Real-world implementation of a smartphone-based psychoeducation program for bipolar disorder: observational ecological study

Background: SIMPLe is an internet-delivered self-management mobile app for bipolar disorder (BD) designed to combine technology with evidence-based interventions and facilitate access to psychoeducational content. The SIMPLe app was launched to the real world to make it available worldwide within th...

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Detalles Bibliográficos
Autores: García-Estela, Aitana, Cantillo, Jordi, Angarita-Osorio, Natalia, Mur-Mila, Estanislao, Anmella, Gerard, Pérez, Víctor, Vieta, Eduard, Hidalgo Mazzei, Diego, Colom, Francesc
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2022
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:10230/54279
Acceso en línea:http://hdl.handle.net/10230/54279
http://dx.doi.org/10.2196/31565
Access Level:acceso abierto
Palabra clave:Intervention
SIMPLe
App
Bipolar disorder
Mobile phone
Psychoeducation
Smartphone
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network_name_str España
repository_id_str
dc.title.none.fl_str_mv Real-world implementation of a smartphone-based psychoeducation program for bipolar disorder: observational ecological study
title Real-world implementation of a smartphone-based psychoeducation program for bipolar disorder: observational ecological study
spellingShingle Real-world implementation of a smartphone-based psychoeducation program for bipolar disorder: observational ecological study
García-Estela, Aitana
Intervention
SIMPLe
App
Bipolar disorder
Mobile phone
Psychoeducation
Smartphone
title_short Real-world implementation of a smartphone-based psychoeducation program for bipolar disorder: observational ecological study
title_full Real-world implementation of a smartphone-based psychoeducation program for bipolar disorder: observational ecological study
title_fullStr Real-world implementation of a smartphone-based psychoeducation program for bipolar disorder: observational ecological study
title_full_unstemmed Real-world implementation of a smartphone-based psychoeducation program for bipolar disorder: observational ecological study
title_sort Real-world implementation of a smartphone-based psychoeducation program for bipolar disorder: observational ecological study
dc.creator.none.fl_str_mv García-Estela, Aitana
Cantillo, Jordi
Angarita-Osorio, Natalia
Mur-Mila, Estanislao
Anmella, Gerard
Pérez, Víctor
Vieta, Eduard
Hidalgo Mazzei, Diego
Colom, Francesc
author García-Estela, Aitana
author_facet García-Estela, Aitana
Cantillo, Jordi
Angarita-Osorio, Natalia
Mur-Mila, Estanislao
Anmella, Gerard
Pérez, Víctor
Vieta, Eduard
Hidalgo Mazzei, Diego
Colom, Francesc
author_role author
author2 Cantillo, Jordi
Angarita-Osorio, Natalia
Mur-Mila, Estanislao
Anmella, Gerard
Pérez, Víctor
Vieta, Eduard
Hidalgo Mazzei, Diego
Colom, Francesc
author2_role author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Intervention
SIMPLe
App
Bipolar disorder
Mobile phone
Psychoeducation
Smartphone
topic Intervention
SIMPLe
App
Bipolar disorder
Mobile phone
Psychoeducation
Smartphone
description Background: SIMPLe is an internet-delivered self-management mobile app for bipolar disorder (BD) designed to combine technology with evidence-based interventions and facilitate access to psychoeducational content. The SIMPLe app was launched to the real world to make it available worldwide within the context of BD treatment. Objective: The main aims of this study are as follows: to describe app use, engagement, and retention rates based on server data; to identify patterns of user retention over the first 6-month follow-up of use; and to explore potential factors contributing to discontinuation of app use. Methods: This was an observational ecological study in which we pooled available data from a real-world implementation of the SIMPLe app. Participation was open on the project website, and the data-collection sources were a web-based questionnaire on clinical data and treatment history administered at inclusion and at 6 months, subjective data gathered through continuous app use, and the use patterns captured by the app server. Characteristics and engagement of regular users, occasional users, and no users were compared using 2-tailed t tests or analysis of variance or their nonparametric equivalent. Survival analysis and risk functions were applied to regular users' data to examine and compare use and user retention. In addition, a user evaluation analysis was performed based on satisfaction, perceived usefulness, and reasons to discontinue app use. Results: We included 503 participants with data collected between 2016 and 2018, of whom 77.5% (n=390) used the app. Among the app users, 44.4% (173/390) completed the follow-up assessment, and data from these participants were used in our analyses. Engagement declined gradually over the first 6 months of use. The probability of retention of the regular users after 1 month of app use was 67.4% (263/390; 95% CI 62.7%-72.4%). Age (P=.002), time passed since illness onset (P<.001), and years since diagnosis of BD (P=.048) correlate with retention duration. In addition, participants who had been diagnosed with BD for longer used the app on more days (mean 97.73, SD 69.15 days; P=.002) than those who had had a more recent onset (mean 66.49, SD 66.18 days; P=.002) or those who had been diagnosed more recently (mean 73.45, SD 66 days; P=.01). Conclusions: The user retention rate of the app decreased rapidly after each month until reaching only one-third of the users at 6 months. There exists a strong association between age and app engagement of individuals with BD. Other variables such as years lived with BD, diagnosis of an anxiety disorder, and taking antipsychotics seem relevant as well. Understanding these associations can help in the definition of the most suitable user profiles for predicting trends of engagement, optimization of app prescription, and management.
