Ansatte – Københavns Universitet

Usability, acceptability, and adherence to an electronic self-monitoring system in patients with major depression discharged from inpatient wards

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Standard

Usability, acceptability, and adherence to an electronic self-monitoring system in patients with major depression discharged from inpatient wards. / Lauritsen, Lise; Andersen, Louise; Olsson, Emilia; Søndergaard, Stine Rauff; Nørregaard, Lasse Benn; Løventoft, Philip Kaare; Svendsen, Signe Dunker; Frøkjær, Erik; Jensen, Hans Mørch; Pedersen, Ida Hageman; Kessing, Lars Vedel; Martiny, Klaus.

I: Journal of Medical Internet Research, Bind 19, Nr. 4, e123, 04.2017.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

Harvard

Lauritsen, L, Andersen, L, Olsson, E, Søndergaard, SR, Nørregaard, LB, Løventoft, PK, Svendsen, SD, Frøkjær, E, Jensen, HM, Pedersen, IH, Kessing, LV & Martiny, K 2017, 'Usability, acceptability, and adherence to an electronic self-monitoring system in patients with major depression discharged from inpatient wards' Journal of Medical Internet Research, bind 19, nr. 4, e123. https://doi.org/10.2196/jmir.6673

APA

Lauritsen, L., Andersen, L., Olsson, E., Søndergaard, S. R., Nørregaard, L. B., Løventoft, P. K., ... Martiny, K. (2017). Usability, acceptability, and adherence to an electronic self-monitoring system in patients with major depression discharged from inpatient wards. Journal of Medical Internet Research, 19(4), [e123]. https://doi.org/10.2196/jmir.6673

Vancouver

Lauritsen L, Andersen L, Olsson E, Søndergaard SR, Nørregaard LB, Løventoft PK o.a. Usability, acceptability, and adherence to an electronic self-monitoring system in patients with major depression discharged from inpatient wards. Journal of Medical Internet Research. 2017 apr;19(4). e123. https://doi.org/10.2196/jmir.6673

Author

Lauritsen, Lise ; Andersen, Louise ; Olsson, Emilia ; Søndergaard, Stine Rauff ; Nørregaard, Lasse Benn ; Løventoft, Philip Kaare ; Svendsen, Signe Dunker ; Frøkjær, Erik ; Jensen, Hans Mørch ; Pedersen, Ida Hageman ; Kessing, Lars Vedel ; Martiny, Klaus. / Usability, acceptability, and adherence to an electronic self-monitoring system in patients with major depression discharged from inpatient wards. I: Journal of Medical Internet Research. 2017 ; Bind 19, Nr. 4.

