(135) Engagement with Digital Health Technologies for Self-Monitoring of Symptoms Among Adolescents with Mood Disorders Treated with Antidepressants

Sunday, August 28, 2022

8:00 AM – 1:45 PM CEST

Location: Hall C

Publication Number: 1180

Presenting Author(s)

Wendy Camelo Castillo, MD, PhD, MSc
– University of Maryland, Baltimore, Maryland, United States

Co-Author(s)

Gloria Reeves, MD
– School of Medicine, University of Maryland Baltimore, Baltimore, MD, United States
Susan DosReis, FISPE
– Professor, Pharmaceutical Health Services Research, School of Pharmacy, Baltimore, Maryland, United States
Oluwadamilola Onasanya
– Department of Pharmaceutical Health Services Research, School of Pharmacy, University of Maryland Baltimore, MD, United States
Udim Damachi
– Student, Department of Pharmaceutical Health Services Research, School of Pharmacy, University of Maryland Baltimore, Baltimore, MD, United States
Margaret Woodbury
– School of Medicine, University of Maryland Baltimore, MD, United States
Martine Solages
– Clinical Team Lead, Division of Psychiatry, Center for Drug Evaluation and Research, US Food and Drug Administration, MD, United States
Michael C. Davis, M.D., Ph.D.
– Clinical Team Leader, Division of Psychiatry, Center for Drug Evaluation and Research, US Food and Drug Administration, MD, United States
Leonard Sacks
– Office of Medical Policy, Center for Drug Evaluation and Research, US Food and Drug Administration, MD, United States

Background: Few studies have examined the acceptability of digital health technology among adolescents with mood disorders on treatment with antidepressants. Compared to traditional monitoring at follow up appointments, digital health technologies allow collection of prospective data at daily time points to better inform treatment decision making. Measuring engagement with technology is critical to understand its potential uses in monitoring response to psychotropics.

Objectives: To assess differences in engagement with a mobile app (MindPWR) and a wearable sleep and activity tracker, between adolescents with mood disorders taking antidepressants (mood) and those without mood disorders (controls).

Methods: In this mixed-methods prospective, pilot study, adolescents (12-17y) were recruited from child psychiatry clinics, primary care practices, and community organizations to trial the first prototype of the MindPWR app. MindPWR is an app that assesses changes in mood, sleep, and fatigue through PROMIS measures administered every other day as Ecological Momentary Assessments (EMA). Eligible participants completed a baseline assessment, downloaded the MindPWR app, and used a wearable tracker 24/7 for 4 weeks. Engagement was defined as 1) proportion of participants responding to >50% of EMA over the 4-week period and 2) proportion of days the activity tracker was used during daytime or night time, estimated as days of use over total days in the study (n=28). We report overall percentages and percent differences in engagement with the MindPWR app and wearable, between adolescents in the mood and control groups. Qualitative interviews were conducted at the end of follow up, to assess challenges with technology engagement.

Results: A total of 20 adolescents (10 controls, 10 mood) participated in the pilot, 55% females, mean age 15 years. A higher proportion of the controls relative to the mood group were engaged with both morning (80% vs 10%, respectively) and evening (100% vs 10%, respectively) EMAs. Engagement with the wearable tracker was 17% higher among controls, during the daytime and 19% higher during the night time, compared to the mood group. Adolescents in the mood group reported the app was easy to use, but noted challenges remembering to complete EMA despite the automatic notifications. Level of comfort with the wearable, especially at night, was described as a factor limiting its use.

Conclusions: Engagement with digital technologies may be challenging among youth with mood disorders. Better evidence is needed on approaches to enhance the use of digital health technologies in this population.