H. Daniel; Carrasco, Álvaro E.; Moessner, Markus; Cáceres, Cristian; Gloger, Sergio; Rojas, Graciela; Pérez, J. Carola; Vanegas, Jorge A.; Bauer, Stéphanie; Krause, Mariane

doi:10.1089/tmj.2015.0124

Cited by 22 publications

(24 citation statements)

References 17 publications

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“…37 Two pilot studies from Chile showed the acceptability of online depression treatment, including an online video game for supporting depression treatment among adolescents 38 and an online programme for symptom monitoring in patients receiving treatment for major depression. 39 An exploratory study 40 also showed that SMS text-messaging was feasible and acceptable for promotion of positive mental health in young women living in urban slums in Bangalore, India.…”

Section: Resultsmentioning

confidence: 99%

Digital technology for treating and preventing mental disorders in low-income and middle-income countries: a narrative review of the literature

Naslund

Aschbrenner

Araya

et al. 2017

The Lancet Psychiatry

390

298

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Few individuals living with mental disorders around the globe have access to mental health care, yet most have access to a mobile phone. Digital technology holds promise for improving access to, and quality of, mental health care. We reviewed evidence on the use of mobile, online, and other remote technologies for treatment and prevention of mental disorders in low-income and middle-income countries. Of the 49 studies identified, most were preliminary evaluations of feasibility and acceptability. The findings were promising, showing the potential effectiveness of online, text-messaging, and telephone support interventions. We summarised the evaluations as: technology for supporting clinical care and educating health workers, mobile tools for facilitating diagnosis and detection of mental disorders, technologies for promoting treatment adherence and supporting recovery, online self-help programmes for individuals with mental disorders, and programmes for substance misuse prevention and treatment. Continued research is needed to rigorously evaluate effectiveness, assess costs, and carefully consider potential risks of digital technology interventions for mental disorders, while determining how emerging technologies might support the scale-up of mental health treatment and prevention efforts across low-resource settings.

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Section: Resultsmentioning

confidence: 99%

Digital technology for treating and preventing mental disorders in low-income and middle-income countries: a narrative review of the literature

Naslund

Aschbrenner

Araya

et al. 2017

The Lancet Psychiatry

390

298

View full text Add to dashboard Cite

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“…Furthermore, in the evaluation of this program, Parada et al (38) suggested using a persuasive systems design approach. Likewise, in the study of Espinosa et al (32) participants who had completed the intervention suggested diversifying the monitoring assessments and having the possibility to interact with a therapist from the treatment center where they underwent face-to-face treatment. Both Martínez et al (under review) and Espinosa et al (32) suggested enabling peer communication.…”

Section: Discussionmentioning

confidence: 99%

“…Likewise, in the study of Espinosa et al (32) participants who had completed the intervention suggested diversifying the monitoring assessments and having the possibility to interact with a therapist from the treatment center where they underwent face-to-face treatment. Both Martínez et al (under review) and Espinosa et al (32) suggested enabling peer communication. ASCENSO and CTA studies showed that email does not seem to be a good way to contact and monitor participants (27,29).…”

Section: Discussionmentioning

confidence: 99%

“…Espinosa et al (32) studied the feasibility and acceptability of the Chilean version of the Supportive Monitoring and Disease Management over the Internet program [SUMMIT (36)], which was called ASCENSO in Spanish. This program aims to monitor and support patients after being discharged from depression treatment.…”

Section: Feasibility and Acceptability Studies For Depression Managementmentioning

confidence: 99%

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Improving Mental Health Care in Developing Countries Through Digital Technologies: A Mini Narrative Review of the Chilean Case

Rojas

Martínez

Franco

et al. 2019

Front. Public Health

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The uneven distribution of mental health resources contributes to the burden of mental disorders in vulnerable groups, especially in developing countries. Internet-based interventions and digital technologies can contribute to reducing the gap between high prevalence of mental disorders, demand for treatment, and access to mental health care, thereby reducing inequities in mental health. This mini review summarizes the current state of the field of e-mental health research in Chile, showing its progress, limitations, and challenges. Internet-based interventions are at an early stage of development in Chile. The interventions included are heterogeneous in terms of participants (e.g., secondary students, patients, healthcare professionals) and contexts (e.g., rural, urban, schools, primary health care), aims, and modalities (e.g., website, online games). While these studies confirmed the feasibility of Internet-based interventions, the shortage of studies on effectiveness and cost-effectiveness makes it difficult to disseminate and scale up these Internet-based programs. However, the growing amount of knowledge accumulated in the Chilean context could guide practices in other developing countries for supporting the mental health of underserved populations.

