Article type
Year
Abstract
Background: Bipolar Disorder (BD) has a global prevalence of 2%. BD in young people is associated with greater illness severity and poorer outcomes. Mood symptom monitoring is an important part of clinical management. Pen and paper charts are the current main approach to mood monitoring in this population, but completion rates are low and review of data is time consuming. Mood monitoring using digital technologies such as smartphone apps could reduce costs, improve accessibility and increase reliability of self-management, but there is currently no evidence to support this in a population of young people with BD.
Objectives: To co-design and co-produce a smartphone mood monitoring app to improve outcomes for young people with BD in a UK tertiary care service.
Methods: Participatory methodology to co-design and co-produce a mood monitoring app. Tertiary care patients aged 16 to 25 years with a DSM-5 diagnosis of BD, and their families, were recruited. In the Co-Design Phase weekly workshops were held with six young people and their families to identify themes of self-management. In the co-production phase the alpha-prototype of the app was developed by young people, clinicians, researchers, graphic designers and software engineers. A mixed methods prospective study (n=13) was used to evaluation the acceptability of the alpha-prototype to young people with BD. The Warwick Edinburgh Mental Wellbeing Scale (WEMWBS) was used to measure mental wellbeing, the Satisfaction Usability Tool (SUT) captured overall satisfaction with the app and qualitative semi-structured interviewing was undertaken.
Results: Six themes of self-management (socialisation, learning, relaxation, excitement, regulation and distraction) were incorporated in the alpha-prototype of the app. Patients requested a sliding scale, rather than Likert scale, for rating their mood on dimensions such as happiness, sadness and irritability. A graphical representation of trends in mood was developed to feedback to users about their own mood trends and a comment section was added so that users could note any triggers associated with their mood fluctuation. A ‘lifeline’ feature was developed, for use in crisis (e.g. suicidal ideation) so users could press one button to call through a list of emergency contacts until someone answered. Scores on the WEMWBS and SUT improved after app use. Interview data suggested the app was well received, but patients requested more personalisation and interactivity. The lifeline function was used twice.
Conclusions: The co-design and co-production of a mood monitoring smartphone app was iterative in nature and maintained the patient focus by incorporating patient suggests into the development of the app. The reported acceptability and usability of the app suggest that a smartphone mood monitoring app could be used clinically to improve engagement with mood monitoring and improve cost-effectiveness of mood monitoring strategies
Patient or healthcare consumer involvement: Patients were involved in co-design and co-production of the app.
Objectives: To co-design and co-produce a smartphone mood monitoring app to improve outcomes for young people with BD in a UK tertiary care service.
Methods: Participatory methodology to co-design and co-produce a mood monitoring app. Tertiary care patients aged 16 to 25 years with a DSM-5 diagnosis of BD, and their families, were recruited. In the Co-Design Phase weekly workshops were held with six young people and their families to identify themes of self-management. In the co-production phase the alpha-prototype of the app was developed by young people, clinicians, researchers, graphic designers and software engineers. A mixed methods prospective study (n=13) was used to evaluation the acceptability of the alpha-prototype to young people with BD. The Warwick Edinburgh Mental Wellbeing Scale (WEMWBS) was used to measure mental wellbeing, the Satisfaction Usability Tool (SUT) captured overall satisfaction with the app and qualitative semi-structured interviewing was undertaken.
Results: Six themes of self-management (socialisation, learning, relaxation, excitement, regulation and distraction) were incorporated in the alpha-prototype of the app. Patients requested a sliding scale, rather than Likert scale, for rating their mood on dimensions such as happiness, sadness and irritability. A graphical representation of trends in mood was developed to feedback to users about their own mood trends and a comment section was added so that users could note any triggers associated with their mood fluctuation. A ‘lifeline’ feature was developed, for use in crisis (e.g. suicidal ideation) so users could press one button to call through a list of emergency contacts until someone answered. Scores on the WEMWBS and SUT improved after app use. Interview data suggested the app was well received, but patients requested more personalisation and interactivity. The lifeline function was used twice.
Conclusions: The co-design and co-production of a mood monitoring smartphone app was iterative in nature and maintained the patient focus by incorporating patient suggests into the development of the app. The reported acceptability and usability of the app suggest that a smartphone mood monitoring app could be used clinically to improve engagement with mood monitoring and improve cost-effectiveness of mood monitoring strategies
Patient or healthcare consumer involvement: Patients were involved in co-design and co-production of the app.