- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03975881
Study for the Use Smartphone Application to Prevent Suicidal Relapse Among 15-35 Years-old With Previous Suicide Attempted (MED COMPANION)
Multicenter Open Pilot Study for the Use Smartphone Application to Prevent Suicidal Relapse Among 15-35 Years-old With Previous Suicide Attempted
Context: Suicide is the 2nd cause of death during adolescence Compliance with post SA care is low and variable with effective compliance ranging from 17.5% to 47% . Therefore, prevention programs should also focus on high-risk individuals with a previous history of SA.
Adolescents and young adults are considered to be digital natives, they are therefore a relevant population for the testing of Smartphone Application.
Project: The Investigators propose an innovative and new approach to prevent SA and Suicide for patients, based on a mobile healthcare application.
The program is an add-on to the usual care process.
Study: In a multicentric randomized pilot study with 15 to 35 years-old patients having previous SA, the primary goal for pilot study is to observe the filling rate of the application (feasibility).
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Suicide is the 2nd cause of death during adolescence in Europe (1.200/year, 7.9 % of deaths in this age group) and the prevalence of Lifetime Suicide Attempts (SA) in this population is 4.2%. Within a year of the SA, the repetition rate in adolescent populations ranges from 15% to 28%.
Post-SA management is crucial and treatment compliance is a major concern in adolescent populations. A French consensus psychiatric workgroup recommends that when patient is discharged from emergency room (ER) or hospitalization, it is important to organize health care. Unfortunately, these recommendations are imprecise and, moreover, from 40 to 77% of adolescents with previous SAs do not follow the recommendations of the post crisis program. In real clinical practice, patients barely follow the recommended treatment.
Reducing the SA repetition rate and increasing compliance with the recommended post-crisis program are two synergic issues.
The incredible and recent adoption of smartphone health applications (apps), that collect data (weight, exercises…) and allow the consumer to see graphs and diagrams, illustrates the sociological and psychological power of digital self-care and self-management. This phenomenon is particularly important for adolescents and young adults, who are considered to be digital natives. Medical experience is mainly based on the idea that is could be very useful to ask the patient to fill in scales or questionnaires on his/her smartphone instead of on a computer or a paper sheet. This is called Ecological Momentary Assessment (EMA) as it is a naturalistic method to access clinical data.
There are a few positive experiments in self-management (or self-care) using smartphone applications in psychiatry. In the field of suicide and mood disorders they have very interesting and promising results (high filling rates and better compliance to heath care programs). However, despite a few self-care aspects most of these apps are based on psycho-education programs and suffer in reality from lack of feedback.
Second field of apps use is Ecological Momentary intervention (EMI). Main idea is to use EMA data in algorithm in order to produce personalized comments and advises for patients. With the development of machine learning, it is obvious that EMI will have great implication in the future. There are few experiences with EMI but recent reviews all suggest that it is results are promising in mood disorders and anxiety.
The investigators are proposing an EMA + EMI new approach to prevent patient SA and Suicide based on a mobile healthcare application. This application is not connected. This is noticeably different then connected approach, using connected technology (phone, visual-phone and text messages) such as the Suicide Intervention Assisted by Message (SIAM) program, with text messages sent (sometimes automatically) by healthcare professionals to high-risk suicide subjects has shown positive preliminary results, with a reduced repetition rate. The App will be customised for each user when redeemed with a personal code provided by the practitioner. The App will collect data from the patient regarding anxiety, mood and sleep disorders twice a day (with a decreased frequence along the period of use), essentially based on analogic visual scales and drop-down lists. An algorithm-based feedback will pro-actively inform the patient with comments and advice based on WHO recommendations and/or associated with self-coping or Mindfulness practices. The aim is to position the smartphone application like a health care partner, it's name will be Medical Companion.
In order to assess the efficiency of the complete app the investigators will first lead a multicentre open pilot study with 6 months of follow-up in an adolescents and young adults population with a history of suicide attempts.
The application is an association of a "conventional" EMA program and an innovative algorithm-based response to the patient. Built on the notion of self-care, this app is not connected and the patient's responses are processed in the algorithm: (i) to provide feed-back regarding their mental state (contextualized, i.e. "you seem to be less anxious then yesterday") and, (ii) to advice them about what to do (for example "call a friend" "breath deeply 5 times in a row"…). Each mental status will be analysed by the Bayesian application algorithm. Regular evaluations are also provided on screen with easy to see graphs that might be viewed by the patient. These graphs could (and should) be seen by the psychiatrist, or psychologist involved in the Care as Usual program that all participants will still have. In sum, medical practitioners involved in the patient's usual care will have access to synthetic presentation of patient's responses and the investigators plan to ask participants about their experience.
