App auf Rezept: Was sind digitale Pillen und braucht es sie in der Psychotherapie?
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App auf Rezept: Was sind
digitale Pillen und braucht es
sie in der Psychotherapie?
Prof. Dr. Tobias Kowatsch
Assistant Professor for Digital Health, University of St.Gallen, Switzerland
Scientific Director, Centre for Digital Health Interventions, ETH Zurich & University of St.Gallen, Switzerland
Lead Principal Investigator, Mobile Health Interventions, Singapore-ETH Centre, Singapore
Partner, Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, USA
Member, Competence Centre for Rehabilitation Engineering and Science, ETH Zurich, Switzerland
Psychiatrische Universitätsklinik Zürich | 12. März 2021 | 11:00 – 12:30 Uhr
Who we are
Center Leadership
Assist. Prof. Dr. Tobias Kowatsch Advisory Board
Olivia Clare Keller, MSc
Matthias Heuberger, MA
Prof. Dr. Elgar Fleisch
Prof. Lisa A. Marsch, PhD
Postdoctoral Researcher Prof. Dr. Urte Scholz
Prof. Dr. Florian v. Wangenheim
Dr. Filipe Barata, Head of AI & Digital Biomarker Research
Dr. med. Thomas Züger, Diabetes Technology
Jacqueline Mair, PhD, Behavioral and Exercise Sciences
Alicia Salamanca, PhD, Clinical Psychology
Doctoral Students
Alina Aishah Caterina George David Christoph Robert Roman Vera Yanick Marcia Joseph Dominik Theresa Gisbert Jiali
Asisof Alattas Bérubé Boateng Cleres Gross Jakob Keller Lehmann Lukic Nißen Ollier Rüegger Schachner Teepe Yao
MobileCoach Team Student Research Assistants, Master & Bachelor Students
and
many
more…
P. Santhanam F. Schneider S. Harperink S. Ultsch Aliena Mutter Z. Kovac T. Tarantini M. Rauch B. Frese T. Stauffer S. Jokić
Software Engineer Software Engineer St.Res.Assist. MA Student MA Student MA Student MA Student MA Student MA Student MA Student BA Student
Folie 2 | App auf Rezept: Was sind digitale Pillen und braucht es sie in der Psychotherapie? © Universität St.Gallen und & ETH Zürich
What we do
SNF Digital
Future Health CSS Health /
PEACH
Technologies Personality Health Lab Project
Singapore Development Respiratory &
Cardiavascular CAS in
Prevention of Diseases & Mental Digital Health
Depression & Health
for Executives
Type-2 Diabetes (coming in 2022)
Open-Source Education
Software
MobileCoach
NIH
The
Sweetgoals
Research Digital Pill
USA Book
Type-1
Diabetes Open
Research Startups
Data
Resmonics
Respiratory
InnoSuisse SNF SNF Conditions
CAir HEADWIND DyMand Pathmate
COPD Type-1 Type-2 Altoida Chronic
Diabetes Alzheimer Disease
Diabetes
Coach
… and much more
Folie 3 | App auf Rezept: Was sind digitale Pillen und braucht es sie in der Psychotherapie? © Universität St.Gallen und & ETH Zürich
Our research partners Folie 4 | App auf Rezept: Was sind digitale Pillen und braucht es sie in der Psychotherapie? © Universität St.Gallen und & ETH Zürich
Funding Folie 5 | App auf Rezept: Was sind digitale Pillen und braucht es sie in der Psychotherapie? © Universität St.Gallen und & ETH Zürich
Wissen Sie schon was eine
digitale Pille ist?
Den Umfrage-Link finden
Sie im Zoom-Chat oder hier:
Was sind digitale Pillen? Digital Pillen sind digitale Gesundheitsanwendungen, Web- oder App-basiert, welche entweder verschreibungspflichtig sind („das ist ganz neu“) oder frei bzw. käuflich erhältlich sind („das kennt jeder“).
Braucht es denn evidenzbasierte
digitale Pillen aus Ihrer Sicht?
Den Umfrage-Link finden
Sie im Zoom-Chat oder hier:
App on Prescription in the U.S.
December 2018
Prescription Digital Therapeutics, or PDTs,
are software-based disease treatments.
