Acceptability of mHealth augmentation of Collaborative Care: A mixed methods pilot study

Gen Hosp Psychiatry. Mar-Apr 2018;51:22-29. doi: 10.1016/j.genhosppsych.2017.11.010. Epub 2017 Nov 24.

Abstract

Objective: To assess the feasibility and acceptability of a mobile health platform supporting Collaborative Care.

Method: Collaborative Care patients (n=17) used a smartphone app to transmit PHQ-9 and GAD-7 scores and sensor data to a dashboard used by one care manager. Patients completed usability and satisfaction surveys and qualitative interviews at 4weeks and the care manager completed a qualitative interview. Mobile metadata on app usage was obtained.

Results: All patients used the app for 4weeks, but only 35% (n=6) sustained use at 8weeks. Prior to discontinuing use, 88% (n=15) completed all PHQ-9 and GAD-7 measures, with lower response rates for daily measures. Four themes emerged from interviews: understanding the purpose; care manager's role in supporting use; benefits of daily monitoring; and privacy / security concerns. Two themes were user-specific: patients' desire for personalization; and care manager burden.

Conclusions: The feasibility and acceptability of the mobile platform is supported by the high early response rate, however attrition was steep. Our qualitative findings revealed nuanced participant experiences and uncovered some concerns about mobile health. To encourage retention, attention may need to be directed toward promoting patient understanding and provider engagement, and offering personalized patient experiences.

Keywords: Depression; Mental health services; Patient reported outcome measures; Primary health care; Smartphone; Telemedicine.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anxiety Disorders / therapy*
  • Delivery of Health Care, Integrated
  • Depressive Disorder / therapy*
  • Feasibility Studies
  • Female
  • Humans
  • Intersectoral Collaboration
  • Male
  • Mental Health Services / statistics & numerical data*
  • Middle Aged
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Patient Compliance / statistics & numerical data
  • Patient Reported Outcome Measures*
  • Pilot Projects
  • Primary Health Care / statistics & numerical data*
  • Smartphone
  • Telemedicine / statistics & numerical data*
  • Young Adult