統合失調症の自己管理と医療従事者の関与を促進するためのデジタルヘルスアプローチの検討

App4Independent (A4i)

実験的: A4i 介入 App4Independent (A4i) 研究介入はデジタル ヘルス プラットフォーム A4i です。 A4i は、データの有無にかかわらず、個人の電話機で動作します。

A4i の具体的な機能には次のものが含まれます。

• パーソナライズされたプロンプト、活動のスケジュール設定、さまざまなリソースへの接続を通じて、社会的孤立と認知的課題に対処します。
• 証拠に基づいたコンテンツを通じて病気の自己管理を促進します。
• ユーザー間での戦略/ヒントの共有を容易にするピアツーピア エンゲージメント プラットフォーム (匿名およびモデレート)。
• 毎日の健康状態と目標達成度のチェックイン。
• オシロスコープタイプのインジケーターを備えた周囲音検出器は、幻聴を持つ人が幻聴と実際の音を区別できるように支援します。
• 電話に関するデータを受動的に収集し、睡眠のプロキシとして使用します。
• プロバイダーのダッシュボード。 対照および実験条件の参加者は両方とも、標準外来治療 (TAU) を受けます。

• A4i

Medication adherence will be measured using the 4-item Brief Adherence Rating Scale with responses obtained by both providers and participants to assess medication adherence. There are two indicators, both are pre-post changes, "days not taken" and "days taken less", and both are not scored as a percentage.

The change scores for taking medication less (days taken less) and medication not taken (days not taken) were calculated as the difference from their 6 month score minus their baseline score. An value of "better" was assigned when the change score is > 0, value of "no change" was assigned when the change score is = 0, and a value of "worse" value was assigned when the change score is < 0.

The Heinrichs-Carpenter Quality of Life Scale, has 21 items, is well validated for schizophrenia, and captures sense of purpose, motivation, emotional and social interaction, role functioning, and engagement in regular activities. Higher values are better. Range 0-126.

Pre-post change scores were calculated by subtracting the pre-score from the post score (= post - pre).

Schizophrenia-specific symptomatology will be assessed with the Positive and Negative Syndrome Scale. Lower values are better. Range 30-210.

Pre-post change scores were calculated by subtracting the pre-score from the post score (= post - pre).

Global Appraisal of Individual Needs- Short Screener (GAIN-SS) - Instrument used for screening possible internalizing or externalizing psychiatric disorders, substance use disorders, or crime and violence problems. Lower values are better. Range 0-20.

Pre-post change scores were calculated by subtracting the pre-score from the post score (= post - pre).

The 5-item, 6-point likert scale Medical Outcomes Study general adherence scale to capture broader adherence to treatment recommendations (again triangulated with provider responses). Higher values are better. Range 5-26.

Pre-post change scores were calculated by subtracting the pre-score from the post score (= post - pre).

Provider-Patient Clinical Alliance will be assessed with Scale to Assess the Therapeutic Relationship - Patient to measure patient perspective of provider-patient relationship. This 12-item measure employing a 5-point likert scale has been used extensively in studies of outpatient care for severe mental illness. This measure supports patient and provider versions. Higher values are better. Range 0-48.

Pre-post change scores were calculated by subtracting the pre-score from the post score (= post - pre).

Service Use History measure to assess past month service use history of patient participant.

Number of visits due to physical health issues (in the past 6 months) included the sum of: family doctor, ER, walk-in clinic, and other services for the patient participant Number of visits due to mental health issues (in the past 6 months) included the sum of: sum of family doctor, outpatient, psychologist, social worker, community service for the patient participant There is no limit on the scale range since it is based on the number of visits to various services in the past 6 months.