PDTs are designed to directly treat disease,
tested for safety and efficacy in randomized
clinical trials, evaluated by the FDA, and
prescribed by healthcare providers.
https://peartherapeutics.com
Folie 9 | App auf Rezept: Was sind digitale Pillen und braucht es sie in der Psychotherapie? © Universität St.Gallen und & ETH Zürich
App on Prescription in Germany diga.bfarm.de/de Folie 10 | App auf Rezept: Was sind digitale Pillen und braucht es sie in der Psychotherapie? © Universität St.Gallen und & ETH Zürich
App on Prescription in Germany diga.bfarm.de/de Folie 11 | App auf Rezept: Was sind digitale Pillen und braucht es sie in der Psychotherapie? © Universität St.Gallen und & ETH Zürich
App on Prescription in Germany diga.bfarm.de/de Folie 12 | App auf Rezept: Was sind digitale Pillen und braucht es sie in der Psychotherapie? © Universität St.Gallen und & ETH Zürich
App on Prescription in Germany diga.bfarm.de/de Folie 13 | App auf Rezept: Was sind digitale Pillen und braucht es sie in der Psychotherapie? © Universität St.Gallen und & ETH Zürich
App on Prescription in Germany diga.bfarm.de/de Folie 14 | App auf Rezept: Was sind digitale Pillen und braucht es sie in der Psychotherapie? © Universität St.Gallen und & ETH Zürich
Example: deprexis https://diga.bfarm.de/de/verzeichnis/450 Folie 15 | App auf Rezept: Was sind digitale Pillen und braucht es sie in der Psychotherapie? © Universität St.Gallen und & ETH Zürich
Ein Schritt zurück: Vom fertigen Produkt in die Forschung. Was könnte denn eine digitale Wunsch-Pille leisten?
Anatomie einer digitalen Pille
Example
Distal
Quality of Life
Outcome
Evidence-
based
knowledge
Proximal Stress
Physical activity Diet Behavior
Outcomes management
Digital Pill
1. Vulnerability 2. Receptivity 3. Support
Folie 17 | App auf Rezept: Was sind digitale Pillen und braucht es sie in der Psychotherapie? © Universität St.Gallen und & ETH ZürichSensing & Support
for People with
Depression
https://www.c4dhi.org/projects/kti-moss/Mobile Sensing and Support for People With
Depression: A Pilot Trial in the Wild
Wahle F, Kowatsch
T, Fleisch E, Rufer
M,Weidt S (2016)
Mobile Sensing and
Support for People
With Depression: A
Pilot Trial in the
Wild
JMIR Mhealth
Uhealth
2016;4(3):e111
doi: 10.2196/mhealt
h.5960
Note: cognitive
behavioral therapy
(CBT)
Folie 19 | App auf Rezept: Was sind digitale Pillen und braucht es sie in der Psychotherapie? © Universität St.Gallen und & ETH ZürichSensing Stress at the Workplace
with the help of a PC mouse
Objective
Development of an early warning system that is able to detect
(chronic) stress, burnout or even depressionVisual Results of the lab experiment (N=18)
Subject was relaxed (Square Task 1) Subject was stressed (Square Task 2)
Kowatsch, T., Wahle, F., Filler, A., Design and Lab Experiment of a Stress Detection Service based on Mouse Movements,
The 11th Mediterranean Conference on Information Systems (MCIS), Genoa, Italy ***Best Paper Award*** https://www.c4dhi.org/projects/jsiss/
Banholzer, N., Feuerriegel, S., Fleisch, E., Bauer, G., Kowatsch, T. (in press) Computer mouse movements as a scalable detector of work stress: A longitudinal observational field study, Journal of Medical Internet Research.
