Use of a Mobile Health (mHealth) Platform for Remote Assessment of Suicidal Ideation, Depression, and Anxiety: A Longitudinal Retrospective Study
Introduction: There is growing support for the use of integrated measurement-based care to capture symptom data in real time so treatment providers can make informed decisions about intervention strategies for mental health problems, such as depression and anxiety, both of which are known to increas...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Innovative Healthcare Institute
2022-01-01
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| Series: | Innovations in Digital Health, Diagnostics, and Biomarkers |
| Subjects: | |
| Online Access: | https://idhd.org/doi/pdf/10.36401/IDDB-21-03 |
| _version_ | 1811197891096608768 |
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| author | Adam Pardes William Lynch Matthew Miclette Ellen McGeoch Brian P Daly |
| author_facet | Adam Pardes William Lynch Matthew Miclette Ellen McGeoch Brian P Daly |
| author_sort | Adam Pardes |
| collection | DOAJ |
| description | Introduction: There is growing support for the use of integrated measurement-based care to capture symptom data in real time so treatment providers can make informed decisions about intervention strategies for mental health problems, such as depression and anxiety, both of which are known to increase suicide. We examined the potential scalability and effectiveness of a mobile health (mHealth) application with integrated behavioral health functions to capture remote patient-reported measurement of suicidal ideation and overall symptoms of depression and anxiety. Methods: This study was an observational retrospective review of deidentified patient data, including symptoms of suicidal ideation, depression, and anxiety as measured by the Patient Health Questionnaire-9 (PHQ-9) or Generalized Anxiety Disorder 7 (GAD-7) scale, which were administered to and completed by patients on a smartphone or desktop application. After controlling for age, sex, and the presence of moderate versus severe symptoms at baseline, mean scores were analyzed with the Student's t-test. Results: Of patients who took the PHQ-9 assessment at baseline and 8 weeks later (n = 764), the proportion who endorsed suicidal thinking decreased from 25% to 14.66% (p < 0.001) over 8 weeks. The mean PHQ-9 score was reduced from 14.69 (standard error [SE], 4.09) to 10.50 (SE, 5.94; p < 0.001), and a subset of individuals who continued use and took the PHQ-9 again at 24 weeks (n = 185) had a further decrease to 9.03 (SE, 7.09, p < 0.01). Although 21.62% of this subset still had suicidal thinking, the frequency of suicidal thoughts decreased. Of patients who took the GAD-7 at baseline and 8 weeks (n = 797) the mean score decreased from 14.20 (SE, 3.31) to 10.08 (SE, 5.55; p < 0.001) at 8 weeks and to 7.48 (SE, 6.54; p < 0.001) for a subset (n = 278) who continued use and took a GAD-7 at 24 weeks (n = 278). The sum of subgroup samples is larger than the whole because of instances of comorbid depression and anxiety. Conclusion: Remote assessments within technology-supported integrated behavioral health care were feasible at scale. Change in symptoms could be observed at the individual and group level in real time, which may allow clinical teams to adjust treatments and improve outcomes. Prospective controlled studies are needed to determine what factors contribute to reductions in symptom severity. |
| first_indexed | 2024-04-12T01:21:44Z |
| format | Article |
| id | doaj.art-5ed066562f0f4431bdc199e55ece2153 |
| institution | Directory Open Access Journal |
| issn | 2688-8130 |
| language | English |
| last_indexed | 2024-04-12T01:21:44Z |
| publishDate | 2022-01-01 |
| publisher | Innovative Healthcare Institute |
| record_format | Article |
| series | Innovations in Digital Health, Diagnostics, and Biomarkers |
