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Assessing the feasibility of a web-based outcome measurement system in child and adolescent mental health services - myHealthE a randomised controlled feasibility pilot study

Research output: Contribution to journalArticlepeer-review

Original languageEnglish
JournalChild and Adolescent Mental Health
E-pub ahead of print9 Jun 2022

Bibliographical note

Funding Information: Z.I., M.P., R.S., M.H., A.P., R.J.B.D., E.S. and J.D. are affiliated with the National Institute of Health Research (NIHR) Biomedical Research Centre for Mental Health (BRC) Nucleus at the South London and Maudsley (SLaM) NHS Foundation Trust and Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London (KCL). Additionally, the Clinical Record Interactive Search (CRIS) is supported by the NIHR BRC at the SLaM NHS Foundation Trust and KCL. A.C.M is supported by the Guy's and St Thomas' (GSST) Charity. Z.I. and R.J.B.D. are additionally supported by the NIHR University College London Hospitals BRC. R.J.B.D. is further supported by (a) Health Data Research (HDR) UK and (b) The BigData@Heart Consortium under grant agreement No. 116074. M.H. reports funding from the NIHR. A.S. is supported by the Intramural Research Program of the National Institute of Mental Health National Institutes of Health (NIH) (Grant No. ZIA‐MH002957‐01). R.S. is additionally part‐funded by (a) a Medical Research Council (MRC) Mental Health Data Pathfinder Award to King's College London; (b) an NIHR Senior Investigator Award; (c) the NIHR Applied Research Collaboration South London (NIHR ARC South London) at King's College Hospital NHS Foundation Trust. The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care. M.H. declares funding from the Innovative Medicines Initiative for the RADAR‐CNS consortium which includes contributions from Janssen, MSD, UCB, Biogen and Lundbeck. A.P. is partially supported by the NIHR (NF‐SI‐0617‐10120). E.S. is supported from the NIHR BRC at SLaM NHS Foundation Trust (IS‐BRC‐1215‐20018), the NIHR through a programme grant (RP‐PG‐1211‐20016) and Senior Investigator Award (NF‐SI‐0514‐10073 and NF‐SI‐0617‐10120), the European Union Innovative Medicines Initiative (EU‐IMI 115300), Autistica (7237) MRC (MR/R000832/1, MR/P019293/1), the Economic and Social Research Council (ESRC 003041/1) and GSST Charity (GSTT EF1150502) and the Maudsley Charity. J.D. is supported by NIHR Clinician Science Fellowship award (CS‐2018‐18‐ST2‐014) and has received support from a Medical Research Council (MRC) Clinical Research Training Fellowship (MR/L017105/1) and Psychiatry Research Trust Peggy Pollak Research Fellowship in Developmental Psychiatry. The authors give thanks to the families and Kaleidoscope staff who participated in this trial and the MHE digital development team – Digital Marmalade (see ) – with particular thanks to Andy McEniry and Jeremy Jones. J.D conceived the trial aims, supervised data analysis and writing. A.C.M led on data analysis and manuscript writing. M.P. assisted with study design and data acquisition. All authors reviewed and provided critical revisions to the manuscript and approved the final version of the manuscript. The remaining authors declare that they have no competing or potential conflicts of interest. Publisher Copyright: © 2022 The Authors. Child and Adolescent Mental Health published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health.

King's Authors


Background: Interest in internet-based patient reported outcome measure (PROM) collection is increasing. The NHS myHealthE (MHE) web-based monitoring system was developed to address the limitations of paper-based PROM completion. MHE provides a simple and secure way for families accessing Child and Adolescent Mental Health Services to report clinical information and track their child's progress. This study aimed to assess whether MHE improves the completion of the Strengths and Difficulties Questionnaire (SDQ) compared with paper collection. Secondary objectives were to explore caregiver satisfaction and application acceptability. Methods: A 12-week single-blinded randomised controlled feasibility pilot trial of MHE was conducted with 196 families accessing neurodevelopmental services in south London to examine whether electronic questionnaires are completed more readily than paper-based questionnaires over a 3-month period. Follow up process evaluation phone calls with a subset (n = 8) of caregivers explored system satisfaction and usability. Results: MHE group assignment was significantly associated with an increased probability of completing an SDQ-P in the study period (adjusted hazard ratio (HR) 12.1, 95% CI 4.7–31.0; p = <.001). Of those caregivers' who received the MHE invitation (n = 68) 69.1% completed an SDQ using the platform compared to 8.8% in the control group (n = 68). The system was well received by caregivers, who cited numerous benefits of using MHE, for example, real-time feedback and ease of completion. Conclusions: MHE holds promise for improving PROM completion rates. Research is needed to refine MHE, evaluate large-scale MHE implementation, cost effectiveness and explore factors associated with differences in electronic questionnaire uptake.

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