Folie 21 | App auf Rezept: Was sind digitale Pillen und braucht es sie in der Psychotherapie? © Universität St.Gallen und & ETH ZürichHealth literacy
intervention for
children with
asthma
www.c4dhi.org/projects/health-literacy-children-asthma/Interaction with MAX
Smartphone
Family Member
SMS
SMS, phone call
face-to-face
or face-to-face
MAX
Digital Health
Assistant
eMail Chat with MAX
Asthma Expert App chat with expert
Patient
Web-based cockpit or face-to-face Mobile App
Folie 23 | App auf Rezept: Was sind digitale Pillen und braucht es sie in der Psychotherapie? © Universität St.Gallen und & ETH ZürichInhalation Assessment of Norah, 12
Informed consent was received from patient and parent to use video, name and age for presentation purposes
1. Video recording by family member 2. Expert rating 3. Feedback to Norah
1
+
Automated
feedback generation
based on inhalation
guidelines
Folie 24 | App auf Rezept: Was sind digitale Pillen und braucht es sie in der Psychotherapie? © Universität St.Gallen und & ETH ZürichMain results of the pilot study 1. The average adherence rate of 49 subjects was 80.4%. 2. The result of a pre-post test shows that asthma knowledge was improved significantly with a large effect size (d=0.9). 3. On average, 1 inhalation mistake was identified in each video clip; 3 serious inhalation mistakes could be directly addressed and eliminated by the experts’ feedback in this trial. Kowatsch, T., Schachner, T., Harperink, S., Barata, F., Dittler, U., Xiao, G., Stanger, C., Oswald, H., Fleisch, E., von Wangenheim, F., Möller, A. (2021) Conversational Agents as Mediating Social Actors in Chronic Disease Management Involving Health Care Professionals, Patients, and Family Members: Multisite Single-Arm Feasibility Study, Journal of Medical Internet Research (JMIR) 23(2):e25060 10.2196/25060. Folie 25 | App auf Rezept: Was sind digitale Pillen und braucht es sie in der Psychotherapie? © Universität St.Gallen und & ETH Zürich
One asthma expert received a lovely “Thank You” post card from a young patient after the intervention Folie 26 | App auf Rezept: Was sind digitale Pillen und braucht es sie in der Psychotherapie? © Universität St.Gallen und & ETH Zürich
One asthma expert received a lovely “Thank You” post card from a young patient after the intervention Folie 27 | App auf Rezept: Was sind digitale Pillen und braucht es sie in der Psychotherapie? © Universität St.Gallen und & ETH Zürich
Den Umfrage-Link finden Sie im Zoom-Chat oder hier:
Design of a prognostic digital biomarker for asthma control https://www.c4dhi.org/projects/css-mobile-asthma-companion/
Overview of the asthma study with Clara
https://vimeo.com/258412196
Folie 30 | App auf Rezept: Was sind digitale Pillen und braucht es sie in der Psychotherapie? © Universität St.Gallen und & ETH ZürichResults of the study Response rate to daily self-reported asthma control tests of 93 participants: 97.3% (2487 / 2557 self-reports) Paper N subjects N coughs Vizel et al. 2010 12 n/a McGuiness et al. 2012 10 n/a Casaseca-de-La-Higuera et al. 2015 9 n/a Monge-Alvarez et al. 2018 13 n/a Swarnkar et al. 2013 3 342 Amoh et al. 2016 14 627 Birring et al. 2008 15 1.836 Barry et al. 2006 15 2.000 Amrulloh et al. 2015 24 2.090 Drugman et al. 2011 22 2.304 Liu et al. 2014 20 2.549 Larson et al. 2011 17 2.558 Coyle et al. 2005 8 3.645 Klco et al. 2018 18 5.200 Kadambi et al 2018 9 5.670 Our Clara study > 77 23.488 Folie 31 | App auf Rezept: Was sind digitale Pillen und braucht es sie in der Psychotherapie? © Universität St.Gallen und & ETH Zürich
Cough Detection with Smartphones is Feasible
“This research represents a
step towards enabling passive
https://www.jmir.org/2020/7/e18082/ and scalable cough monitoring
for adults with asthma.”
see also…
Tinschert, P., Rassouli, F., Barata, F., Steurer-Stey, C., Fleisch, E., Puhan, M., Kowatsch, T., Brutsche, M. (2020) Nocturnal cough and sleep quality
to assess asthma control and predict attacks, Journal of Asthma and Allergy 13, 669-678 10.2147/JAA.S278155.
Rassouli, F., Tinschert, P., Barata, F., Steurer-Stey, C., Fleisch, E., Puhan, M., Baty, F., Kowatsch, T., Brutsche, M. (2020) Characteristics of Asthma-
related Nocturnal Cough: A Potential New Digital Biomarker, Journal of Asthma and Allergy 13, 649—657 10.2147/JAA.S278119 .
