David C. Mohr, Colleen Stiles-Shields, Christopher Brenner, Hannah Palac, Enid Montague, Eric Carty-Fickes, Jenna Duffecy from the Northwestern University (Evanston, IL, USA) and Susan M. Kaiser from the University of Illinois (Chicago, IL, USA), won the Best Paper Award at the 9th edition of the International Conference on Pervasive Computing Technologies for Healthcare (PervasiveHealth 2015) which took place in Istanbul, Turkey on May 20–23, 2015, with the paper: ‘MedLink: A Mobile Intervention to Address Failure Points in the Treatment of Depression in General Medicine‘.
The study reports on the 4week pilot deployment of MedLink: a mobile intervention aimed at systemically addressing the failure points in depression therapy, such as: patient non-adherence, failure of physicians to optimize the treatment regimens, and lack of patient-physician communication. The researchers developed this mobile intervention, MedLink, to improve the quality of pharmacotherapy for depression in general medicine, based on a model of known person and system failure points. MedLink is intended to support the care of patients initiating a new prescription for an antidepressant and is intended to support the establishment of durable medication taking behaviors, communication between the patient and physician, and decision making for the physician.
The evaluation period was 4 weeks, as this allowed the researchers to evaluate all aspects of the system’s functionality, including the provision of information on symptoms, side effects, and adherence to physicians and patients, as well as the occurrence of follow-up visits. The MedLink app was subjected to in-lab usability testing with 23 patients taking medications, which have been recruited from Northwestern University’s General Internal Medicine Clinic. The app was installed on the patient’s phone for those who had an Android device. Patients who did not have an Android phone were provided one with a full data and call plan. Each week patients was notified to complete in-app assessments of depressive symptom severity using the Patient Health Questionnaire.
And finally, what about the evaluation of this app? Usability evaluation was generally favorable. Medication adherence rates in this first deployment were high with no patients discontinuing, and 84% of doses taken. Depressive symptom severity was significantly reduced. So, MedLink approaches pervasive health from a systems approach, addressing a comprehensive set of known failure points in processes of pharmacotherapy for depression in general medicine. These include improving patient knowledge and motivation, preventing forgetfulness, reporting and treatment recommendations to foster patientphysician communication, and prompting physicians and patients to ensure guideline concordant care, thereby improving medication adherence and depression outcomes.
The Best Paper will be published in the ICST’s own EU Digital Library (EUDL).
