Self-monitoring practices, attitudes, and needs of individuals with bipolar disorder: implications for the design of technologies to manage mental health

Murnane, Elizabeth L.; Cosley, Dan; Chang, Pamara F.; Lee, Min Kyung; Frank, Ellen; Gay, Geri; Matthews, Mark

doi:10.1093/jamia/ocv165

Cited by 112 publications

(61 citation statements)

References 33 publications

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“…However, psychopathology tracking is not necessarily benign. It can magnify rumination and self-focus, and it has been reported to trigger emotional instability (Murnane et al., 2016). Similarly, the immediate delivery of interventions might create reliance upon them which could interfere with the acquisition of self-management skills.…”

Section: Digital Assessmentmentioning

confidence: 99%

The impact of digital technology on psychological treatments and their dissemination

Fairburn

Patel

2017

Behaviour Research and Therapy

356

227

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The psychological treatment of mental health problems is beginning to undergo a sea-change driven by the widespread availability of digital technology. In this paper we provide an overview of the developments to date and those in the pipeline. We describe the various uses of digital interventions and consider their likely impact on clinical practice, clinical services and the global dissemination of psychological treatments. We note the importance of online clinics, blended treatment, digital assessment and digital training.

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Section: Digital Assessmentmentioning

confidence: 99%

The impact of digital technology on psychological treatments and their dissemination

Fairburn

Patel

2017

Behaviour Research and Therapy

356

227

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“…Monitoring symptoms is also a prerequisite for measuring mood instability in BP and for delivering interventions that address needs of specific individuals in the moment . Many mobile and wearable technologies are available for individuals to self‐monitor their symptoms, but engagement is a common problem . This study evaluated engagement strategies for individuals with BP to monitor symptoms longitudinally.…”

Section: Introductionmentioning

confidence: 99%

A comparative study of engagement in mobile and wearable health monitoring for bipolar disorder

2019

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Objectives Self‐monitoring is recommended for individuals with bipolar disorder, with numerous technological solutions available. This study aimed to identify basic components of these solutions that increase engagement with self‐monitoring. Methods Participants with bipolar disorder (n = 47) monitored their symptoms with a Fitbit and a smartphone app and were randomly assigned to either review or not review recorded symptoms weekly. We tested whether individuals would better adhere to and prefer monitoring with passive monitoring with an activity tracker compared to active monitoring with a smartphone app and whether individuals would better adhere to self‐monitoring if their recorded symptoms were reviewed with an interviewer. Results Monitoring with a smartphone app achieved similar adherence and preference to Fitbit (P > .85). Linear mixed effects modeling found adherence decreased significantly more over the study for the Fitbit (12% more, P < .001) even though more participants reported they would use the Fitbit over a year compared to the app (72.3% vs 46.8%). Reviewing symptoms weekly did not improve adherence, but most participants reported they would prefer to review symptoms with a clinician (74.5%) and on monthly basis (57.5%) compared to alternatives. Participants endorsed sleep as the most important symptom to monitor, forgetfulness as the largest barrier to self‐monitoring, and raising self‐awareness as the best reason for self‐monitoring. Conclusions We recommend a combined strategy of wearable and mobile monitoring that includes reminders, targets raising self‐awareness, and tracks sleep. A clinician may want to review symptoms on a monthly basis. Trial registration: http://ClinicalTrials.gov NCT03358238.

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“…These decisions can be made individually or in collaboration with health care professionals, and ODLs such as PGHD can be used for personal tracking and improvement as well as to inform clinical care [13,17,18]. PGHD collected through a range of different types of smart devices and other new technologies can provide patients with innovative ways to actively manage their health [11,19-21], improving patient self-knowledge [12], and management of health concerns, including diabetes [4-6,14,22], physical activity [8,10], and behavioral health triggers such as anxiety [7,9,23]. …”

Section: Introductionmentioning

confidence: 99%

Integrating Patient-Generated Health Data Into Clinical Care Settings or Clinical Decision-Making: Lessons Learned From Project HealthDesign

et al. 2016

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BackgroundPatient-generated health data (PGHD) are health-related data created or recorded by patients to inform their self-care and understanding about their own health. PGHD is different from other patient-reported outcome data because the collection of data is patient-driven, not practice- or research-driven. Technical applications for assisting patients to collect PGHD supports self-management activities such as healthy eating and exercise and can be important for preventing and managing disease. Technological innovations (eg, activity trackers) are making it more common for people to collect PGHD, but little is known about how PGHD might be used in outpatient clinics.ObjectiveThe objective of our study was to examine the experiences of health care professionals who use PGHD in outpatient clinics.MethodsWe conducted an evaluation of Project HealthDesign Round 2 to synthesize findings from 5 studies funded to test tools designed to help patients collect PGHD and share these data with members of their health care team. We conducted semistructured interviews with 13 Project HealthDesign study team members and 12 health care professionals that participated in these studies. We used an immersion-crystallization approach to analyze data. Our findings provide important information related to health care professionals’ attitudes toward and experiences with using PGHD in a clinical setting.ResultsHealth care professionals identified 3 main benefits of PGHD accessibility in clinical settings: (1) deeper insight into a patient’s condition; (2) more accurate patient information, particularly when of clinical relevance; and (3) insight into a patient’s health between clinic visits, enabling revision of care plans for improved health goal achievement, while avoiding unnecessary clinic visits. Study participants also identified 3 areas of consideration when implementing collection and use of PGHD data in clinics: (1) developing practice workflows and protocols related to PGHD collection and use; (2) data storage, accessibility at the point of care, and privacy concerns; and (3) ease of using PGHD data.ConclusionsPGHD provides value to both patients and health care professionals. However, more research is needed to understand the benefit of using PGHD in clinical care and to identify the strategies and clinic workflow needs for optimizing these tools.

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Self-monitoring practices, attitudes, and needs of individuals with bipolar disorder: implications for the design of technologies to manage mental health

Cited by 112 publications

References 33 publications

The impact of digital technology on psychological treatments and their dissemination

The impact of digital technology on psychological treatments and their dissemination

A comparative study of engagement in mobile and wearable health monitoring for bipolar disorder

Integrating Patient-Generated Health Data Into Clinical Care Settings or Clinical Decision-Making: Lessons Learned From Project HealthDesign

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