A comparative study of engagement in mobile and wearable health monitoring for bipolar disorder

ObjectivesSelf‐monitoring is recommended for individuals with bipolar disorder, with numerous technological solutions available. This study aimed to identify basic components of these solutions that increase engagement with self‐monitoring.MethodsParticipants with bipolar disorder (n = 47) monitored their symptoms with a Fitbit and a smartphone app and were randomly assigned to either review or not review recorded symptoms weekly. We tested whether individuals would better adhere to and prefer monitoring with passive monitoring with an activity tracker compared to active monitoring with a smartphone app and whether individuals would better adhere to self‐monitoring if their recorded symptoms were reviewed with an interviewer.ResultsMonitoring with a smartphone app achieved similar adherence and preference to Fitbit (P > .85). Linear mixed effects modeling found adherence decreased significantly more over the study for the Fitbit (12% more, P < .001) even though more participants reported they would use the Fitbit over a year compared to the app (72.3% vs 46.8%). Reviewing symptoms weekly did not improve adherence, but most participants reported they would prefer to review symptoms with a clinician (74.5%) and on monthly basis (57.5%) compared to alternatives. Participants endorsed sleep as the most important symptom to monitor, forgetfulness as the largest barrier to self‐monitoring, and raising self‐awareness as the best reason for self‐monitoring.ConclusionsWe recommend a combined strategy of wearable and mobile monitoring that includes reminders, targets raising self‐awareness, and tracks sleep. A clinician may want to review symptoms on a monthly basis.Trial registration: ClinicalTrials.gov NCT03358238.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/154615/1/bdi12849_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/154615/2/bdi12849.pd

Incentivizing the Use of Quantified Self Devices: The Cases of Digital Occupational Health Programs and Data-Driven Health Insurance Plans

Initially designed for a use in private settings, smartwatches, activity trackers and other quantified self devices are receiving a growing attention from the organizational environment. Firms and health insurance companies, in particular, are developing digital occupational health programs and data-driven health insurance plans centered around these systems, in the hope of exploiting their potential to improve individual health management, but also to gather large quantities of data. As individual participation in such organizational programs is voluntary, organizations often rely on motivational incentives to prompt engagement. Yet, little is known about the mechanisms employed in organizational settings to incentivize the use of quantified self devices. We therefore seek, in this exploratory paper, to offer a first structured overview of this topic and identify the main motivational incentives in two emblematical cases: digital occupational health programs and data-driven health insurance plans. By doing so, we aim to specify the nature of this new dynamic around the use of quantified self devices and define some of the key lines for further investigation

Recommendations for the conduct of clinical trials for drugs to treat or prevent sarcopenia

PURPOSE: Sarcopenia is an age-related muscle condition which is frequently a precursor of frailty, mobility disability and premature death. It has a high prevalence in older populations and presents a considerable social and economic burden. Potential treatments are under development but, as yet, no guidelines support regulatory studies for new drugs to manage sarcopenia. The objective of this position paper is therefore to suggest a set of potential endpoints and target population definitions to stimulate debate and progress within the medico-scientific and regulatory communities. METHODS: A multidisciplinary expert working group was hosted by the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis, which reviewed and discussed the recent literature from a perspective of clinical experience and guideline development. Relevant parallels were drawn from the development of definition of osteoporosis as a disease and clinical assessment of pharmaceutical treatments for that indication. RESULTS: A case-finding decision tree is briefly reviewed with a discussion of recent prevalence estimations of different relevant threshold values. The selection criteria for patients in regulatory studies are discussed according to the aims of the investigation (sarcopenia prevention or treatment) and the stage of project development. The possible endpoints of such studies are reviewed and a plea is made for the establishment of a core outcome set to be used in all clinical trials of sarcopenia. CONCLUSIONS: The current lack of guidelines for the assessment of new therapeutic treatments for sarcopenia could potentially hinder the delivery of effective medicines to patients at risk

ORGANISATIE-STRUKTUUR EN COMMUNICATIE

ORGANISATIE-STRUKTUUR EN COMMUNICATI