Real-world Implementation of a Smartphone-Based Psychoeducation Program for Bipolar Disorder: Observational Ecological Study

Background: SIMPLe is an internet-delivered self-management mobile app for bipolar disorder (BD) designed to combine technology with evidence-based interventions and facilitate access to psychoeducational content. The SIMPLe app was launched to the real world to make it available worldwide within th...

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Authors: García-Estela, A.; Cantillo, Jordi; Angarita Osorio, Natalia; Mur Milà, Estanislao; Anmella, Gerard; Pérez, Víctor; Vieta i Pascual, Eduard, 1963-; Hidalgo Mazzei, Diego; Colom, Francesc, 1971-
Format: Article
Status:Published version
Publication date:2022
Country:España
Institution:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repository:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/199432
Online Access:https://hdl.handle.net/2445/199432
Access Level:Open access
Keyword:Trastorn bipolar
Telèfons intel·ligents
Avaluació educativa
Aplicacions mòbils
Intervenció psicològica
Manic-depressive illness
Smartphones
Educational evaluation
Mobile apps
Psychological intervention
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author García-Estela, A.
author2 Cantillo, Jordi
Angarita Osorio, Natalia
Mur Milà, Estanislao
Anmella, Gerard
Pérez, Víctor
Vieta i Pascual, Eduard, 1963-
Hidalgo Mazzei, Diego
Colom, Francesc, 1971-
author2_role author
author
author
author
author
author
author
author
author_browse Angarita Osorio, Natalia
Anmella, Gerard
Cantillo, Jordi
Colom, Francesc, 1971-
García-Estela, A.
Hidalgo Mazzei, Diego
Mur Milà, Estanislao
Pérez, Víctor
Vieta i Pascual, Eduard, 1963-
author_facet García-Estela, A.
Cantillo, Jordi
Angarita Osorio, Natalia
Mur Milà, Estanislao
Anmella, Gerard
Pérez, Víctor
Vieta i Pascual, Eduard, 1963-
Hidalgo Mazzei, Diego
Colom, Francesc, 1971-
author_role author
collection Recercat. Dipósit de la Recerca de Catalunya
description Background: SIMPLe is an internet-delivered self-management mobile app for bipolar disorder (BD) designed to combine technology with evidence-based interventions and facilitate access to psychoeducational content. The SIMPLe app was launched to the real world to make it available worldwide within the context of BD treatment. Objective: The main aims of this study are as follows: to describe app use, engagement, and retention rates based on server data; to identify patterns of user retention over the first 6-month follow-up of use; and to explore potential factors contributing to discontinuation of app use. Methods: This was an observational ecological study in which we pooled available data from a real-world implementation of the SIMPLe app. Participation was open on the project website, and the data-collection sources were a web-based questionnaire on clinical data and treatment history administered at inclusion and at 6 months, subjective data gathered through continuous app use, and the use patterns captured by the app server. Characteristics and engagement of regular users, occasional users, and no users were compared using 2-tailed t tests or analysis of variance or their nonparametric equivalent. Survival analysis and risk functions were applied to regular users' data to examine and compare use and user retention. In addition, a user evaluation analysis was performed based on satisfaction, perceived usefulness, and reasons to discontinue app use. Results: We included 503 participants with data collected between 2016 and 2018, of whom 77.5% (n=390) used the app. Among the app users, 44.4% (173/390) completed the follow-up assessment, and data from these participants were used in our analyses. Engagement declined gradually over the first 6 months of use. The probability of retention of the regular users after 1 month of app use was 67.4% (263/390; 95% CI 62.7%-72.4%). Age (P=.002), time passed since illness onset (P<.001), and years since diagnosis of BD (P=.048) correlate with retention duration. In addition, participants who had been diagnosed with BD for longer used the app on more days (mean 97.73, SD 69.15 days; P=.002) than those who had had a more recent onset (mean 66.49, SD 66.18 days; P=.002) or those who had been diagnosed more recently (mean 73.45, SD 66 days; P=.01). Conclusions: The user retention rate of the app decreased rapidly after each month until reaching only one-third of the users at 6 months. There exists a strong association between age and app engagement of individuals with BD. Other variables such as years lived with BD, diagnosis of an anxiety disorder, and taking antipsychotics seem relevant as well. Understanding these associations can help in the definition of the most suitable user profiles for predicting trends of engagement, optimization of app prescription, and management.