Folie 32 | App auf Rezept: Was sind digitale Pillen und braucht es sie in der Psychotherapie? © Universität St.Gallen und & ETH ZürichUsing Car Sensor Data to Predict Hypoglycemia
The “healing” car
Hey Mercedes,
make it cooler and
play my music!
Hey Joe, I recommend
you to take in some
glucose!
Source: youtu.be/sgF4jj2FGlw
Sinergia
Mercedes text was developed with a type-1 diabetes patient.
https://voicebot.ai/2019/02/04/mercedes-focuses-entire-super-bowl-ad-around-hey-mercedes-voice-assistant/
Folie 33 | App auf Rezept: Was sind digitale Pillen und braucht es sie in der Psychotherapie? © Universität St.Gallen und & ETH ZürichIncreasing adherence to
home exercises in chronic
Alex
back pain patients
https://www.c4dhi.org/projects/digital-physiotherapy-coaching-with-alex/Overview of the blended treatment with Alex
Kowatsch, T., Lohse, K.M., Erb, V., Schittenhelm, L., Galliker, H., Lehner, R., Huang, E.M. (2021) Hybrid Ubiquitous Coaching With a Novel Combination of Mobile and Holographic
Conversational Agents Targeting Adherence to Home Exercises: 4 Design and Evaluation Studies, Journal of Medical Internet Research, 23(2):e23612, 10.2196/23612
Folie 35 | App auf Rezept: Was sind digitale Pillen und braucht es sie in der Psychotherapie? © Universität St.Gallen und & ETH ZürichParticipant performing the squat exercise while
wearing the augmented reality hardware.
Kowatsch, T., Lohse, K.M., Erb, V., Schittenhelm, L., Galliker, H., Lehner, R., Huang, E.M. (2021) Hybrid Ubiquitous Coaching With a Novel Combination of Mobile and Holographic
Conversational Agents Targeting Adherence to Home Exercises: 4 Design and Evaluation Studies, Journal of Medical Internet Research, 23(2):e23612, 10.2196/23612
Folie 36 | App auf Rezept: Was sind digitale Pillen und braucht es sie in der Psychotherapie? © Universität St.Gallen und & ETH ZürichResults from a lab experiment (N=15) &
4-week intervention in the field (N=1)
3 modes of
instructions
Alex (Augmented Reality) Video Paper
1. What is your preferred 2. Session Alliance Inventory 3. Four-week intervention study (N=1)
mode of instruction?
Completely 7
Goal: 3 sessions per week for 4 weeks
8 6
Number of answers
6 5 Adherence: 92% (11 of 12 sessions)
4
Feedback: Intention to continue working
3
with Alex
1 2
Not at all 1
naR dn2 knaR ts1
Alex Kowatsch, T., Lohse, K.M., Erb, V., Schittenhelm, L., Galliker, H., Lehner, R.,
Huang, E.M. (2021) Hybrid Ubiquitous Coaching With a Novel
Error bar indicates 95% confidence interval Combination of Mobile and Holographic Conversational Agents
Targeting Adherence to Home Exercises: 4 Design and Evaluation
Studies, Journal of Medical Internet Research, 23(2):e23612, 10.2196/23612
Folie 37 | App auf Rezept: Was sind digitale Pillen und braucht es sie in der Psychotherapie? © Universität St.Gallen und & ETH ZürichResults from the 4-week
intervention in the field (N=1)
Box plot of the exercise execution errors during the 4 weeks. The number of errors was aggregated for each week.
Kowatsch, T., Lohse, K.M., Erb, V., Schittenhelm, L., Galliker, H., Lehner, R., Huang, E.M. (2021) Hybrid Ubiquitous Coaching With a Novel Combination of Mobile and Holographic
Conversational Agents Targeting Adherence to Home Exercises: 4 Design and Evaluation Studies, Journal of Medical Internet Research, 23(2):e23612, 10.2196/23612
Folie 38 | App auf Rezept: Was sind digitale Pillen und braucht es sie in der Psychotherapie? © Universität St.Gallen und & ETH ZürichAlly The Assistant to Lift Your Level of Activity https://www.c4dhi.org/projects/ally-a-digital-assistant-to-lift-your-level-of-activity/
63% of push notifications
are sent at the wrong time
“Most push notifications are
being sent and not opened,
because they arrive at the
wrong time, according to
Leanplum’s research. It
examined more than
671,500,000 push
notifications sent during
2015, and found 63% were
sent at a time when they
were less likely to be
opened.”
