PDF(Pubmed)
Abstract：
BACKGROUND: Nonadherence to pharmaceutical antidepressant treatment is common among patients with depression. Digitalized follow-up (ie, self-monitoring systems through mobile apps) has been suggested as an effective adjunct to conventional antidepressant treatment to increase medical adherence, improve symptoms of depression, and reduce health care resource use.
OBJECTIVE: The aim of this study was to determine patients\' experience of digitalized follow-up using a mobile app as an adjunct to treatment concurrent with a new prescription, a change of antidepressant, or a dose increase.
METHODS: This was a qualitative, descriptive study. Patients at 2 psychiatric outpatient clinics were recruited at the time of changing antidepressant medication. After using a mobile app (either a commercial app or a public app) for 4-6 weeks with daily registrations of active data, such as medical intake and questions concerning general mental health status, individual semistructured interviews were conducted. Recorded data were transcribed and then analyzed using content analysis.
RESULTS: In total, 13 patients completed the study. The mean age was 35 (range 20-67) years, 8 (61.5%) were female, and all reported high digital literacy. Overall, the emerging themes indicated that the patients found the digital app to be a valuable adjunct to antidepressant treatment but with potential for improvement. Both user adherence and medical adherence were positively affected by a daily reminder and the app\'s ease of use. User adherence was negatively affected by the severity of depression. The positive experience of visually presented data as graphs was a key finding, which was beneficial for self-awareness, the patient-physician relationship, and user adherence. Finally, the patients had mixed reactions to the app\'s content and requested tailored content.
CONCLUSIONS: The patients identified several factors addressing both medical adherence and user adherence to a digital app when using it for digitalized follow-up concurrent with the critical time related to changes in antidepressant medication. The findings highlight the need for rigorous evidence-based empirical studies to generate sustainable research results.
OBJECTIVE: The aim of this study was to determine patients\' experience of digitalized follow-up using a mobile app as an adjunct to treatment concurrent with a new prescription, a change of antidepressant, or a dose increase.
METHODS: This was a qualitative, descriptive study. Patients at 2 psychiatric outpatient clinics were recruited at the time of changing antidepressant medication. After using a mobile app (either a commercial app or a public app) for 4-6 weeks with daily registrations of active data, such as medical intake and questions concerning general mental health status, individual semistructured interviews were conducted. Recorded data were transcribed and then analyzed using content analysis.
RESULTS: In total, 13 patients completed the study. The mean age was 35 (range 20-67) years, 8 (61.5%) were female, and all reported high digital literacy. Overall, the emerging themes indicated that the patients found the digital app to be a valuable adjunct to antidepressant treatment but with potential for improvement. Both user adherence and medical adherence were positively affected by a daily reminder and the app\'s ease of use. User adherence was negatively affected by the severity of depression. The positive experience of visually presented data as graphs was a key finding, which was beneficial for self-awareness, the patient-physician relationship, and user adherence. Finally, the patients had mixed reactions to the app\'s content and requested tailored content.
CONCLUSIONS: The patients identified several factors addressing both medical adherence and user adherence to a digital app when using it for digitalized follow-up concurrent with the critical time related to changes in antidepressant medication. The findings highlight the need for rigorous evidence-based empirical studies to generate sustainable research results.
摘要：
背景：不坚持药物抗抑郁治疗在抑郁症患者中很常见。数字化随访(即，通过移动应用程序进行自我监测系统）已被建议作为常规抗抑郁治疗的有效辅助手段，以增加医疗依从性，改善抑郁症的症状，减少医疗资源的使用。
目的：本研究的目的是确定患者使用移动应用程序作为辅助治疗同时使用新处方的数字化随访的经验，抗抑郁药的变化，或剂量增加。
方法：这是定性的，描述性研究。在更换抗抑郁药物时招募了2个精神病门诊诊所的患者。在使用移动应用程序（商业应用程序或公共应用程序）4-6周后，每天注册活动数据，如药物摄入量和有关一般心理健康状况的问题，进行了个人半结构化访谈。记录的数据被转录,然后使用内容分析进行分析。
结果：总计，13名患者完成了研究。平均年龄为35岁（范围20-67岁），8人（61.5%）为女性，都报告了很高的数字素养。总的来说,新出现的主题表明，患者发现数字应用程序是抗抑郁治疗的有价值的辅助手段，但具有改善的潜力。用户依从性和医疗依从性都受到每日提醒和应用程序易用性的积极影响。用户的依从性受到抑郁严重程度的负面影响。以图形形式直观呈现数据的积极经验是一个关键发现，这有利于自我意识，医患关系,和用户的坚持。最后,患者对app的内容反应不一，并要求定制内容。
结论：当使用数字应用程序进行数字化随访时，患者确定了几个因素，解决了医疗依从性和用户对数字应用程序的依从性，同时考虑了与抗抑郁药物变化相关的关键时间。研究结果突出表明，需要进行严格的基于证据的实证研究，以产生可持续的研究结果。
目的：本研究的目的是确定患者使用移动应用程序作为辅助治疗同时使用新处方的数字化随访的经验，抗抑郁药的变化，或剂量增加。
方法：这是定性的，描述性研究。在更换抗抑郁药物时招募了2个精神病门诊诊所的患者。在使用移动应用程序（商业应用程序或公共应用程序）4-6周后，每天注册活动数据，如药物摄入量和有关一般心理健康状况的问题，进行了个人半结构化访谈。记录的数据被转录,然后使用内容分析进行分析。
结果：总计，13名患者完成了研究。平均年龄为35岁（范围20-67岁），8人（61.5%）为女性，都报告了很高的数字素养。总的来说,新出现的主题表明，患者发现数字应用程序是抗抑郁治疗的有价值的辅助手段，但具有改善的潜力。用户依从性和医疗依从性都受到每日提醒和应用程序易用性的积极影响。用户的依从性受到抑郁严重程度的负面影响。以图形形式直观呈现数据的积极经验是一个关键发现，这有利于自我意识，医患关系,和用户的坚持。最后,患者对app的内容反应不一，并要求定制内容。
结论：当使用数字应用程序进行数字化随访时，患者确定了几个因素，解决了医疗依从性和用户对数字应用程序的依从性，同时考虑了与抗抑郁药物变化相关的关键时间。研究结果突出表明，需要进行严格的基于证据的实证研究，以产生可持续的研究结果。