publishDate 2022
dc.date.none.fl_str_mv 2022
2022
2022
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10230/54279
http://dx.doi.org/10.2196/31565
url http://hdl.handle.net/10230/54279
http://dx.doi.org/10.2196/31565
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv J Med Internet Res. 2022 Feb 2;24(2):e31565
dc.rights.none.fl_str_mv https://creativecommons.org/licenses/by/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv JMIR Publications
publisher.none.fl_str_mv JMIR Publications
dc.source.none.fl_str_mv reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
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spelling Real-world implementation of a smartphone-based psychoeducation program for bipolar disorder: observational ecological studyGarcía-Estela, AitanaCantillo, JordiAngarita-Osorio, NataliaMur-Mila, EstanislaoAnmella, GerardPérez, VíctorVieta, EduardHidalgo Mazzei, DiegoColom, FrancescInterventionSIMPLeAppBipolar disorderMobile phonePsychoeducationSmartphoneBackground: SIMPLe is an internet-delivered self-management mobile app for bipolar disorder (BD) designed to combine technology with evidence-based interventions and facilitate access to psychoeducational content. The SIMPLe app was launched to the real world to make it available worldwide within the context of BD treatment. Objective: The main aims of this study are as follows: to describe app use, engagement, and retention rates based on server data; to identify patterns of user retention over the first 6-month follow-up of use; and to explore potential factors contributing to discontinuation of app use. Methods: This was an observational ecological study in which we pooled available data from a real-world implementation of the SIMPLe app. Participation was open on the project website, and the data-collection sources were a web-based questionnaire on clinical data and treatment history administered at inclusion and at 6 months, subjective data gathered through continuous app use, and the use patterns captured by the app server. Characteristics and engagement of regular users, occasional users, and no users were compared using 2-tailed t tests or analysis of variance or their nonparametric equivalent. Survival analysis and risk functions were applied to regular users' data to examine and compare use and user retention. In addition, a user evaluation analysis was performed based on satisfaction, perceived usefulness, and reasons to discontinue app use. Results: We included 503 participants with data collected between 2016 and 2018, of whom 77.5% (n=390) used the app. Among the app users, 44.4% (173/390) completed the follow-up assessment, and data from these participants were used in our analyses. Engagement declined gradually over the first 6 months of use. The probability of retention of the regular users after 1 month of app use was 67.4% (263/390; 95% CI 62.7%-72.4%). Age (P=.002), time passed since illness onset (P<.001), and years since diagnosis of BD (P=.048) correlate with retention duration. In addition, participants who had been diagnosed with BD for longer used the app on more days (mean 97.73, SD 69.15 days; P=.002) than those who had had a more recent onset (mean 66.49, SD 66.18 days; P=.002) or those who had been diagnosed more recently (mean 73.45, SD 66 days; P=.01). Conclusions: The user retention rate of the app decreased rapidly after each month until reaching only one-third of the users at 6 months. There exists a strong association between age and app engagement of individuals with BD. Other variables such as years lived with BD, diagnosis of an anxiety disorder, and taking antipsychotics seem relevant as well. Understanding these associations can help in the definition of the most suitable user profiles for predicting trends of engagement, optimization of app prescription, and management.JMIR Publications202220222022info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/54279http://dx.doi.org/10.2196/31565reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésJ Med Internet Res. 2022 Feb 2;24(2):e31565©Aitana García-Estela, Jordi Cantillo, Natalia Angarita-Osorio, Estanislao Mur-Milà, Gerard Anmella, Víctor Pérez, Eduard Vieta, Diego Hidalgo-Mazzei, Francesc Colom. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 02.02.2022. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on https://www.jmir.org/, as well as this copyright and license information must be included.https://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:recercat.cat:10230/542792026-05-29T05:05:01Z
score 15,81155

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