JMIR Publications

ABSTRACT

Background:

Clinical trials of psychological therapies such as cognitive behavioural therapy typically show sustained post-treatment effects. However, less is known about individuals’ outcomes following treatment in routine practice, and additionally, patient representatives have highlighted a need for better post-discharge support. The ‘Paddle’ app aims to address these issues. Paddle allows patients to store their therapy materials, reflect on sessions, and monitor their wellbeing during and after treatment, completing outcome questionnaires and monthly reviews. Method: Study 1 evaluated patients’ use of Paddle during treatment in routine practice. Patient and therapist surveys explored feasibility, acceptability and helpfulness. Study 2 examined the feasibility of using the app post-discharge, inviting users to submit monthly questionnaires for six months, and seeking feedback via survey.

Results:

Findings indicated Paddle was feasible to implement with few technical problems. Although not all patients wanted to use an app in Study 1, uptake was 66% and users found it acceptable and helpful for organising and remembering therapy information. In Study 2, 49% of users submitted follow-up data. Of those who reliably improved during treatment, 73% remained so throughout the six-month follow-up period. Among all users, 20% showed further reliable improvement at least once compared to their end of treatment score. We introduce the concept of ‘reliable relapse’, which occurred for 36% of users who had reliably recovered during treatment, highlighting that some experience fluctuations or deterioration. Conclusion: These preliminary findings suggest Paddle shows promise in supporting patients to collate therapy resources and monitor their wellbeing during and after treatment. It may help to improve rates of follow-up data collection, which warrants further investigation.