Mobile monitoring system improves depressive symptoms, patient-clinician communication

Danielle Blanch-Hartigan

Patients who used a mobile monitoring system with clinician access experienced significant improvement in depressive symptoms and psychological health compared with those who received usual care, according to results of a randomized clinical trial published in JAMA Network Open.

“What was particularly exciting about this platform was that monitoring was accessible to both patients and their clinicians,” Danielle Blanch-Hartigan, PhD, MPH, of the department of natural and applied sciences at Bentley University in Massachusetts, told Healio Psychiatry. “As someone who studies the interactions between patients and clinicians, I'm excited by the myriad possibilities for mobile sensing tools as an additional form of information exchange and their potential to foster communication.”

According to Blanch-Hartigan and colleagues, although early detection and monitoring of mental health symptoms are crucial to patient well-being, many clinicians and patients are unable to receive indicators of clinical progress that are reliable and timely. They noted that mobile monitoring systems can address these health care shortcomings by providing a secure infrastructure to store, analyze and give feedback to patients and clinicians, as well as to allow for passive tracking of behavioral and vocal indicators of symptoms. Despite the potential of these systems, research into their effectiveness in clinical settings is limited, they wrote.

To address this research gap, the researchers randomly assigned 68 patients to either usual care or usual care plus the mobile monitoring system, which was downloaded in the form of a smartphone application to patients’ smartphones. Over 6 months, the application passively collected smartphone use metadata, including geolocation data, call logs and short message service logs. The researchers analyzed metadata against previously modeled DSM-IV diagnostic criteria for depression and PTSD. Patients also had the option to leave short audio recordings through the application, thus allowing voice feature analyses for an additional measure of depressed mood. They used sum scores from the Patient Health Questionnaire and the Schwartz Outcome Scale as the primary outcome measures.

Blanch-Hartigan and colleagues reported a significant treatment-by-time interaction effect, which supported decreased depressive symptoms (P = .042) and improved psychological health (P = 0.45) among patients who received the mobile monitoring system compared with usual care. Of 15 patients who completed a user experience survey from the intervention group, 12 (80%) reported that they would likely or definitely provide mobile monitoring data to their clinician. Further, eight (53%) noted that the application had at least somewhat improved their communication with clinicians. A total of 4 (27%) directly discussed scores with their clinicians.

“This trial is a step in the right direction toward furthering the evidence base for the efficacy and feasibility of mobile sensing platforms in mental health settings,” Blanch-Hartigan said. – by Joe Gramigna

Disclosures: Blanch-Hartigan reports consulting work for CompanionMX and a grant from the Arnold P. Gold Foundation. Please see the study for all other authors’ relevant financial disclosures.