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

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Abstract

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.
Original languageEnglish
JournalJMIR mHealth and uHealth
Volume6
Issue number10
DOIs
Publication statusPublished - 30 Oct 2018

Keywords

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

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