Clinicians' perspective on an app for patient self‐monitoring in eating disorder treatment

Lindgreen, Pil; Clausen, Loa; Lomborg, Kirsten

doi:10.1002/eat.22833

Cited by 23 publications

(23 citation statements)

References 27 publications

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“…Furthermore, the patients’ perception of treatment workload may depend on their abilities to counteract the ED pathology in general; in ED treatment, a common challenge is the egosyntonic nature of some ED symptoms and patients’ ambivalence toward some treatment activities, for example, weight gain [ 48 ]. Finally, the clinicians’ reception of the training on how to use RR and with that their specific RR usage [ 49 ] may also influence the patients’ experiences of treatment workload. Thus, minimally disruptive medicine might be especially complicated to apply in ED treatment.…”

Section: Discussionmentioning

confidence: 99%

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Patient Experiences Using a Self-Monitoring App in Eating Disorder Treatment: Qualitative Study

Lindgreen¹,

Lomborg²,

Clausen³

2018

JMIR Mhealth Uhealth

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BackgroundThe Recovery Record smartphone app is a self-monitoring tool for individuals recovering from an eating disorder. Unlike traditional pen-and-paper meal diaries, which are often used in eating disorder treatment, the app holds novel features, such as meal reminders, affirmations, and patient-clinician in-app linkage, the latter allowing for clinicians to continuously monitor patients' app data.ObjectiveTo explore patients' experiences with using Recovery Record as part of outpatient eating disorder treatment.MethodsA total of 41 patients from a Danish eating disorder treatment facility were included in the study. All 41 patients participated in participant observations of individual or group treatment sessions, and 26 were interviewed about their experiences with using the app in treatment. The data material was generated and analyzed concurrently, applying the inductive methodology of Interpretive Description.ResultsThe patients' experiences with Recovery Record depended on its app features, the impact of these features on patients, and their specific app usage. This patient-app interaction affected and was affected by changeable contexts making patients' experiences dynamic. The patient-app interaction affected patients' placement of specific Recovery Record app features along a continuum from supportive to obstructive of individual everyday life activities including the eating disorder treatment. As an example, some patients found it supportive being notified by their clinician when their logs had been monitored as it gave them a sense of relatedness. Contrarily, other patients felt under surveillance, which was obstructive, as it made them feel uneasy or even dismissing the app.ConclusionsSome patients experienced the app and its features as mostly supportive of their everyday life and the eating disorder treatment, while others experienced it primarily as obstructive. When applying apps in eating disorder treatment, we therefore recommend that patients and clinicians collaborate to determine how the app in question best fits the capacities, preferences, and treatment needs of the individual patient. Thus, we encourage patients and clinicians to discuss how specific features of the applied app affect the individual patient to increase the use of supportive features, while limiting the use of obstructive ones.

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Section: Discussionmentioning

confidence: 99%

“…Clinical practice is in need of explicit guidelines on the usage of apps in ED treatment [ 49 ]. Although the specific content and design of such guidelines require more research, our study outlines possible recommendations.…”

Section: Discussionmentioning

confidence: 99%

Patient Experiences Using a Self-Monitoring App in Eating Disorder Treatment: Qualitative Study

Lindgreen¹,

Lomborg²,

Clausen³

2018

JMIR Mhealth Uhealth

Self Cite

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“…Experts of technology‐based mental health tools emphasize the importance of adopting a user‐centric approach, lest the tools remain unused (Taylor et al, 2019). Featured next are three articles providing data about patients' (Linardon, Shatte, Tepper, & Fuller‐Tyszkiewicz, 2020; Neumayr, Voderholzer, Tregarthen, & Schlegl, 2019) perspectives on and examining clinicians' (Lindgreen, Clausen, & Lomborg, 2018) experiences with technology tools used in the treatment of eating disorders.…”

Section: Patients' and Therapists' Perspectives On Technology Toolsmentioning

confidence: 99%

“…Various applications have been developed to help patients accomplish self‐monitoring via mobile phone or online entry (Bauer & Moessner, 2013). In their paper entitled “Clinicians' perspective on an app for patient self‐monitoring in eating disorder treatment,” Lindreen and colleagues describe a qualitative study of clinicians' experience with integrating Recovery Record into their practice with eating disorder patients (Lindgreen et al, 2018). The clinicians recognized the value in being able to monitor patients' self‐monitoring records.…”