www.businessofapps.com/63-of-push-notifications-
are-sent-at-the-wrong-time
https://www.accengage.com/benchmark-opt-in-and-reaction-rates-of-push-notifications-and-in-app-messages-for-mobile-apps-2018-edition/
Folie 40 | App auf Rezept: Was sind digitale Pillen und braucht es sie in der Psychotherapie? © Universität St.Gallen und & ETH ZürichThe Ally App Kramer, J., Künzler, F., Mishra, V., Smith, S.N., Kotz, D.F., Scholz, U., Fleisch, E., Kowatsch, T. (2020) Which Components of a Smartphone Walking App Help Users to Reach Personalized Step Goals? Results from an Optimization Trial, Annals of Behavioral Medicine, 10.1093/abm/kaaa002. Folie 41 | App auf Rezept: Was sind digitale Pillen und braucht es sie in der Psychotherapie? © Universität St.Gallen und & ETH Zürich
Results from the Ally Study
(274 participants, 6 weeks, random notifications)
Positive effect on …
a) response rate (within 10min) b) response delay
Weekend: after 6pm
10am-6pm
Weekday: 10am-6pm
Unplugged Home
Unlocked Unplugged
Walking Walking
Künzler, F., Mishra, V., Kramer, J., Kotz, D.F., Fleisch, E., Kowatsch, T. (2019) Exploring the State-of-Receptivity for mHealth Interventions, Proceedings of the
ACM on Interactive, Mobile, Wearable and Ubiquitous Technologies (IMWUT) 3(4): Paper 140 10.1145/3369805.
Folie 42 | App auf Rezept: Was sind digitale Pillen und braucht es sie in der Psychotherapie? © Universität St.Gallen und & ETH ZürichAlly 2.0 USA (N=83, 3 weeks)
Just-in-time response rate:
Percentage of users
responding to a notification
within 10 minutes.
Mishra, V., Künzler, F., Kramer, J., Fleisch, E., Kowatsch, T., Kotz, D.F. (2020) Detecting Receptivity for mHealth Interventions in the Natural
Environment, Preprint arXiv arXiv:2011.08302.
Folie 43 | App auf Rezept: Was sind digitale Pillen und braucht es sie in der Psychotherapie? © Universität St.Gallen und & ETH ZürichProf. Dr. Mathias Allemand
Prof. Dr. Christoph Flückiger
Psychologists, Zurich University
https://www.c4dhi.org/projects/snf-personality-change/PEACH – Personality Coach
Stieger, M., Nißen, M.K., Rüegger, D., Kowatsch, T., Flückiger, C., Allemand, M. (2019) PEACH, a smartphone- and conversational agent-based coaching intervention for intentional
personality change: study protocol of a randomized, wait-list controlled trial, BMC Psychology 6(43), pp. 1-15. [PDF]
Folie 45 | App auf Rezept: Was sind digitale Pillen und braucht es sie in der Psychotherapie? © Universität St.Gallen und & ETH Zürich“Strongest evidence to date”: PEACH Study
10-week intervention results (self-assessments)
Stieger, M., Flückiger, C., Rüegger, D., Kowatsch, T., Roberts, B.W., Allemand, M. (2021) Changing Personality Traits with the Help of a
Digital Personality Change Intervention, Proceedings of the National Academy of Sciences of the United States of America (PNAS)
18(8):e2017548118 10.1073/pnas.2017548118 (Preprint: 10.31234/osf.io/sur2j)
Folie 46 | App auf Rezept: Was sind digitale Pillen und braucht es sie in der Psychotherapie? © Universität St.Gallen und & ETH ZürichBreeze: A Playful
Biofeedback Breathing
Training for Mental and
Physical Well-being
https://www.c4dhi.org/projects/breeze/A Playful Smartphone-based Self-regulation
Training for the Prevention and Treatment of
Child and Adolescent Obesity
Kowatsch, T., Shih, I., Lukic, Y., Keller, O., Heldt, K., Durrer, D., Stasinaki, A., Büchter, D., Brogle, B., Farpour-Lambert, N., l’Allemand, D. (in press) A Playful Smartphone-based Self-regulation Training for the
