TY  - JOUR
AU  - Hamlin, Matilda
AU  - Holmén, Joacim
AU  - Wentz, Elisabet
AU  - Aiff, Harald
AU  - Ali, Lilas
AU  - Steingrimsson, Steinn
PY  - 2023
DA  - 2023/10/11
TI  - Patient Experience of Digitalized Follow-up of Antidepressant Treatment in Psychiatric Outpatient Care: Qualitative Analysis
JO  - JMIR Ment Health
SP  - e48843
VL  - 10
KW  - major depressive disorder
KW  - digital psychiatry
KW  - mobile app
KW  - adherence
KW  - antidepressant
KW  - antidepressants
KW  - depressive
KW  - depression
KW  - mHealth
KW  - mobile health
KW  - app
KW  - apps
KW  - application
KW  - applications
KW  - experience
KW  - interview
KW  - interviews
KW  - medication
KW  - prescribe
KW  - prescription
KW  - dose
AB  - Background: Nonadherence to pharmaceutical antidepressant treatment is common among patients with depression. Digitalized follow-up (ie, self-monitoring systems through mobile apps) has been suggested as an effective adjunct to conventional antidepressant treatment to increase medical adherence, improve symptoms of depression, and reduce health care resource use. Objective: The aim of this study was to determine patients’ experience of digitalized follow-up using a mobile app as an adjunct to treatment concurrent with a new prescription, a change of antidepressant, or a dose increase. Methods: This was a qualitative, descriptive study. Patients at 2 psychiatric outpatient clinics were recruited at the time of changing antidepressant medication. After using a mobile app (either a commercial app or a public app) for 4-6 weeks with daily registrations of active data, such as medical intake and questions concerning general mental health status, individual semistructured interviews were conducted. Recorded data were transcribed and then analyzed using content analysis. Results: In total, 13 patients completed the study. The mean age was 35 (range 20-67) years, 8 (61.5%) were female, and all reported high digital literacy. Overall, the emerging themes indicated that the patients found the digital app to be a valuable adjunct to antidepressant treatment but with potential for improvement. Both user adherence and medical adherence were positively affected by a daily reminder and the app’s ease of use. User adherence was negatively affected by the severity of depression. The positive experience of visually presented data as graphs was a key finding, which was beneficial for self-awareness, the patient-physician relationship, and user adherence. Finally, the patients had mixed reactions to the app’s content and requested tailored content. Conclusions: The patients identified several factors addressing both medical adherence and user adherence to a digital app when using it for digitalized follow-up concurrent with the critical time related to changes in antidepressant medication. The findings highlight the need for rigorous evidence-based empirical studies to generate sustainable research results. 
SN  - 2368-7959
UR  - https://mental.jmir.org/2023/1/e48843
UR  - https://doi.org/10.2196/48843
UR  - http://www.ncbi.nlm.nih.gov/pubmed/37819697
DO  - 10.2196/48843
ID  - info:doi/10.2196/48843
ER  -