We all know that there are apps for that, and for healthcare, there isn’t just one app; there are over 165,000 of them. Arguably the largest category of healthcare apps is mental health. People use it to manage conditions such as addiction, anxiety, depression, and bipolar disorder. In addition to visiting a trusted drug or treatment of methamphetamine abuse facilities, mental aid apps have become part of the treatment for some recovering addicts.
However, despite their ubiquity, there is not much scientific evidence to support their use. Software designed for use on mobile devices has not been subject to rigorous scientific review, so its efficacy is questionable. However, the fact that the research literature has been outpaced by the production of apps has not hurt the level of interest from consumers and industry to create and release more apps.
For example, in a recent literature review, only 14 apps for people with major depressive disorder or bipolar disorder were examined, and only seven apps for people with psychosis. And this review reveals studies that have included little if any data on safety, efficacy, or clinical outcomes. However, this does not have an impact on increasing demand for the application.
This issue is further complicated by the need for professional groups to determine how these applications should be used. The American Psychiatric Association, for example, must decide how psychiatric health workers should use the app. The Food and Drug Administration has stated that it will not begin to address this major issue.
An article in the Journal of Clinical Psychiatry identifies two options for providers to consider when they consider the use of apps and other consumer devices in clinical care. On the one hand, they can reject the app and direct their patients not to use it because there is not much evidence that the app works. Or, they can accept that the app will stay and patients use it.
At this point, people are already taking activity monitoring devices (like Fitbits), sleep tracking data, and apps to their doctors for a professional perspective on how to get the most out of them. This is a lot like people bringing information from WebMD or the Mayo Clinic website to their doctor.
The reality is patients are already looking for applications and using them, but they may not be pursuing the most effective uses or figuring out the best approach to take. By talking with doctors about the tools available to them, patients can make informed decisions about the tools they use to manage their mental health care. It is best for doctors to accept the application and engage with patients to make the best of it.
Psychiatric providers are advised to consider the ASPECT of the application:
- Actionable: Does the app collect relevant data that can be easily integrated with electronic health records?
- Secure: Is the app HIPAA compliant, and is data encrypted to protect patients if the phone is lost or stolen?
- Professional: Does the app meet professional standards, including ethical and legal guidelines?
- Evidence-based: Does the app have enough data to use it safely?
- Customizable: Does the app allow doctors and patients to simultaneously evaluate, select, and customize the app?
- Transparent: Does the app clearly report how information is collected, stored, reviewed, used and shared?
