Mobile Health (mHealth) vs Clinic-Based Intervention for People with - - PowerPoint PPT Presentation

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Mobile Health (mHealth) vs Clinic-Based Intervention for People with - - PowerPoint PPT Presentation

Oct 26, 2022 194 likes •423 views

How Telehealth Can Improve Patient Care and Outcomes: Mobile Health (mHealth) vs Clinic-Based Intervention for People with Serious Mental Illness Discussant: Mark Ishaug, MA Speaker: Dror Ben-Zeev, PhD CEO, Thresholds Professor of Psychiatry

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How Telehealth Can Improve Patient Care and Outcomes:

Mobile Health (mHealth) vs Clinic-Based Intervention for People with Serious Mental Illness

Speaker: Dror Ben-Zeev, PhD Professor of Psychiatry and Behavioral Sciences, University

  • f Washington

Director, mHealth for Mental Health Program Discussant: Mark Ishaug, MA CEO, Thresholds

November 1, 2018

#PCORI2018

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2 • November 1, 2018

Dror Ben-Zeev, PhD

  • Disclosure: Intervention content licensing agreement with

Pear Therapeutics

Mark Ishaug, MA

Disclosure: Nothing to disclose

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3 • November 1, 2018

Serious Mental Illness (SMI)

  • Schizophrenia, Bipolar Disorder, Major Depressive Disorder
  • 4% of world population
  • Significant functional impairment
  • May be chronic but certainly not static
  • Illness management strategies increase and lengthen recovery

periods

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4 • November 1, 2018

Barriers of Clinic-Based Mental Health Care

  • Distance/transportation
  • Hours of operation
  • Other patients/people
  • Stigma
  • Quality of care
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5 • November 1, 2018

Mobile Health (mHealth) for Mental Health

  • Mobile phones are ubiquitous (Ben-Zeev et al., 2012; Carras et al., 2014; Torous, 2018)
  • People with SMI are interested in mHealth (Firth et al., 2015)
  • Smartphones can bring mHealth to life
  • mHealth for SMI shows promise

How does mHealth compare to clinic-based care?

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6 • November 1, 2018

FOCUS: mHealth Intervention for people with SMI

  • 3 Daily prompts
  • “On-demand” resources
  • 5 treatment targets: voices, social,

meds, sleep, mood

  • Dashboard
  • mHealth Support Specialist

Hello, Drori!

MEDICATION VOICES MOOD SOCIAL TOOLBOX SLEEP

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7 • November 1, 2018

FOCUS interactions

  • System prompt:

3 times daily

  • Patient initiated:

On demand 24/7

  • mHealth specialist:

1 phone call weekly

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8 • November 1, 2018

FOCUS Clinical Status Assessment

Hello, Rachel! Have you been bothered by voices today?

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9 • November 1, 2018

FOCUS Cognitive Assessment

How would you describe the voices:

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10 • November 1, 2018

FOCUS Intervention: Written

Voices may sound like they know everything, but they don’t. Can you think of any time when the voices made a mistake? How about when the voices were sure something was going to happen, but it didn’t? If the voices got it wrong once, they probably don’t know everything, right? Think about it.

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11 • November 1, 2018

FOCUS Intervention: Videos

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12 • November 1, 2018

FOCUS Online Dashboard

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13 • November 1, 2018

PCORI-funded comparative effectiveness trial: 2015- 2017

  • Study site: Thresholds Chicago
  • Randomized Controlled Trial (RCT)
  • N=163 (49% schizophrenia, 28% bipolar disorder, 23% MDD)
  • 18 years or older (Average age: 49)
  • Ethnicity: 65% African-American, 27.5% White
  • Fifth grade reading level or higher
  • Assessments:

Baseline (0 months) Post treatment (3 months) Follow Up (6 months)

Ben-Zeev et al. (2018) Psychiatric Services.

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14 • November 1, 2018

Comparative Effectiveness Trial (12 Week RCT)

FOCUS (N=82)

Hello, Peter!

MEDICATION VOICES MOOD SOCIAL TOOLBOX SLEEP

vs

WRAP (N=81)

No Significant Difference in Clinical Outcomes or Satisfaction Ratings Between Conditions

Ben-Zeev et al. (2018) Psychiatric Services.

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15 • November 1, 2018

Study Results: Treatment Commencement and Patient Engagement

Ben-Zeev et al. (2018) Psychiatric Services.

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16 • November 1, 2018

Study Results: Depression

Ben-Zeev et al. (2018) Psychiatric Services.

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17 • November 1, 2018

Study Results: General Psychopathology

Ben-Zeev et al. (2018) Psychiatric Services.

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18 • November 1, 2018

Study Results: Recovery

Ben-Zeev et al. (2018) Psychiatric Services.

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19 • November 1, 2018

Study Results: Patient Satisfaction

Ben-Zeev et al. (2018) Psychiatric Services.

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20 • November 1, 2018

Conclusion and Next Steps

  • mHealth demonstrated superior treatment commencement and

engagement

  • FOCUS and WRAP produced similar patient satisfaction and

clinical outcomes

  • How do we disseminate and implement mHealth in real-world mental

health treatment settings?

  • FCC’s Lifeline program?
  • Billing Codes for mHealth related activities?

Ben-Zeev et al. (2018) Psychiatric Services.

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21 • November 1, 2018

Learn More

  • www.pcori.org/research-results/2014/comparing-smartphone-

program-peer-led-program-help-people-serious- mentalinfo@pcori.org

  • #PCORI2018
  • www.mhh4mh.org
  • Ben-Zeev, D., Brian, R.M., Jonathan, G.K., et al. (2018). Mobile Health

(mHealth) vs Clinic-Based Group Intervention for People with Serious Mental Illness: A Randomized Controlled Trial. Psychiatric Services 69 (9), 978-985. https://ps.psychiatryonline.org/doi/10.1176/appi.ps.201800063