Prevention and Treatment of Child and Adolescent Obesity: Technical Feasibility and Perceptions of Young Patients, 1st Workshop on Healthy Interfaces (HEALTHI), collocated with the 26th ACM Annual
Conference on Intelligent User Interfaces (IUI) – Where HCI meets AI, Virtually Hosted by Texas A&M University, April 13-17, 2021
Folie 48 | App auf Rezept: Was sind digitale Pillen und braucht es sie in der Psychotherapie? © Universität St.Gallen und & ETH ZürichPerceptions of 11 Young Children
and Adolescents with Obesity
Kowatsch, T., Shih, I., Lukic, Y., Keller, O., Heldt, K., Durrer, D., Stasinaki, A., Büchter, D., Brogle, B., Farpour-Lambert, N., l’Allemand, D. (in press) A Playful Smartphone-based Self-regulation Training for the
Prevention and Treatment of Child and Adolescent Obesity: Technical Feasibility and Perceptions of Young Patients, 1st Workshop on Healthy Interfaces (HEALTHI), collocated with the 26th ACM Annual
Conference on Intelligent User Interfaces (IUI) – Where HCI meets AI, Virtually Hosted by Texas A&M University, April 13-17, 2021
Folie 49 | App auf Rezept: Was sind digitale Pillen und braucht es sie in der Psychotherapie? © Universität St.Gallen und & ETH ZürichBreeze
Lukic, Y., Shih, I., Hernández, Á., Cotti, A.,
Fleisch, E., Kowatsch, T. (2021) Physiological
Responses and User Feedback on a
Gameful Breathing Training App: Within-
Subject Experiment, JMIR Serious Games
2021;9(1):e22802 10.2196/22802.
Shih, I., Tomita, N., Lukic, Y., Hernández, Á.,
Fleisch, E., Kowatsch, T. (2019) Breeze:
Smartphone-based Acoustic Real-time
Detection of Breathing Phases for a
Gamified Biofeedback Breathing Training,
Proceedings of the ACM on Interactive, Mobile,
Wearable and Ubiquitous Technologies
(IMWUT) 3(4): Paper 152. 10.1145/3369835
Folie 50 | App auf Rezept: Was sind digitale Pillen und braucht es sie in der Psychotherapie? © Universität St.Gallen und & ETH ZürichBreeze: First results of the slow-paced
breathing training (Lab study, N=3/16)
Shih, I., Tomita, N., Lukic, Y., Hernández, Á., Fleisch, E., Kowatsch, T. (2019) Breeze: Smartphone-based Acoustic Real-time Detection of Breathing Phases for a Gamified
Biofeedback Breathing Training, Proceedings of the ACM on Interactive, Mobile, Wearable and Ubiquitous Technologies (IMWUT) 3(4): Paper 152. 10.1145/3369835
Folie 51 | App auf Rezept: Was sind digitale Pillen und braucht es sie in der Psychotherapie? © Universität St.Gallen und & ETH ZürichElena+, Care for COVID-19
30+ Volunteers
Elena+ Care for COVID-19:
A pandemic lifestyle care intervention
https://youtu.be/cRPKGbNcCnw
Screencast
https://vimeo.com/412004844
The Team’s Story
https://youtu.be/ajDa9qnqnPU
www.elena.plus Elena+ inspired by Elena Pagliarini
Folie 52 | App auf Rezept: Was sind digitale Pillen und braucht es sie in der Psychotherapie? © Universität St.Gallen und & ETH ZürichUnd nochmals zur Erinnerung:
Anatomie einer „idealen“ digitalen Pille
Example
Distal
Quality of Life
Outcome
Evidence-
based
knowledge
Proximal Stress
Physical activity Diet Behavior
Outcomes management
Digital Pill
1. Vulnerability 2. Receptivity 3. Support
Folie 53 | App auf Rezept: Was sind digitale Pillen und braucht es sie in der Psychotherapie? © Universität St.Gallen und & ETH ZürichVor dem Hintergrund des Gesagten:
Braucht es denn evidenzbasierte digitale
Pillen aus Ihrer Sicht jetzt?