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Fanny GOLLIER BRIANT
- Phone Number: 0253482653
- Email: fanny.gollierbriant@chu-nantes.fr
Study Contact Backup
- Name: Olivier BONNOT
- Phone Number: 0253482653
- Email: olivier.bonnot@chu-nantes.fr
Study Locations
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-
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Angers, France
- CHU d'Angers
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Contact:
- Bénédicte GOHIER
- Email: BeGoohier@chu-anger.fr
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Poitiers, France
- CH Poitiers
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Contact:
- Ludovic Gicquel
- Email: ludovic.gicquel@ch-poitiers.fr
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Rennes, France
- CH Rennes
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Contact:
- Dominique Drapier
- Email: d.drapier@ch-guillaumerenier.fr
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Boy or girl, aged 15 to 35 years and having made a suicide attempt within 96 hours requiring emergency admission.
- Informed and signed consent of patient and parents (if applicable)
- Patient affiliated to social security
Exclusion Criteria:
- Patient with a severe psychiatric condition such as, schizophrenia, autistic spectrum disorder and antecedent of more than one suicide attempt (not counting this).
- Patient without smartphone under iOS (mobile operating system developed by Apple) or Android, or without easy access (eg boarding school, social center ...)
- Patient with an intellectual disability making it impossible to use the application (clinically estimated).
- Absence of motivation in relation to the study.
- Patient who does not want or can not give informed consent or understand it.
- Patient whose follow-up seems difficult for psychological, geographical or social reasons, according to the judgment of the investigator
- Not affiliated to social security
Study Plan
How is the study designed?
Design Details
- Primary Purpose: PREVENTION
- Allocation: NA
- Interventional Model: SINGLE_GROUP
- Masking: NONE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
EXPERIMENTAL: Open Label
Patients aged 15 to 35 who made a suicide attempt and went through the emergency departments of the participating hospitals (Nantes, Angers, Rennes and Poitiers).
|
The aim of this study is to test the feasibility of our approach of preventing suicide relapse with the use of a smartphone application.
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Evaluate the usage rate of the Medical Companion application over a period of 6 months.
Time Frame: 6 months
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Ratio calculation (r) : r = (number of uses done) / (number of uses expected)
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6 months
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Evaluation of the use rate of the application over 6 months
Time Frame: 6 months
|
Frequency of use of the application, data generated automatically by the internal program of the application Medical Companion
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6 months
|
Evaluation of the use rate of the application over 6 months
Time Frame: 6 months
|
duration of use of the application
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6 months
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Evaluation of suicidal ideation after 6 months of use of the application,
Time Frame: 6 months
|
Rate of suicidal ideation at 6 months assessed by telephone call in families using ( 1 to 7)
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6 months
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Evaluation of suicidal recidivism at 6 months
Time Frame: 6 months
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Rate of suicidal recidivism at 6 months evaluated by phone call in families
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6 months
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Assessment of the compliance rate at recommended care
Time Frame: 6 months
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Rate of compliance to recommended care at discharge from hospital (number of appointments honored)
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6 months
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Assessment of the compliance rate at recommended care
Time Frame: 6 months
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Rate of compliance to recommended care at 6 months evaluated by phone call in families
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6 months
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Evaluation of the evolution of the level of sadness of the subject during the 6 months of follow-up
Time Frame: 6 months
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Visual Analogic scale (1 is bad to 10 is perfect ) generated automatically from the subject's responses by the application's internal program
|
6 months
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Evaluation of the evolution of the level of sleep disorders of the subject during the 6 months of follow-up
Time Frame: 6 months
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Visual Analogic scale (1 is bad to 10 is perfect ) generated automatically from the subject's responses by the application's internal program.
|
6 months
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Study Chair: Fanny GOLLIER BRIANT, Nantes University Hospital
Publications and helpful links
Study record dates
Study Major Dates
Study Start (ANTICIPATED)
Primary Completion (ANTICIPATED)
Study Completion (ANTICIPATED)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (ACTUAL)
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- RC18_0038
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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