Capturing Rest-Activity Profiles in Schizophrenia using Wearable and Mobile Technologies: Development, Implementation, Feasibility and Acceptability of a Remote Monitoring Platform.

TY - JOUR

T1 - Capturing Rest-Activity Profiles in Schizophrenia using Wearable and Mobile Technologies

T2 - Development, Implementation, Feasibility and Acceptability of a Remote Monitoring Platform.

AU - Meyer, Nicholas

AU - Kerz, Maximilian

AU - Folarin, Amos

AU - Joyce, Dan W.

AU - Jackson, Richard

AU - Karr, Chris

AU - Dobson, Richard James Butler

AU - MacCabe, James

PY - 2018/10/30

Y1 - 2018/10/30

N2 - Background: There is growing interest in the potential for wearable and mobile devices to deliver clinically relevant information in real-world contexts. However, there is limited information on their acceptability and barriers to long-term use in people living with psychosis. Objective: We describe the development, implementation, feasibility, acceptability and user-experiences of the Sleepsight platform, which harnesses consumer wearable devices and smartphones for the passive and unobtrusive capture of sleep and rest-activity profiles in people with schizophrenia, living in their homes. Methods: Fifteen outpatients with a diagnosis of schizophrenia used a consumer wrist-worn device and smartphone to continuously and remotely gather rest-activity profiles over two months. Once-daily sleep and self-rated symptom diaries were also collected via a smartphone application. Adherence with the devices and smartphone application, end of study user-experiences and agreement between subjective and objective sleep measures were analysed. Thresholds for acceptability were set at a wear-time or diary response rate of 70% or greater. Results: 14/15 participants completed the study. In individuals with a mild to moderate symptom severity at baseline (mean total PANSS score 58.4 (SD = 14.4)), we demonstrated high rates of engagement with the wearable device (all participants meeting acceptability criteria), sleep and symptom diary (93% and 86% meeting criteria, respectively), with negative symptoms being associated with lower diary completion rate. The end of study usability and acceptability questionnaire and qualitative analysis identified facilitators and barriers to long-term use, and paranoia with study devices was not a significant barrier to engagement. Comparison between sleep-diary and wearable estimated sleep times showed good correspondence (r = 0.50, P < .001). Conclusions: Extended use of wearable and mobile technologies are acceptable to people with schizophrenia living in a community setting. In the future, these technologies may allow predictive, objective markers of clinical status, including early markers of impending relapse.

AB - Background: There is growing interest in the potential for wearable and mobile devices to deliver clinically relevant information in real-world contexts. However, there is limited information on their acceptability and barriers to long-term use in people living with psychosis. Objective: We describe the development, implementation, feasibility, acceptability and user-experiences of the Sleepsight platform, which harnesses consumer wearable devices and smartphones for the passive and unobtrusive capture of sleep and rest-activity profiles in people with schizophrenia, living in their homes. Methods: Fifteen outpatients with a diagnosis of schizophrenia used a consumer wrist-worn device and smartphone to continuously and remotely gather rest-activity profiles over two months. Once-daily sleep and self-rated symptom diaries were also collected via a smartphone application. Adherence with the devices and smartphone application, end of study user-experiences and agreement between subjective and objective sleep measures were analysed. Thresholds for acceptability were set at a wear-time or diary response rate of 70% or greater. Results: 14/15 participants completed the study. In individuals with a mild to moderate symptom severity at baseline (mean total PANSS score 58.4 (SD = 14.4)), we demonstrated high rates of engagement with the wearable device (all participants meeting acceptability criteria), sleep and symptom diary (93% and 86% meeting criteria, respectively), with negative symptoms being associated with lower diary completion rate. The end of study usability and acceptability questionnaire and qualitative analysis identified facilitators and barriers to long-term use, and paranoia with study devices was not a significant barrier to engagement. Comparison between sleep-diary and wearable estimated sleep times showed good correspondence (r = 0.50, P < .001). Conclusions: Extended use of wearable and mobile technologies are acceptable to people with schizophrenia living in a community setting. In the future, these technologies may allow predictive, objective markers of clinical status, including early markers of impending relapse.

KW - Sleep, circadian rhythm, rest-activity, mHealth, wearables, Fitbit, smartphone, relapse, psychosis

U2 - 10.2196/mhealth.8292

DO - 10.2196/mhealth.8292

M3 - Article

VL - 6

JO - JMIR mHealth and uHealth

JF - JMIR mHealth and uHealth

IS - 10

ER -