Bibtex

@article{f3f843aaac4b4c2ea5f64e6a78f5af5f,
title = "Usability, acceptability, and adherence to an electronic self-monitoring system in patients with major depression discharged from inpatient wards",
abstract = "Background: Patients suffering from depression have a high risk of relapse and readmission in the weeks following discharge from inpatient wards. Electronic self-monitoring systems that offer patient-communication features are now available to offer daily support to patients, but the usability, acceptability, and adherence to these systems has only been sparsely investigated. Objective: We aim to test the usability, acceptability, adherence, and clinical outcome of a newly developed computer-based electronic self-assessment system (the Daybuilder system) in patients suffering from depression, in the period from discharge until commencing outpatient treatment in the Intensive Outpatient Unit for Affective Disorders. Methods: Patients suffering from unipolar major depression that were referred from inpatient wards to an intensive outpatient unit were included in this study before their discharge, and were followed for four weeks. User satisfaction was assessed using semiqualitative questionnaires and the System Usability Scale (SUS). Patients were interviewed at baseline and at endpoint with the Hamilton depression rating scale (HAM-D17), the Major Depression Inventory (MDI), and the 5-item World Health Organization Well-Being Index (WHO-5). In this four-week period patients used the Daybuilder system to self-monitor mood, sleep, activity, and medication adherence on a daily basis. The system displayed a graphical representation of the data that was simultaneously displayed to patients and clinicians. Patients were phoned weekly to discuss their data entries. The primary outcomes were usability, acceptability, and adherence to the system. The secondary outcomes were changes in: the electronically self-assessed mood, sleep, and activity scores; and scores from the HAM-D17, MDI, and WHO-5 scales. Results: In total, 76{\%} of enrolled patients (34/45) completed the four-week study. Five patients were readmitted due to relapse. The 34 patients that completed the study entered data for mood on 93.8{\%} of the days (872/930), sleep on 89.8{\%} of the days (835/930), activity on 85.6{\%} of the days (796/930), and medication on 88.0 {\%} of the days (818/930). SUS scores were 86.2 (standard deviation [SD] 9.7) and 79{\%} of the patients (27/34) found that the system lived up to their expectations. A significant improvement in depression severity was found on the HAM-D17 from 18.0 (SD 6.5) to 13.3 (SD 7.3; P<.01), on the MDI from 27.1 (SD 13.1) to 22.1 (SD 12.7; P=.006), and in quality of life on the WHO-5 from 31.3 (SD 22.9) to 43.4 (SD 22.1; P<.001) scales, but not on self-assessed mood (P=.08). Mood and sleep parameters were highly variable from day-to-day. Sleep-offset was significantly delayed from baseline, averaging 48 minutes (standard error 12 minutes; P<.001). Furthermore, when estimating delay of sleep-onset (with sleep quality included in the model) during the study period, this showed a significant negative effect on mood (P=.03) Conclusions: The Daybuilder systems performed well technically, and patients were satisfied with the system and had high adherence to self-assessments. The dropout rate and the gradual delay in sleep emphasize the need for continued clinical support for these patients, especially when considering sleep guidance.",
keywords = "Chronotherapeutics, Depressive disorder, Electronic monitoring, Graph drawing, Inpatients, Major, Observational study, Patient participation, Self-assessment, Sleep",
author = "Lise Lauritsen and Louise Andersen and Emilia Olsson and S{\o}ndergaard, {Stine Rauff} and N{\o}rregaard, {Lasse Benn} and L{\o}ventoft, {Philip Kaare} and Svendsen, {Signe Dunker} and Erik Fr{\o}kj{\ae}r and Jensen, {Hans M{\o}rch} and Pedersen, {Ida Hageman} and Kessing, {Lars Vedel} and Klaus Martiny",
year = "2017",
month = "4",
doi = "10.2196/jmir.6673",
language = "English",
volume = "19",
journal = "Journal of Medical Internet Research",
issn = "1439-4456",
publisher = "JMIR Publications",
number = "4",

}

RIS

TY - JOUR

T1 - Usability, acceptability, and adherence to an electronic self-monitoring system in patients with major depression discharged from inpatient wards

AU - Lauritsen, Lise

AU - Andersen, Louise

AU - Olsson, Emilia

AU - Søndergaard, Stine Rauff

AU - Nørregaard, Lasse Benn

AU - Løventoft, Philip Kaare

AU - Svendsen, Signe Dunker

AU - Frøkjær, Erik

AU - Jensen, Hans Mørch

AU - Pedersen, Ida Hageman

AU - Kessing, Lars Vedel

AU - Martiny, Klaus

PY - 2017/4

Y1 - 2017/4

N2 - Background: Patients suffering from depression have a high risk of relapse and readmission in the weeks following discharge from inpatient wards. Electronic self-monitoring systems that offer patient-communication features are now available to offer daily support to patients, but the usability, acceptability, and adherence to these systems has only been sparsely investigated. Objective: We aim to test the usability, acceptability, adherence, and clinical outcome of a newly developed computer-based electronic self-assessment system (the Daybuilder system) in patients suffering from depression, in the period from discharge until commencing outpatient treatment in the Intensive Outpatient Unit for Affective Disorders. Methods: Patients suffering from unipolar major depression that were referred from inpatient wards to an intensive outpatient unit were included in this study before their discharge, and were followed for four weeks. User satisfaction was assessed using semiqualitative questionnaires and the System Usability Scale (SUS). Patients were interviewed at baseline and at endpoint with the Hamilton depression rating scale (HAM-D17), the Major Depression Inventory (MDI), and the 5-item World Health Organization Well-Being Index (WHO-5). In this four-week period patients used the Daybuilder system to self-monitor mood, sleep, activity, and medication adherence on a daily basis. The system displayed a graphical representation of the data that was simultaneously displayed to patients and clinicians. Patients were phoned weekly to discuss their data entries. The primary outcomes were usability, acceptability, and adherence to the system. The secondary outcomes were changes in: the electronically self-assessed mood, sleep, and activity scores; and scores from the HAM-D17, MDI, and WHO-5 scales. Results: In total, 76% of enrolled patients (34/45) completed the four-week study. Five patients were readmitted due to relapse. The 34 patients that completed the study entered data for mood on 93.8% of the days (872/930), sleep on 89.8% of the days (835/930), activity on 85.6% of the days (796/930), and medication on 88.0 % of the days (818/930). SUS scores were 86.2 (standard deviation [SD] 9.7) and 79% of the patients (27/34) found that the system lived up to their expectations. A significant improvement in depression severity was found on the HAM-D17 from 18.0 (SD 6.5) to 13.3 (SD 7.3; P<.01), on the MDI from 27.1 (SD 13.1) to 22.1 (SD 12.7; P=.006), and in quality of life on the WHO-5 from 31.3 (SD 22.9) to 43.4 (SD 22.1; P<.001) scales, but not on self-assessed mood (P=.08). Mood and sleep parameters were highly variable from day-to-day. Sleep-offset was significantly delayed from baseline, averaging 48 minutes (standard error 12 minutes; P<.001). Furthermore, when estimating delay of sleep-onset (with sleep quality included in the model) during the study period, this showed a significant negative effect on mood (P=.03) Conclusions: The Daybuilder systems performed well technically, and patients were satisfied with the system and had high adherence to self-assessments. The dropout rate and the gradual delay in sleep emphasize the need for continued clinical support for these patients, especially when considering sleep guidance.