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“…Some systems offer interactive self-help with psychotherapy/psychoeducation [9], some include clinical backup, some are designed for use on smartphones, and others are designed for computers or tablets [10]. A small number of systems use a bidirectional feedback loop between patients and clinicians [11,12], in which data entered by patients can be seen in real-time by the clinician, and responses can occur immediately if needed. These systems make it easier for patients and clinicians to notice changes in conditions over time, be it behavioral changes such as activity or medication, or psychopathological symptoms (eg, mood and sleep).…”

Section: Introductionmentioning

confidence: 99%

Usability, Acceptability, and Adherence to an Electronic Self-Monitoring System in Patients With Major Depression Discharged From Inpatient Wards

et al. 2017

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BackgroundPatients suffering from depression have a high risk of relapse and readmission in the weeks following discharge from inpatient wards. Electronic self-monitoring systems that offer patient-communication features are now available to offer daily support to patients, but the usability, acceptability, and adherence to these systems has only been sparsely investigated.ObjectiveWe aim to test the usability, acceptability, adherence, and clinical outcome of a newly developed computer-based electronic self-assessment system (the Daybuilder system) in patients suffering from depression, in the period from discharge until commencing outpatient treatment in the Intensive Outpatient Unit for Affective Disorders.MethodsPatients suffering from unipolar major depression that were referred from inpatient wards to an intensive outpatient unit were included in this study before their discharge, and were followed for four weeks. User satisfaction was assessed using semiqualitative questionnaires and the System Usability Scale (SUS). Patients were interviewed at baseline and at endpoint with the Hamilton depression rating scale (HAM-D17), the Major Depression Inventory (MDI), and the 5-item World Health Organization Well-Being Index (WHO-5). In this four-week period patients used the Daybuilder system to self-monitor mood, sleep, activity, and medication adherence on a daily basis. The system displayed a graphical representation of the data that was simultaneously displayed to patients and clinicians. Patients were phoned weekly to discuss their data entries. The primary outcomes were usability, acceptability, and adherence to the system. The secondary outcomes were changes in: the electronically self-assessed mood, sleep, and activity scores; and scores from the HAM-D17, MDI, and WHO-5 scales.ResultsIn total, 76% of enrolled patients (34/45) completed the four-week study. Five patients were readmitted due to relapse. The 34 patients that completed the study entered data for mood on 93.8% of the days (872/930), sleep on 89.8% of the days (835/930), activity on 85.6% of the days (796/930), and medication on 88.0 % of the days (818/930). SUS scores were 86.2 (standard deviation [SD] 9.7) and 79% of the patients (27/34) found that the system lived up to their expectations. A significant improvement in depression severity was found on the HAM-D17 from 18.0 (SD 6.5) to 13.3 (SD 7.3; P<.01), on the MDI from 27.1 (SD 13.1) to 22.1 (SD 12.7; P=.006), and in quality of life on the WHO-5 from 31.3 (SD 22.9) to 43.4 (SD 22.1; P<.001) scales, but not on self-assessed mood (P=.08). Mood and sleep parameters were highly variable from day-to-day. Sleep-offset was significantly delayed from baseline, averaging 48 minutes (standard error 12 minutes; P<.001). Furthermore, when estimating delay of sleep-onset (with sleep quality included in the model) during the study period, this showed a significant negative effect on mood (P=.03)ConclusionsThe Daybuilder systems performed well technically, and patients were satisfied with the system and h...

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Acceptability Study of “Ascenso”: An Online Program for Monitoring and Supporting Patients with Depression in Chile

Abstract: ASCENSO appears to be a promising complement to regular care for depression. Following improvements of the program based on participants' feedback, future research should evaluate its efficacy and cost-effectiveness.

Cited by 22 publications

References 17 publications

Digital technology for treating and preventing mental disorders in low-income and middle-income countries: a narrative review of the literature

Digital technology for treating and preventing mental disorders in low-income and middle-income countries: a narrative review of the literature

Improving Mental Health Care in Developing Countries Through Digital Technologies: A Mini Narrative Review of the Chilean Case

Usability, Acceptability, and Adherence to an Electronic Self-Monitoring System in Patients With Major Depression Discharged From Inpatient Wards

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