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. 2015 May:2015:100-107.
doi: 10.4108/icst.pervasivehealth.2015.259042.

MedLink: A Mobile Intervention to Address Failure Points in the Treatment of Depression in General Medicine

David C Mohr  1 , Colleen Stiles-Shields  1 , Christopher Brenner  1 , Hannah Palac  1 , Enid Montague  2 , Susan M Kaiser  1 , Eric Carty-Fickes  1 , Jenna Duffecy  3
Affiliations

MedLink: A Mobile Intervention to Address Failure Points in the Treatment of Depression in General Medicine

David C Mohr et al. Int Conf Pervasive Comput Technol Healthc. 2015 May.

Abstract

Major depression is common, and imposes a high burden in terms of cost, morbidity, and suffering. Most people with depression are treated in general medicine using antidepressant medication. Outcomes are poor due to failure points across the care system, including patient non-adherence, failure of physicians to optimize the treatment regimens, and lack of patient-physician communication. This study reports on the 4-week pilot deployment of MedLink, a mobile intervention aimed at systemically addressing each of these failure points. A mobile app provides the patient with information and collects data on symptoms and side-effects. A cellularly enabled pill bottle monitors medication adherence. Data from these are provided to the physician and patient to foster communication and medication adjustments. 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. This study supports the use of a comprehensive, systemic approach to mHealth solutions to enhance processes of care for depression by general medicine physicians.

Keywords: adherence; mHealth; mental health.

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Figures

Figure 1
Figure 1
Failure Points in Antidepressant Therapy
Figure 2
Figure 2
MedLink Screenshots from top to bottom: Home Screen, Lesson, Assessment, Graphic Feedback, and Notification
Figure 3
Figure 3
Physician Report
See this image and copyright information in PMC

References

    1. Kessler RC, Berglund P, Demler O, Jin R, Koretz D, Merikangas KR, et al. The Epidemiology of Major Depressive Disorder: Results From the National Comorbidity Survey Replication (NCS-R) Jama. 2003 Jun 18;289:3095–3105. - PubMed
    1. Wells KB, Stewart A, Hays RD, Burnam MA, Rogers W, Daniels M, et al. The functioning and well-being of depressed patients. Results from the Medical Outcomes Study. Jama. 1989 Aug 18;262:914–919. - PubMed
    1. Ferrari AJ, Charlson FJ, Norman RE, Patten SB, Freedman G, Murray CJ, et al. Burden of depressive disorders by country, sex, age, and year: findings from the global burden of disease study 2010. PLoS Med. 2013 Nov;10:e1001547. - PMC - PubMed
    1. Regier DA, Narrow WE, Rae DS, Manderscheid RW, Locke BZ, Goodwin FK. The de facto US mental and addictive disorders service system. Epidemiologic catchment area prospective 1-year prevalence rates of disorders and services. Arch Gen Psychiatry. 1993 Feb;50:85–94. - PubMed
    1. Olfson M, Marcus SC, Tedeschi M, Wan GJ. Continuity of antidepressant treatment for adults with depression in the United States. Am J Psychiatry. 2006 Jan;163:101–108. - PubMed

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