AB - Background: Patients suffering from depression have a high risk of relapse and readmission in the weeks following discharge from inpatient wards. Electronic self-monitoring systems that offer patient-communication features are now available to offer daily support to patients, but the usability, acceptability, and adherence to these systems has only been sparsely investigated. Objective: We aim to test the usability, acceptability, adherence, and clinical outcome of a newly developed computer-based electronic self-assessment system (the Daybuilder system) in patients suffering from depression, in the period from discharge until commencing outpatient treatment in the Intensive Outpatient Unit for Affective Disorders. Methods: Patients suffering from unipolar major depression that were referred from inpatient wards to an intensive outpatient unit were included in this study before their discharge, and were followed for four weeks. User satisfaction was assessed using semiqualitative questionnaires and the System Usability Scale (SUS). Patients were interviewed at baseline and at endpoint with the Hamilton depression rating scale (HAM-D17), the Major Depression Inventory (MDI), and the 5-item World Health Organization Well-Being Index (WHO-5). In this four-week period patients used the Daybuilder system to self-monitor mood, sleep, activity, and medication adherence on a daily basis. The system displayed a graphical representation of the data that was simultaneously displayed to patients and clinicians. Patients were phoned weekly to discuss their data entries. The primary outcomes were usability, acceptability, and adherence to the system. The secondary outcomes were changes in: the electronically self-assessed mood, sleep, and activity scores; and scores from the HAM-D17, MDI, and WHO-5 scales. Results: In total, 76% of enrolled patients (34/45) completed the four-week study. Five patients were readmitted due to relapse. The 34 patients that completed the study entered data for mood on 93.8% of the days (872/930), sleep on 89.8% of the days (835/930), activity on 85.6% of the days (796/930), and medication on 88.0 % of the days (818/930). SUS scores were 86.2 (standard deviation [SD] 9.7) and 79% of the patients (27/34) found that the system lived up to their expectations. A significant improvement in depression severity was found on the HAM-D17 from 18.0 (SD 6.5) to 13.3 (SD 7.3; P<.01), on the MDI from 27.1 (SD 13.1) to 22.1 (SD 12.7; P=.006), and in quality of life on the WHO-5 from 31.3 (SD 22.9) to 43.4 (SD 22.1; P<.001) scales, but not on self-assessed mood (P=.08). Mood and sleep parameters were highly variable from day-to-day. Sleep-offset was significantly delayed from baseline, averaging 48 minutes (standard error 12 minutes; P<.001). Furthermore, when estimating delay of sleep-onset (with sleep quality included in the model) during the study period, this showed a significant negative effect on mood (P=.03) Conclusions: The Daybuilder systems performed well technically, and patients were satisfied with the system and had high adherence to self-assessments. The dropout rate and the gradual delay in sleep emphasize the need for continued clinical support for these patients, especially when considering sleep guidance.

KW - Chronotherapeutics

KW - Depressive disorder

KW - Electronic monitoring

KW - Graph drawing

KW - Inpatients

KW - Major

KW - Observational study

KW - Patient participation

KW - Self-assessment

KW - Sleep

UR - http://www.scopus.com/inward/record.url?scp=85018764893&partnerID=8YFLogxK

U2 - 10.2196/jmir.6673

DO - 10.2196/jmir.6673

M3 - Journal article

VL - 19

JO - Journal of Medical Internet Research

JF - Journal of Medical Internet Research

SN - 1439-4456

IS - 4

M1 - e123

ER -

ID: 179556821