JMIR Publications

ABSTRACT

Background:

As demand for mental health services, especially around clinical high risk and early psychosis increases, there is a need for new solutions to increase access to and quality of care. Smartphones and mobile technology offer a potential tool support care for coordinated specialty care for early psychosis given their potential to support the six core roles of such care: case management, recovery-oriented psychotherapy, medication management, support for employment and education, coordination with primary care services, and family education and support. However, it is not known what services smartphones are actually offering specifically for coordinated specialty care and with what level of evidence.

Objective:

To review the published literature of smartphone technology to enhance care for prodromal and early course psychosis and schizophrenia patients and analyze studies by type and aligned with coordinated specialty care domains.

Methods:

A systematic literature search was conducted on August 16 and 17, 2019 using the following electronic databases – PubMed, EMBASE, Web of Sciences and PsycINFO. The eligible studies were reviewed and screened based on inclusion and exclusion criteria.

Results:

The search uncovered 388 unique results, of which 32 articles met initial inclusion criteria. The final outcome resulted in 21 eligible studies and 16 unique app platforms. Feasibility studies showcased high user engagement and interest among patients, monitoring studies demonstrated a correlation between app assessments and clinical outcomes, and intervention studies indicated that these apps have the potential to advance care. Eighteen studies reported on app use for the case management role of coordinated specialty care. No app studies focused or reported the roles of employment and education, coordination with primary care services, and family education and support.

Conclusions:

Although the current published literature on smartphone apps for prodromal and first episode psychosis is small, it is growing exponentially and holds promise to augment both monitoring and interventions. While research results and protocols for studies of apps are not well aligned with all coordained specialty care roles today, high rates of adoption and feasibility suggest potential for future efforts. These results will be used to develop coordinated specialty care specific app evaluation scales and toolkits.