| spelling | doaj.art-5ed066562f0f4431bdc199e55ece21532022-12-22T03:53:46ZengInnovative Healthcare InstituteInnovations in Digital Health, Diagnostics, and Biomarkers2688-81302022-01-0181510.36401/IDDB-21-03i2688-8130-2-2022-8Use of a Mobile Health (mHealth) Platform for Remote Assessment of Suicidal Ideation, Depression, and Anxiety: A Longitudinal Retrospective StudyAdam Pardes0William Lynch1Matthew Miclette2Ellen McGeoch3Brian P Daly41 NeuroFlow, Inc, Philadelphia, PA, USA1 NeuroFlow, Inc, Philadelphia, PA, USA1 NeuroFlow, Inc, Philadelphia, PA, USA1 NeuroFlow, Inc, Philadelphia, PA, USA1 NeuroFlow, Inc, Philadelphia, PA, USAIntroduction: There is growing support for the use of integrated measurement-based care to capture symptom data in real time so treatment providers can make informed decisions about intervention strategies for mental health problems, such as depression and anxiety, both of which are known to increase suicide. We examined the potential scalability and effectiveness of a mobile health (mHealth) application with integrated behavioral health functions to capture remote patient-reported measurement of suicidal ideation and overall symptoms of depression and anxiety. Methods: This study was an observational retrospective review of deidentified patient data, including symptoms of suicidal ideation, depression, and anxiety as measured by the Patient Health Questionnaire-9 (PHQ-9) or Generalized Anxiety Disorder 7 (GAD-7) scale, which were administered to and completed by patients on a smartphone or desktop application. After controlling for age, sex, and the presence of moderate versus severe symptoms at baseline, mean scores were analyzed with the Student's t-test. Results: Of patients who took the PHQ-9 assessment at baseline and 8 weeks later (n = 764), the proportion who endorsed suicidal thinking decreased from 25% to 14.66% (p < 0.001) over 8 weeks. The mean PHQ-9 score was reduced from 14.69 (standard error [SE], 4.09) to 10.50 (SE, 5.94; p < 0.001), and a subset of individuals who continued use and took the PHQ-9 again at 24 weeks (n = 185) had a further decrease to 9.03 (SE, 7.09, p < 0.01). Although 21.62% of this subset still had suicidal thinking, the frequency of suicidal thoughts decreased. Of patients who took the GAD-7 at baseline and 8 weeks (n = 797) the mean score decreased from 14.20 (SE, 3.31) to 10.08 (SE, 5.55; p < 0.001) at 8 weeks and to 7.48 (SE, 6.54; p < 0.001) for a subset (n = 278) who continued use and took a GAD-7 at 24 weeks (n = 278). The sum of subgroup samples is larger than the whole because of instances of comorbid depression and anxiety. Conclusion: Remote assessments within technology-supported integrated behavioral health care were feasible at scale. Change in symptoms could be observed at the individual and group level in real time, which may allow clinical teams to adjust treatments and improve outcomes. Prospective controlled studies are needed to determine what factors contribute to reductions in symptom severity.https://idhd.org/doi/pdf/10.36401/IDDB-21-03anxietybehavioral healthcollaborative caredepressionintegrated behavioral health caremeasurement-based caremobile healthpatient health questionnairesuicide |
| spellingShingle | Adam Pardes William Lynch Matthew Miclette Ellen McGeoch Brian P Daly Use of a Mobile Health (mHealth) Platform for Remote Assessment of Suicidal Ideation, Depression, and Anxiety: A Longitudinal Retrospective Study Innovations in Digital Health, Diagnostics, and Biomarkers anxiety behavioral health collaborative care depression integrated behavioral health care measurement-based care mobile health patient health questionnaire suicide |
| title | Use of a Mobile Health (mHealth) Platform for Remote Assessment of Suicidal Ideation, Depression, and Anxiety: A Longitudinal Retrospective Study |
| title_full | Use of a Mobile Health (mHealth) Platform for Remote Assessment of Suicidal Ideation, Depression, and Anxiety: A Longitudinal Retrospective Study |
| title_fullStr | Use of a Mobile Health (mHealth) Platform for Remote Assessment of Suicidal Ideation, Depression, and Anxiety: A Longitudinal Retrospective Study |
| title_full_unstemmed | Use of a Mobile Health (mHealth) Platform for Remote Assessment of Suicidal Ideation, Depression, and Anxiety: A Longitudinal Retrospective Study |
| title_short | Use of a Mobile Health (mHealth) Platform for Remote Assessment of Suicidal Ideation, Depression, and Anxiety: A Longitudinal Retrospective Study |
| title_sort | use of a mobile health mhealth platform for remote assessment of suicidal ideation depression and anxiety a longitudinal retrospective study |
| topic | anxiety behavioral health collaborative care depression integrated behavioral health care measurement-based care mobile health patient health questionnaire suicide |
| url | https://idhd.org/doi/pdf/10.36401/IDDB-21-03 |
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