Emily Yeung

Rotation 1: Psychiatry, CPEP

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

Reasoning:

• Patient enjoys playing on tablets and computers and is adept at using that technology
• Mother is exasperated and wants to be proactive. She wants to know what she can do on her end while we make recommendations for the patient on our end
• Possible to combine the patient being tech-savvy to introduce the idea of telemedicine or teletherapy in hopes of increasing treatment and medication adherence
• In order to do that, we should identify what kind of information is significant enough or important to track

Purpose:

• Bipolar disorder (BD) episodes have been associated with disturbing circadian rhythm and regular everyday life, thus intervention targeting the tracking of behavioral, social, and sleep-wake routines may prevent these episodes from occurring or improve outcomes
• Original practices for tracking involve paper-based diaries but nonadherence was common especially due to compromised concentration and paper format is less friendly for data analysis
• Investigate how patients with BD monitor/manage their condition
• Assess patient experience/attitudes about tracking mental health indicators (benefits or limitations)
• Evaluate attitudes towards future tracking technologies with functions of automatic tracking, feedback, and predictions

Methods:

• Total of 552 respondents from Sept. 2013 – April 2015
• Survey with multiple-choice, multiple-answer, open-ended questions
  • Quantitative data from close-ended questions = analyzed descriptively
  • Qualitative data from open-ende questions = analyzed with open coding
• 3 researchers independently developed a list of themes from this data to cover the following survey items:
  • Health management practices = health indicators monitored, how these indicators were tracked, whether this data was shared with providers, patient thoughts about how tracking impacts health and BD episodes
    • Tracked mood, sleep, finances, exercise, social interactions
  • Technology use’s relation to BD = variance in usage before, during, or after mood episode and whether technology-based triggers warned patients about signs of relapse
  • Demographics

Key Points:

• 9% of patients tracked other items such as medications, side effects, f/u appointments, personal triggers, manifestation of symptoms (caffeine, alcohol), pain levels, appetite, libido, suicidal ideation, and self-harm
• Individual tracking practices may shift over time depending on the severity of BD
• Long time users report gaining a sense of control that stems from a better understanding of the illness and how it affects their everyday routine
• Tracking allows for making health management more manageable
  • Manage condition between follow up or between therapy visits
• Promotes self awareness, reflection, and empowerment = instrumental in recovery
  • Keep calm since feel more structured, purposeful
  • Learn patterns of recovery for dealing with mood shifts
  • Increase confidence with coping strategies
• Supports interactions with clinicians
  • About 66% of participants reported using such self tracked information during discussion with a provider
  • Helps recount behaviors and events
  • Clinicians are receptive to tracking, establishes better rapport

Conclusion:

• Patient may benefit from using such technology and track information related to his BD early to develop better habits later on in life and to improve his relationship to his mother

This entry is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International license.