Off-hours use of a smartphone intervention to extend support for individuals with schizophrenia spectrum disorders recently discharged from a psychiatric hospital

Affiliations

¹ Cherry Health, 100 Cherry Street, Grand Rapids, MI 49503, USA; Division of Psychiatry and Behavioral Medicine, Michigan State University, College of Human Medicine, Secchia Center, Rm 482, 15 Michigan Street, Grand Rapids, MI 49503, USA. Electronic address: Achtyes@msu.edu.
² Dartmouth Psychiatric Research Center, Geisel School of Medicine at Dartmouth, 2 Pillsbury Street, Suite 401, Concord, NH 03301, USA. Electronic address: dbenzeev@uw.edu.
³ Department of Epidemiology and Biostatistics, Michigan State University, College of Human Medicine, B627 West Fee Hall, 909 Fee Road, East Lansing, MI 48824, USA. Electronic address: zluo@epi.msu.edu.
⁴ Cherry Health, 100 Cherry Street, Grand Rapids, MI 49503, USA. Electronic address: heathermayle@cherryhealth.com.
⁵ Division of Psychiatry and Behavioral Medicine, Michigan State University, College of Human Medicine, Secchia Center, Rm 482, 15 Michigan Street, Grand Rapids, MI 49503, USA. Electronic address: Brandi.burke@emory.edu.
⁶ Department of Critical Care Medicine, University of Pittsburgh, 3550 Terrace Street, Pittsburgh, PA 15261, USA; Mental Illness Research, Education and Clinical Center, Department of Veterans Affairs Medical Center, 151R-H, VA Pittsburgh Healthcare System, 7180 Highland Drive, Pittsburgh, PA 15206, USA. Electronic address: rotondiaj@ccm.upmc.edu.
⁷ Center for Psychiatric Rehabilitation and Department of Occupational Therapy, Sargent College of Health and Rehabilitation Sciences, 940 Commonwealth Avenue West, Boston, MA 02215, USA; Departments of Psychological and Brain Sciences and Psychiatry, Boston University, 940 Commonwealth Avenue West, Boston, MA 02215, USA. Electronic address: jgott@bu.edu.
⁸ Dartmouth Psychiatric Research Center, Geisel School of Medicine at Dartmouth, 2 Pillsbury Street, Suite 401, Concord, NH 03301, USA. Electronic address: Mary.F.Brunette@hitchcock.org.
⁹ Center for Psychiatric Rehabilitation and Department of Occupational Therapy, Sargent College of Health and Rehabilitation Sciences, 940 Commonwealth Avenue West, Boston, MA 02215, USA; Departments of Psychological and Brain Sciences and Psychiatry, Boston University, 940 Commonwealth Avenue West, Boston, MA 02215, USA. Electronic address: mueser@bu.edu.
¹⁰ Independent Consultant, 14 Schiller Avenue, Narberth, PA 19072, USA. Electronic address: gingsusan@yahoo.com.
¹¹ University of Minnesota, School of Social Work, 170 Peters Hall, 1404 Gortner Avenue, St. Paul, MN 55108, USA. Electronic address: psmeyer@umn.edu.
¹² Vanguard Research Group, 75-59 263rd Street, Glen Oaks, NY 11004, USA. Electronic address: PMarcy@northwell.edu.
¹³ Department of Psychiatry and Behavioral Sciences, State University of New York Downstate Medical Center, 450 Clarkson Ave, Brooklyn, NY 11203, USA; The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra Blvd, Hempstead, NY 11549, USA. Electronic address: nina.schooler@gmail.com.
¹⁴ The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra Blvd, Hempstead, NY 11549, USA; Feinstein Institute for Medical Research, 350 Community Dr, Manhasset, NY 11030, USA.; Department of Psychiatry, Hofstra Northwell School of Medicine, 500 Hofstra Blvd, Hempstead, NY 11549, USA.. Electronic address: DRobinso@northwell.edu.
¹⁵ The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra Blvd, Hempstead, NY 11549, USA; Feinstein Institute for Medical Research, 350 Community Dr, Manhasset, NY 11030, USA.; Department of Psychiatry, Hofstra Northwell School of Medicine, 500 Hofstra Blvd, Hempstead, NY 11549, USA.. Electronic address: JKane2@northwell.edu.

PMID: 30551981
DOI: 10.1016/j.schres.2018.11.026

Multicenter Study

Off-hours use of a smartphone intervention to extend support for individuals with schizophrenia spectrum disorders recently discharged from a psychiatric hospital

Eric D Achtyes et al. Schizophr Res. 2019 Apr.

. 2019 Apr:206:200-208.

doi: 10.1016/j.schres.2018.11.026. Epub 2018 Dec 11.