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id ES_28126136a6bbb93b3e2072bfa2f6fb58
institution Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
network_acronym_str ES
network_name_str España
oai_identifier_str oai:recercat.cat:2445/199432
publishDate 2022
publishDateSort 2022
publisher JMIR Publications
publisherStr JMIR Publications
reponame_str Recercat. Dipósit de la Recerca de Catalunya
spelling Real-world Implementation of a Smartphone-Based Psychoeducation Program for Bipolar Disorder: Observational Ecological Study García-Estela, A. Cantillo, Jordi Angarita Osorio, Natalia Mur Milà, Estanislao Anmella, Gerard Pérez, Víctor Vieta i Pascual, Eduard, 1963- Hidalgo Mazzei, Diego Colom, Francesc, 1971- Trastorn bipolar Telèfons intel·ligents Avaluació educativa Aplicacions mòbils Intervenció psicològica Manic-depressive illness Smartphones Educational evaluation Mobile apps Psychological intervention Background: SIMPLe is an internet-delivered self-management mobile app for bipolar disorder (BD) designed to combine technology with evidence-based interventions and facilitate access to psychoeducational content. The SIMPLe app was launched to the real world to make it available worldwide within the context of BD treatment. Objective: The main aims of this study are as follows: to describe app use, engagement, and retention rates based on server data; to identify patterns of user retention over the first 6-month follow-up of use; and to explore potential factors contributing to discontinuation of app use. Methods: This was an observational ecological study in which we pooled available data from a real-world implementation of the SIMPLe app. Participation was open on the project website, and the data-collection sources were a web-based questionnaire on clinical data and treatment history administered at inclusion and at 6 months, subjective data gathered through continuous app use, and the use patterns captured by the app server. Characteristics and engagement of regular users, occasional users, and no users were compared using 2-tailed t tests or analysis of variance or their nonparametric equivalent. Survival analysis and risk functions were applied to regular users' data to examine and compare use and user retention. In addition, a user evaluation analysis was performed based on satisfaction, perceived usefulness, and reasons to discontinue app use. Results: We included 503 participants with data collected between 2016 and 2018, of whom 77.5% (n=390) used the app. Among the app users, 44.4% (173/390) completed the follow-up assessment, and data from these participants were used in our analyses. Engagement declined gradually over the first 6 months of use. The probability of retention of the regular users after 1 month of app use was 67.4% (263/390; 95% CI 62.7%-72.4%). Age (P=.002), time passed since illness onset (P<.001), and years since diagnosis of BD (P=.048) correlate with retention duration. In addition, participants who had been diagnosed with BD for longer used the app on more days (mean 97.73, SD 69.15 days; P=.002) than those who had had a more recent onset (mean 66.49, SD 66.18 days; P=.002) or those who had been diagnosed more recently (mean 73.45, SD 66 days; P=.01). Conclusions: The user retention rate of the app decreased rapidly after each month until reaching only one-third of the users at 6 months. There exists a strong association between age and app engagement of individuals with BD. Other variables such as years lived with BD, diagnosis of an anxiety disorder, and taking antipsychotics seem relevant as well. Understanding these associations can help in the definition of the most suitable user profiles for predicting trends of engagement, optimization of app prescription, and management. JMIR Publications https://hdl.handle.net/2445/199432
spellingShingle Real-world Implementation of a Smartphone-Based Psychoeducation Program for Bipolar Disorder: Observational Ecological Study
García-Estela, A.
Trastorn bipolar
Telèfons intel·ligents
Avaluació educativa
Aplicacions mòbils
Intervenció psicològica
Manic-depressive illness
Smartphones
Educational evaluation
Mobile apps
Psychological intervention
status_str publishedVersion
title Real-world Implementation of a Smartphone-Based Psychoeducation Program for Bipolar Disorder: Observational Ecological Study
title_full Real-world Implementation of a Smartphone-Based Psychoeducation Program for Bipolar Disorder: Observational Ecological Study
title_fullStr Real-world Implementation of a Smartphone-Based Psychoeducation Program for Bipolar Disorder: Observational Ecological Study
title_full_unstemmed Real-world Implementation of a Smartphone-Based Psychoeducation Program for Bipolar Disorder: Observational Ecological Study
title_short Real-world Implementation of a Smartphone-Based Psychoeducation Program for Bipolar Disorder: Observational Ecological Study
title_sort Real-world Implementation of a Smartphone-Based Psychoeducation Program for Bipolar Disorder: Observational Ecological Study
topic Trastorn bipolar
Telèfons intel·ligents
Avaluació educativa
Aplicacions mòbils
Intervenció psicològica
Manic-depressive illness
Smartphones
Educational evaluation
Mobile apps
Psychological intervention
topic_facet Trastorn bipolar
Telèfons intel·ligents
Avaluació educativa
Aplicacions mòbils
Intervenció psicològica
Manic-depressive illness
Smartphones
Educational evaluation
Mobile apps
Psychological intervention
url https://hdl.handle.net/2445/199432