Accepted for/Published in: JMIR Formative Research
Date Submitted: Mar 28, 2019
Date Accepted: Jan 17, 2021
Ecological momentary assessment using patient smartphone in depression: a feasibility study
ABSTRACT
Background:
Ecological Momentary Assessment (EMA) is a promising tool in the management of psychiatric disorders and particularly depression; it allows for a real-time evaluation of symptoms and an earlier detection of relapse or efficiency of the treatment. The generalization of the smartphone in modern societies offers a new large-scale support for EMA.
Objective:
The main objective of this study is twofold (i) assessing the compliance to the smartphone application for each patient defined by the number of EMAs answered (ii) estimate the external validity of the EMA using a correlation between self-esteem/guilt/mood variables with the HDRS severity.
Methods:
Eleven patients at the Pitié Salpêtrière Hospital were followed during 28 days with the help of a smartphone application. Every patient enrolled in the study had two type of assessments: (i) three outpatient consultations with a psychiatrist at three different timepoints (day 1, day 15 and day 28 (ii) a real-time data collection using the EMA smartphone application with one single fixed notification per day at 3pm during 28 days. The results of the real-time collected data were reviewed during the three outpatient consultations by a psychiatrist using a “dashboard” aggregating all the patient’s data in a user-friendly manner.
Results:
Out of the total of eleven, six patients have attended the 3 outpatient consultations with the psychiatrist and have completed the HDRS scale at each consultation. We found a positive correlation between HDRS score and the variables “self-esteem”, “guilt”, “mood” (correlation spearman = 0.57). Seven patients responded to the EMAs for a duration greater than or equal to 28 days with an average response rate to the EMAs of 60%. Furthermore, we demonstrate a positive correlation between the number of responses to EMAs and the duration of follow-up. (spearman correlation = 0.63).
Conclusions:
This first study with such a long follow-up demonstrates significant patient compliance to the smartphone application. In addition, the self-assessment carried out by the patient seems fairly faithful to the standardized measurement carried out by the psychiatrist. The results suggest also that for some patients, it is more convenient to use the smartphone application rather than going to the outpatient consultations
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