Den Umfrage-Link finden
Sie im Zoom-Chat oder hier:Are mobile apps for mental health effective? “Effect sizes for single trials ranged from g = −0.05 to 0.14 for PTSD and g = 0.72 to 0.84 for insomnia. Although some trials showed potential of apps targeting mental health symptoms, using smartphone apps as standalone psychological interventions cannot be recommended based on the current level of evidence.” https://doi.org/10.1038/s41746-019-0188-8 Folie 55 | App auf Rezept: Was sind digitale Pillen und braucht es sie in der Psychotherapie? © Universität St.Gallen und & ETH Zürich
How about extremely popular mental health apps?
Teepe et al. (manuscript in preparation)
…
Folie 56 | App auf Rezept: Was sind digitale Pillen und braucht es sie in der Psychotherapie? © Universität St.Gallen und & ETH ZürichHow about extremely popular mental health apps?
Teepe et al. (manuscript in preparation)
!
Teepe et al (manuscript in preparation)
Folie 57 | App auf Rezept: Was sind digitale Pillen und braucht es sie in der Psychotherapie? © Universität St.Gallen und & ETH ZürichTry it out: BLV MySwissFoodPyramid & Sanitas Coach Folie 58 | App auf Rezept: Was sind digitale Pillen und braucht es sie in der Psychotherapie? © Universität St.Gallen und & ETH Zürich
Braucht es denn evidenzbasierte
digitale Pillen in der Psychotherapie?
Den Umfrage-Link finden
Sie im Zoom-Chat oder hier:Wo könnten digitale Pillen in der
Psychotherapie am sinnvollsten
eingesetzt werden?
Den Umfrage-Link finden
Sie im Zoom-Chat oder hier:Haben Sie weitere Ideen, wie evidenzbasierte digitale
Pillen am sinnvollsten in der Psychotherapie eingesetzt
werden könnten? Dann schreiben Sie diese bitte jetzt
gerne in einem kurzen Satz auf.
Den Umfrage-Link finden
Sie im Zoom-Chat oder hier:Die Teilnehmer haben geantwortet…
1. Um z.B. bei Essstoerungen Ausloeser zu identifizieren
2. manualisierte Therapien für Patienten, die aus sprachlichen Gründen keine Psychotherapie im
Wohnort machen können
3. Psychoedukative Informationen
4. Erreichen von Patienten in Regionen mit Versorgungsproblemen (z.B. auf dem Land)
5. präventive Apps für Schüler, wo Mental Gesundheit & Quality of Life erfasst und gleichzeitig Hilfen
aktiviert werden ....
Dies v.a. weil ein nicht unbeträchtlicher Teil der Schüler (v.a. mit interner Symptomatik) schlicht
nicht wahrgenommen wird, wenn er/sie Probleme im Bereich von Mental Health hat ...
... evtl. dann mit Aktivierung auch von Schul-gebundenen Personal ....
... oder auch Apps, die Familien in Kommunikation über das Thema bringt .... wären toll
6. Sinnvoll wäre eine Evaluation der digitalen Affinität von Patienten vor einer "digitalen Pille"
7. Alkohol Intoxikation überwachen, Warnung bei gesteigerte Affektivität ==> Gewaltschutz
8. Blended approach in Ergänzung zu regulärer Psychotherapie um die zeitliche Interaktion und
durchgeführte konkrete Übungen für den Patienten zu erhöhen - am besten mit natürlichem
Chatbot.