Authors

Affiliations

¹ Cherry Health, 100 Cherry Street, Grand Rapids, MI 49503, USA; Division of Psychiatry and Behavioral Medicine, Michigan State University, College of Human Medicine, Secchia Center, Rm 482, 15 Michigan Street, Grand Rapids, MI 49503, USA. Electronic address: Achtyes@msu.edu.
² Dartmouth Psychiatric Research Center, Geisel School of Medicine at Dartmouth, 2 Pillsbury Street, Suite 401, Concord, NH 03301, USA. Electronic address: dbenzeev@uw.edu.
³ Department of Epidemiology and Biostatistics, Michigan State University, College of Human Medicine, B627 West Fee Hall, 909 Fee Road, East Lansing, MI 48824, USA. Electronic address: zluo@epi.msu.edu.
⁴ Cherry Health, 100 Cherry Street, Grand Rapids, MI 49503, USA. Electronic address: heathermayle@cherryhealth.com.
⁵ Division of Psychiatry and Behavioral Medicine, Michigan State University, College of Human Medicine, Secchia Center, Rm 482, 15 Michigan Street, Grand Rapids, MI 49503, USA. Electronic address: Brandi.burke@emory.edu.
⁶ Department of Critical Care Medicine, University of Pittsburgh, 3550 Terrace Street, Pittsburgh, PA 15261, USA; Mental Illness Research, Education and Clinical Center, Department of Veterans Affairs Medical Center, 151R-H, VA Pittsburgh Healthcare System, 7180 Highland Drive, Pittsburgh, PA 15206, USA. Electronic address: rotondiaj@ccm.upmc.edu.
⁷ Center for Psychiatric Rehabilitation and Department of Occupational Therapy, Sargent College of Health and Rehabilitation Sciences, 940 Commonwealth Avenue West, Boston, MA 02215, USA; Departments of Psychological and Brain Sciences and Psychiatry, Boston University, 940 Commonwealth Avenue West, Boston, MA 02215, USA. Electronic address: jgott@bu.edu.
⁸ Dartmouth Psychiatric Research Center, Geisel School of Medicine at Dartmouth, 2 Pillsbury Street, Suite 401, Concord, NH 03301, USA. Electronic address: Mary.F.Brunette@hitchcock.org.
⁹ Center for Psychiatric Rehabilitation and Department of Occupational Therapy, Sargent College of Health and Rehabilitation Sciences, 940 Commonwealth Avenue West, Boston, MA 02215, USA; Departments of Psychological and Brain Sciences and Psychiatry, Boston University, 940 Commonwealth Avenue West, Boston, MA 02215, USA. Electronic address: mueser@bu.edu.
¹⁰ Independent Consultant, 14 Schiller Avenue, Narberth, PA 19072, USA. Electronic address: gingsusan@yahoo.com.
¹¹ University of Minnesota, School of Social Work, 170 Peters Hall, 1404 Gortner Avenue, St. Paul, MN 55108, USA. Electronic address: psmeyer@umn.edu.
¹² Vanguard Research Group, 75-59 263rd Street, Glen Oaks, NY 11004, USA. Electronic address: PMarcy@northwell.edu.
¹³ Department of Psychiatry and Behavioral Sciences, State University of New York Downstate Medical Center, 450 Clarkson Ave, Brooklyn, NY 11203, USA; The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra Blvd, Hempstead, NY 11549, USA. Electronic address: nina.schooler@gmail.com.
¹⁴ The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra Blvd, Hempstead, NY 11549, USA; Feinstein Institute for Medical Research, 350 Community Dr, Manhasset, NY 11030, USA.; Department of Psychiatry, Hofstra Northwell School of Medicine, 500 Hofstra Blvd, Hempstead, NY 11549, USA.. Electronic address: DRobinso@northwell.edu.
¹⁵ The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra Blvd, Hempstead, NY 11549, USA; Feinstein Institute for Medical Research, 350 Community Dr, Manhasset, NY 11030, USA.; Department of Psychiatry, Hofstra Northwell School of Medicine, 500 Hofstra Blvd, Hempstead, NY 11549, USA.. Electronic address: JKane2@northwell.edu.

PMID: 30551981
DOI: 10.1016/j.schres.2018.11.026

Abstract

Introduction: Technology-delivered healthcare interventions may enhance dissemination of evidence-based treatments in low-resource areas. These interventions may be accessed 'on-demand,' including after hours. Patients with schizophrenia do engage with technological aids but when/how they would utilize these tools is not known.

Methods: We conducted a large, prospective, ten-site, longitudinal study of four technology-assisted interventions for patients with schizophrenia spectrum disorders within 60 days of psychiatric hospital discharge, a high risk period. One tool employed was a smartphone intervention called 'FOCUS,' which could be used by patients as needed, providing help in five content areas: medications, mood, social, sleep and voices. Each login was date- and time-stamped as occurring during normal clinic hours, or 'off-hours,' and the pattern of use described.

Results: 347 of 368 patients utilized FOCUS during the 6-month study. There were a total of 75,447 FOCUS logins; 35,739 (47.4%) were self-initiated and 38,139 (50.6%) were off-hours. 18,450 of the logins during off-hours were self-initiated (24.5%). No differences in average usage per month were found based on race/ethnicity. A subset of 'high utilizers' (n = 152, 43.8%) self-initiated use of all five FOCUS modules both on- and off-hours. They tended to be women, >35 years old, and had a high school diploma or greater.

Conclusion: Most patients with schizophrenia spectrum disorders recently discharged from the hospital utilized a smartphone intervention targeted to address troublesome residual symptoms. One quarter of the total smartphone utilization was self-initiated off-hours, indicating the potential utility of this tool to extend support for patients during periods of elevated risk.

Keywords: Off-hours; Relapse; Schizophrenia; Smartphone; Technology; Underserved.

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Off-hours use of a smartphone intervention to extend support for individuals with schizophrenia spectrum disorders recently discharged from a psychiatric hospital

Affiliations

Off-hours use of a smartphone intervention to extend support for individuals with schizophrenia spectrum disorders recently discharged from a psychiatric hospital

Authors

Affiliations

Abstract

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical