Translating the Intention to Seek Treatment into Action: Does Symptom Monitoring Make a Difference? Results from a Randomized Controlled Trial

Shafran, Roz; Gyani, Alex; Rostron, Jane; Allen, Sarah; Myles-Hooton, Pamela; Allcott-Watson, Hannah; Rose, Suzanna

doi:10.1017/s1352465818000498

Cited by 7 publications

(6 citation statements)

References 34 publications

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“…Self-monitoring of depressive symptoms on patients' phones has been shown to be easy and reliable [51,52] and several studies highlighted its effectiveness to improve depressive symptoms [36,53,54]. A study on untreated patients with symptoms of depression and anxiety also showed that access to daily self-monitoring helped them to translate their intention to seek treatment into actual treatment-seeking behaviour [55]. Even if this effect was small, it defines self-monitoring as a promising tool to decrease the number of untreated patients suffering from depression.…”

Section: Discussionmentioning

confidence: 99%

Patient and physician perspectives of a smartphone application for depression: a qualitative study

et al. 2021

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Background Despite an increasing number of smartphone apps, such therapeutic tools have not yet consistently demonstrated their efficacy and many suffer from low retention rates. To ensure the development of efficient apps associated with high adherence, we aimed to identify, through a user-centred design approach, patient and physician expectations of a hypothetical app dedicated to depression. Methods We conducted semi-structured interviews with physicians (psychiatrists and general practitioners) and patients who had experienced a major depressive episode during the last 12 months using the focus group method. The interviews were audio recorded, transcribed and analysed using qualitative content analysis to define codes, categories and emergent themes. Results A total of 26 physicians and 24 patients were included in the study. The focus groups showed balanced sex and age distributions. Most participants owned a smartphone (83.3% of patients, 96.1% of physicians) and were app users (79.2% of patients and 96.1% of physicians). The qualitative content analysis revealed 3 main themes: content, operating characteristics and barriers to the use of the app. Expected content included the data collected by the app, aiming to provide information about the patient, data provided by the app, gathering psychoeducation elements, therapeutic tools and functionalities to help with the management of daily life and features expected for this tool. The “operating characteristics” theme gathered aims considered for the app, its potential target users, considered modalities of use and considerations around its accessibility and security of use. Finally, barriers to the use of the app included concerns about potential app users, its accessibility, safety, side-effects, utility and functioning. All themes and categories were the same for patients and physicians. Conclusions Physician and patient expectations of a hypothetical smartphone app dedicated to depression are high and confirmed the important role it could play in depression care. The key points expected by the users for such a tool are an easy and intuitive use and a personalised content. They are also waiting for an app that gives information about depression, offers a self-monitoring functionality and helps them in case of emergency.

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Section: Discussionmentioning

confidence: 99%

Patient and physician perspectives of a smartphone application for depression: a qualitative study

et al. 2021

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“…Symptom monitoring has benefited numerous clinical populations, including patients with fibromyalgia, clinical depression, and cancer (3)(4)(5). Symptom monitoring involves recording symptoms using diaries, symptom questionnaires, or electronic health (e-health) instruments, including mobile apps or online symptom trackers; this can take place across time, or retrospectively at one or more given time points (6).…”

Section: Introductionmentioning

confidence: 99%

“…Symptom monitoring involves recording symptoms using diaries, symptom questionnaires, or electronic health (e-health) instruments, including mobile apps or online symptom trackers; this can take place across time, or retrospectively at one or more given time points ( 6 ). Notable outcomes have included increased likelihood of accessing healthcare, heightened survival rates, and reductions in symptom prevalence and severity ( 3 – 5 , 7 , 8 ).…”

Section: Introductionmentioning

confidence: 99%

“…Despite broader literature demonstrating beneficial effects, symptom monitoring has not been formally evaluated as an intervention ( 3 – 5 , 7 , 8 ). According to the Medical Research Council's (MRC) framework for developing complex interventions, existing evidence for an intervention should ideally be collated into a systematic review to understand whether it is likely to be effective, whether it can be implemented into a research setting, and whether it can be widely implemented if the results are favourable ( 9 ).…”

Section: Introductionmentioning

confidence: 99%

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Evaluating the Effects of Symptom Monitoring on Menopausal Health Outcomes: A Systematic Review and Meta-Analysis

Andrews

Hale

John

et al. 2021

Front. Glob. Womens Health

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Evidence suggests that monitoring and appraising symptoms can result in increased engagement in medical help-seeking, improved patient-doctor communication, and reductions in symptom prevalence and severity. To date, no systematic reviews have investigated whether symptom monitoring could be a useful intervention for menopausal women. This review explored whether symptom monitoring could improve menopausal symptoms and facilitate health-related behaviours. Results suggested that symptom monitoring was related to improvements in menopausal symptoms, patient-doctor communication and medical decision-making, heightened health awareness, and stronger engagement in setting treatment goals. Meta-analyses indicated large effects for the prolonged use of symptom diaries on hot flush frequencies. Between April 2019 and April 2021, PsychInfo, EMBASE, MEDLINE, CINAHL, Cochrane, ProQuest, PsychArticles, Scopus, and Web of Science were searched. Eighteen studies met the eligibility criteria and contributed data from 1,718 participants. Included studies quantitatively or qualitatively measured the impact of symptom monitoring on menopausal populations and symptoms. Research was narratively synthesised using thematic methods, 3 studies were examined via meta-analysis. Key themes suggest that symptom monitoring is related to improvements in menopausal symptoms, improved patient-doctor communication and medical decision-making, increased health awareness, and stronger engagement in goal-setting behaviours. Meta-analysis results indicated large effects for the prolonged use of symptom diaries on hot flush frequency: 0.73 [0.57, 0.90]. This review is limited due to the low number of studies eligible for inclusion, many of which lacked methodological quality. These results indicate that symptom monitoring has potential as an effective health intervention for women with menopausal symptoms. This intervention may be beneficial within healthcare settings, in order to improve patient-doctor relations and adherence to treatment regimes. However, findings are preliminary and quality assessments suggest high risk of bias. Thus, further research is needed to support these promising outcomes.Systematic Review Registration Number:https://www.crd.york.ac.uk/prospero/display_record.php?, PROSPERO, identifier: CRD42019146270.

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“…However, upon the increased intention to use those apps, patients need to learn effective coping strategies and skills to perform and maintain the actual behavior without using excessive reassurance-seeking and relying on safety behaviors. Shafran et al highlighted the importance of daily self-monitoring through, for example, digital trainings in supporting patients with reduced mental health status in translating intentions into actual behavior [69].…”

Section: Xsl • Fomentioning

confidence: 99%

Psychosomatic Rehabilitation Patients and the General Population During COVID-19: Online Cross-sectional and Longitudinal Study of Digital Trainings and Rehabilitation Effects

Keller¹,

Dahmen²,

Kötting³

et al. 2021

JMIR Ment Health

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Background:The COVID-19 pandemic has largely affected people's mental health and psychological well-being. Specifically, individuals with a pre-existing mental health disorder seem more impaired by lockdown measures posing as major stress factors. Medical rehabilitation treatment can help people cope with these stressors. The internet and digital apps provide a platform to contribute to regular treatment and to conduct research on this topic.Objective: Making use of internet-based assessments, this study investigated individuals from the general population and patients from medical, psychosomatic rehabilitation clinics. Levels of depression, anxiety, loneliness, and perceived stress during the COVID-19 pandemic, common COVID-19-related worries, and the intention to use digital apps were compared. Furthermore, we investigated whether participating in internet-delivered digital trainings prior to and during patients' rehabilitation stay, as well as the perceived usefulness of digital trainings, were associated with improved mental health after rehabilitation. Methods: A large-scale, online, cross-sectional study was conducted among a study sample taken from the general population (N=1812) in Germany from May 2020 to April 2021. Further, a longitudinal study was conducted making use of the internet among a second study sample of psychosomatic rehabilitation patients at two measurement time points-before (N=1719) and after (n=738) rehabilitation-between July 2020 and April 2021. Validated questionnaires and adapted items were used to assess mental health and COVID-19-related worries. Digital trainings were evaluated. Propensity score matching, multivariate analyses of covariance, an exploratory factor analysis, and hierarchical regression analyses were performed.Results: Patients from the psychosomatic rehabilitation clinics reported increased symptoms with regard to depression, anxiety, loneliness, and stress (F 4,2028 =183.74, P<.001, η 2 p =0.27) compared to the general population. Patients perceived greater satisfaction in communication with health care professionals (F 1,837 =31.67, P<.001, η 2 p =0.04), had lower financial worries (F 1,837 =38.96, P<.001, η 2 p =0.04), but had higher household-related worries (F 1,837 =5.34, P=.02, η 2 p =0.01) compared to the general population. Symptoms of depression, anxiety, loneliness, and perceived stress were lower postrehabilitation (F 1,712 =23.21, P<.001, η 2 p =0.04) than prior to rehabilitation. Psychosomatic patients reported a higher intention to use common apps and digital trainings (F 3,2021 =51.41, P<.001, η 2 p =0.07) than the general population. With regard to digital trainings offered prior to and during the rehabilitation stay, the perceived usefulness of digital trainings on rehabilitation goals was associated with decreased symptoms of depression (β=-.14, P<.001), anxiety (β=-.12, P<.001), loneliness (β=-.18, P<.001), and stress postrehabilitation (β=-.19, P<.001). Participation in digital group therapy for depression was associated with an overall change...

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Translating the Intention to Seek Treatment into Action: Does Symptom Monitoring Make a Difference? Results from a Randomized Controlled Trial

Abstract: Symptom monitoring can increase actual treatment-seeking in those with an intention to seek treatment.

Cited by 7 publications

References 34 publications

Patient and physician perspectives of a smartphone application for depression: a qualitative study

Patient and physician perspectives of a smartphone application for depression: a qualitative study

Evaluating the Effects of Symptom Monitoring on Menopausal Health Outcomes: A Systematic Review and Meta-Analysis

Psychosomatic Rehabilitation Patients and the General Population During COVID-19: Online Cross-sectional and Longitudinal Study of Digital Trainings and Rehabilitation Effects

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