Section: Patients' and Therapists' Perspectives On Technology Toolsmentioning

confidence: 99%

Access to evidence‐based care for eating disorders during the COVID‐19 crisis

Weissman

Bauer

Thomas

2020

Intl J Eating Disorders

131

143

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The COVID‐19 pandemic has forced an abrupt change in the delivery of clinical services, including for individuals with an eating disorder. We present this Virtual Issue as a resource for the eating disorder community to showcase research published in the International Journal of Eating Disorders that provides information on effective strategies to help address the challenges arising from COVID‐19‐related disruptions. Articles included describe original research or systematic reviews on obstacles to health services use and strategies to improve access to care; technological tools to provide or enhance interventions; patients' and clinicians' attitudes or perspectives on using digital tools for clinical care; factors influencing therapeutic alliance; and ideas for improving reach and uptake of digital interventions. We hope that readers will find ways to observe and record their own experiences during this global crisis; the experiences of people at risk for developing or exhibiting an eating disorder; and the experiences of those who care for people with an eating disorder. These lived experiences will be invaluable in formulating hypotheses for future studies in service of advancing the understanding of eating disorders and improving interventions and policies for reducing the burden of suffering attributable to eating disorders.

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“…They found clinically significant improvements (defined as at least a 0.5 SD reduction in global EDE‐Q score) in 40% of users (Darcy et al, n.d.). Furthermore, there are two qualitative evaluations of RR in a clinical sample, one from the patients' and one from the clinicians' perspective (Lindgreen, Clausen, & Lomborg, ; Lindgreen, Lomborg, & Clausen, ). The studies found that the acceptance of the app mainly depends on individual factors of the user.…”

Section: Introductionmentioning

confidence: 99%

Improving aftercare with technology for anorexia nervosa after intensive inpatient treatment: A pilot randomized controlled trial with a therapist‐guided smartphone app

Neumayr

Voderholzer

Tregarthen

et al. 2019

Intl J Eating Disorders

110

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Objective To evaluate the feasibility, acceptability, and preliminary efficacy of an innovative therapist‐guided smartphone‐based aftercare intervention following inpatient treatment of patients with severe anorexia nervosa (AN). Method Forty female patients with AN (ICD‐10: F50.0/F50.1) (aged: 15–36 years) were randomized either to an 8‐week smartphone‐based aftercare intervention (German version of “Recovery Record”) with therapist feedback as an adjunct to treatment as usual (intervention group [IG]) or to treatment as usual alone (control group [CG]). Body mass index (BMI) and eating disorder (ED) symptoms were assessed at discharge (baseline), postintervention (after 8 weeks), and at 6‐month follow‐up. Additionally, patients' satisfaction, adherence to the smartphone‐based intervention, and postdischarge health care utilization were evaluated. Results Patients showed a high level of adherence and reported a very high acceptance of the app and the aftercare intervention. We found at postintervention nonsignificant small to moderate between‐group effect sizes favoring the IG regarding BMI (d = −0.24; 95% confidence interval [CI] [−0.90, 0.41]) and ED symptoms (Eating Disorder Examination‐Questionnaire global: d = 0.56; 95% CI [−0.10, 1.22]). At 6‐month follow‐up, effects wore off and no significant differences between the IG and CG were evident. Discussion This was the first study to evaluate a therapist‐guided smartphone‐based aftercare intervention for discharged inpatients with AN. Results suggest that such an intervention is highly accepted by patients and that it could support symptom stabilization or continued improvement as an add‐on therapy to treatment as usual. A larger scale randomized controlled trial is now planned to further evaluate the efficacy of this aftercare intervention for patients with AN.

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Clinicians' perspective on an app for patient self‐monitoring in eating disorder treatment

Cited by 23 publications

References 27 publications

Patient Experiences Using a Self-Monitoring App in Eating Disorder Treatment: Qualitative Study

Patient Experiences Using a Self-Monitoring App in Eating Disorder Treatment: Qualitative Study

Access to evidence‐based care for eating disorders during the COVID‐19 crisis

Improving aftercare with technology for anorexia nervosa after intensive inpatient treatment: A pilot randomized controlled trial with a therapist‐guided smartphone app

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