Harnessing digital for selfmanagement and recovery in psychosis Simon Bradstreet, Research Fellow & Trial Manager
This talk Introduce the EMPOWER App and approach Consider feasibility and wider experiences of digital in psychosis Study progress and getting involved control! Faramarz Hashemi flickr
What is EMPOWER? Supported mobile phone App: Early Warning Signs monitoring Informs early intervention Supports self management Stepped care response Nurse and peer supported
The App
Question time
Behind the scenes Responses compared to baseline No change Message generated Small change Targeted message generated Empower 17:32 Larger change Message generated Alert raised Suspicious thoughts are common. In one recent study, 70% of people said that they had, at some time, experienced the feeling that people were deliberately trying to harm them or upset them in some way and 80% felt strangers were looking at them critically.
Functions
But will people actually use it? 72% - 82% have mobile phone (Firth et al. 2016) Psychosis, mobile phones, paranoia, are you serious? People want to use Apps for monitoring (e.g. Ben-Zeev et al. 2016) and like doing so (e.g. Alvarez-Jimenez, 2014; Palmier- Claus et al. 2012)
But will people actually use it? Actual acceptability higher than hypothetical and peer support important (Berry et al. 2016) Very high acceptability in some studies: e.g. 80% over 3-months (Granholm et al. 2012) and 1 year (Spaniel et al. 2012) Overall we have found good levels of coherence and enthusiasm
But will people actually use it? Conclusions: Although small, the current published literature demonstrates strong evidence for the feasibility of using smartphones to enhance the care of people with schizophrenia. High rates of engagement and satisfaction with a broad range of apps suggest the nascent potential of this mobile technology. However, there remains limited data on the efficacy of such interventions. Firth & Torus, 2015
The research Phase 1: qualitative work Phase 2: Cluster Randomised Controlled Trial: 6 community teams NHS Greater Glasgow and Clyde 2 teams in Melbourne Late summer start
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References Alvarez-Jimenez, M., Alcazar-Corcoles, M. A., González-Blanch, C., Bendall, S., McGorry, P. D., & Gleeson, J. F. (2014). Online, social media and mobile technologies for psychosis treatment: A systematic review on novel user-led interventions. Schizophrenia Research, 156(1), 96 106. http://doi.org/10.1016/j.schres.2014.03.021 Ben-Zeev, D., Scherer, E. A., Gottlieb, J. D., Rotondi, A. J., Brunette, M. F., Achtyes, E. D., Kane, J. M. (2016). mhealth for Schizophrenia: Patient Engagement With a Mobile Phone Intervention Following Hospital Discharge. JMIR Mental Health, 3(3), e34. http://doi.org/10.2196/mental.6348 Firth, J., Cotter, J., Torous, J., Bucci, S., Firth, J. A., & Yung, A. R. (2015). Mobile Phone Ownership and Endorsement of mhealth Among People With Psychosis: A Meta-analysis of Cross-sectional Studies. Schizophrenia Bulletin, sbv132. http://doi.org/10.1093/schbul/sbv132 Firth, J., & Torous, J. (2015). Smartphone Apps for Schizophrenia: A Systematic Review. JMIR mhealth and uhealth, 3(4), e102. http://doi.org/10.2196/mhealth.4930 Palmier-Claus, et al. (2012). The feasibility and validity of ambulatory self-report of psychotic symptoms using a smartphone software application. BMC Psychiatry, 12(1), 172. http://doi.org/10.1186/1471-244x-12-172