JMIR Publications

ABSTRACT

Background:

Mental Health Applications (MHAs) provide opportunities for accessible, immediate and innovative approaches to better understand mental health disorders especially those with high burden such as Bipolar Disorder (BD). Many MHAs have been developed but few have had their effectiveness evaluated.

Objective:

This systematic scoping review explores current process and outcome measures of MHAs for BD (MHA-BD) with an aim to provide a comprehensive overview of current research. This will identify best practice for evaluating MHA-BDs and provide a solid base for future studies whilst also aiding professionals on MHA selection in BD.

Methods:

A systematic literature search of the health science databases PsycINFO, Medline, Embase, EBSCO, Scopus and Web of Science was undertaken up to January 2021 to narratively assess how other studies had evaluated MHAs for BD.

Results:

A total of 3342 articles were identified, and 12 were included. Across all studies, 507 participants were studied, 376 with BD Type I or II. Data from 372 participants were analysed. Of the 507, the mean age of participants in 11 of the studies was 36.5 years, with 302 being females. The final study did not collect age data. The most widely employed validated outcome measure were YMRS used 8 times, HDRS-17 & HAMD were both applied three times and ASRM, QID and FAST used twice, while CISS, EQ-5D, GAD-7, IDS-C, MASS, MDI, Morisky-Green 8-item, PSS and WHOQOL-BREF were all utilised once. Subjective markers were also measured in 9 different studies, 6 of which used MONARCA. Mood and energy levels were the most commonly utilised subjective markers, being used 4 four times each. Eleven of the 12 studies discussed the various confounding factors and barrier to MHA-BD usage.

Conclusions:

Reported low adherence rates, usability challenges and privacy concerns act as barriers to usage of MHA-BD. Moreover, as MHA evaluation is itself developing, so must guidance for clinicians in how to aid patient choices in m-Health. These obstacles could be ameliorated by incorporating co-production and co-design using participatory patient approaches during the development and evaluation stages of MHA-BD. Further, including qualitative aspects in trials that examine patient experience of both mental ill health and the MHA itself could result in a more patient-friendly, fit-for-purpose MHA-BD. Clinical Trial: Not applicable