6533b7ddfe1ef96bd127487e

RESEARCH PRODUCT

T59. FILLING THE GAP BETWEEN RESEARCH AND CLINICAL PRACTICE: A NEW APP FOR PATIENTS WITH FIRST EPISODE OF PSYCHOSIS

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BACKGROUND: In spite of promising results of mobile Health (mHealth) interventions for patients with psychosis, integration of these appliances into clinical practice remains a significant challenge (Bonet et al. 2017). Moreover, some studies have pointed out that percentages between 19–38% of patients have had negative experiences related to internet or cell phone usage, which may increase the risk of psychotic relapses (Bonet et al. 2018). In order to address these issues, we have developed an app called “ReMindCare” whose main objective is being simple, useful and automatically integrated into clinical practice. METHODS: ReMindCare is an app that collects the following information: a) Three daily questions regarding anxiety, sadness and irritability b) 18 weekly questions about: 1. level of adherence to medication, 2. presence of medication side-effects, 3. prodromal psychotic symptoms and 4. attitude towards medication. Answers to these questions are displayed following a Likert scale (1 to 5). In addition, patients are able to contact clinicians by clicking an “urgent consultation” tab. All this information is summarized in a clinical report which is given to patients and uploaded at their electronic medical record at the hospital database, being accessible for consultation for any clinician involved in treatment of the patient. Exclusion criteria are: presence of severe mental disability, language barriers and not to sign the informant consent. All patients from the First Episode of Psychosis Unit are being offered the use of ReMindCare as a part of their usual treatment. RESULTS: 56 patients have been offered the app (from 26 September to 26 November). Mean age 32.96 (SD=8.82), 78.6% are male, 87,5% Caucasian, 80.4% single, 80% have medium education level (until 16 years old) or more and 98.2% are taking antipsychotic medication. From this sample, 38 patients (67.9%) accepted using the app. Significant differences were found between users and no-users regarding: previous suicidal attempts (None of no-users have had previous suicidal attempts while 37.8% of users have) (χ2= 8.23 p=.004), years of illness (65.8% of users have less than 3 years of illness compared to 38.9% of no-users) (χ2= 3.61 p=.005) and in GAF punctuations (50% of users have punctuations between 100–60 in GAF compared to 33.3% of no users, and 13.2% have punctuations lower than 50 compared 50% of no-users) (χ2=9.03 p=.01). No differences were found in other clinical and demographic factors. DISCUSSION: To our knowledge, this is the first attempt to integrate the use of mHealth technologies into daily practice and electronic clinical records. Rate of acceptance is high, however some clinical differences regarding years of illness and GAF punctuations, may indicate that chronic patients are less willing to use ReMindCare. On the contrary, patients who have had previous suicide attempts are very interested in using the app. This can be due to the “urgent consultation” function which would allow them to contact clinicians in case of mood aggravation. ReMindCare is being especially useful in order to detect deception into medication intake in some patients. Encouraging feedback is being received for patients and clinicians, especially in regards of improvement of quality of interview and clinical alliance. References: Bonet L, Izquierdo C, Escartí MJ, Sancho JV, Arce D, Blanquer I et al. Utilización de tecnologías móviles en pacientes con psicosis: una revisión sistemática. Rev Psiquiatr Salud Ment 2017 Jul-Sept; 10(3): 168–78. Bonet L, Llácer B, Hernandez-Viadel M, Arce D, Blanquer I, Cañete C et al. Differences in the Use and Opinions About New eHealth Technologies Among Patients with Psychosis: Structured Questionnaire. JMIR Ment Health. 2018 Jul;5(3):e51.