9. Konsumtagegebuch, Symptomtagebuch, Erinnerungsfunktionen für Interventionen (z.B.
Medikamenteneinnahme), Psychoedukation to-go
10. Suizidalität
11. Social Networking
12. Bessere Ästhetik.
13. Physiotherapeutische Motivation bei Depression
14. Vernetzung mit anderen BetroffenenPsychiatry in the Digital Age Aref-Adib, G., McCloud, T., Ross, J., O'Hanlon, P., Appleton, V., Rowe, S., . . . Lobban, F. (2019). Factors affecting implementation of digital health interventions for people with psychosis or bipolar disorder, and their family and friends: a systematic review. The Lancet Psychiatry, 6(3), 257-266. doi:10.1016/S2215-0366(18)30302-X Graham, A. K., Lattie, E. G., & Mohr, D. C. (2019). Experimental Therapeutics for Digital Mental Health. JAMA Psychiatry, 76(12), 1223–1224. doi:10.1001/jamapsychiatry.2019.2075 Grover, S., Nguyen, J. A., Viswanathan, V., & Reinhart, R. M. G. (2021). High-frequency neuromodulation improves obsessive–compulsive behavior. Nature Medicine, 27(2), 232-238. doi:10.1038/s41591-020-01173-w Hariman, K., Ventriglio, A., & Bhugra, D. (2019). The Future of Digital Psychiatry. Curr Psychiatry Rep, 21(9), 88. doi:10.1007/s11920-019-1074-4 Marshall, J. M., Dunstan, D. A., & Bartik, W. (2020). Smartphone psychology: New approaches towards safe and efficacious mobile mental health apps. Professional Psychology: Research and Practice, 51(3), 214-222. doi:10.1037/pro0000278 Wasil, A. R., Venturo-Conerly, K. E., Shingleton, R. M., & Weisz, J. R. (2019). A review of popular smartphone apps for depression and anxiety: Assessing the inclusion of evidence-based content. Behav Res Ther, 123, 103498. doi:10.1016/j.brat.2019.103498 Wasil, A. R., Gillespie, S., Patel, R., Petre, A., Venturo-Conerly, K. E., Shingleton, R. M., . . . DeRubeis, R. J. (2020). Reassessing evidence-based content in popular smartphone apps for depression and anxiety: Developing and applying user-adjusted analyses. J Consult Clin Psychol, 88(11), 983-993. doi:10.1037/ccp0000604 Weisel, K. K., Fuhrmann, L. M., Berking, M., Baumeister, H., Cuijpers, P., & Ebert, D. D. (2019). Standalone smartphone apps for mental health—a systematic review and meta-analysis. npj Digital Medicine, 2(1), 118. doi:10.1038/s41746- 019-0188-8 Wilhelm, S., Weingarden, H., Ladis, I., Braddick, V., Shin, J., & Jacobson, N. C. (2020). Cognitive-Behavioral Therapy in the Digital Age: Presidential Address. Behavior Therapy, 51(1), 1-14. doi:https://doi.org/10.1016/j.beth.2019.08.001 Wright, J. H., Mishkind, M., Eells, T. D., & Chan, S. R. (2019). Computer-Assisted Cognitive-Behavior Therapy and Mobile Apps for Depression and Anxiety. Curr Psychiatry Rep, 21(7), 62. doi:10.1007/s11920-019-1031-2 Folie 63 | App auf Rezept: Was sind digitale Pillen und braucht es sie in der Psychotherapie? © Universität St.Gallen und & ETH Zürich
Prof. Dr. Tobias Kowatsch Assistant Professor for Digital Health, University of St.Gallen, Switzerland Scientific Director, Centre for Digital Health Interventions, ETH Zurich & University of St.Gallen, Switzerland Lead Principal Investigator, Mobile Health Interventions, Singapore-ETH Centre, Singapore Partner, Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, USA Member, Competence Centre for Rehabilitation Engineering and Science, ETH Zurich, Switzerland www.c4dhi.org | www.mobile-coach.eu | tobias.Kowatsch@unisg.ch Folie 64 | App auf Rezept: Was sind digitale Pillen und braucht es sie in der Psychotherapie? © Universität St.Gallen und & ETH Zürich
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Folie 65 | App auf Rezept: Was sind digitale Pillen und braucht es sie in der Psychotherapie? © Universität St.Gallen und & ETH ZürichAdditional Glossary (Sim 2019, p. 957) Decentralized clinical trials: Trials executed through telemedicine, mobile health, or local health care providers, with the use of procedures such as virtual recruitment, investigational products shipped directly to participants, or smartphone-based outcomes assessment. Digital biomarkers: Physiological and behavioral measures collected by means of digital devices such as portables, wearables, implantables, or digestibles that characterize, influence, or predict health-related outcomes. Digital diagnostics: The application of wearable and ambient sensors, mobile apps, social media, and location-tracking technology singly or in combination to diagnose medical conditions. Digital patient experience: The sum of online interactions that a patient has with a health care organization on web- sites, mobile devices, or wearables across all touchpoints and phases of care. Digital therapeutics: Interventions that use wearable and ambient sensors, mobile apps, social media, and location- tracking technology independently or in conjunction with medications, devices, or other therapies to improve patient care and health outcomes. Ecologic momentary assessment: An approach that involves repeated sampling of persons’ current behaviors and experiences in real time, in these persons’ natural environments. Food and Drug Administration (FDA) approval: FDA approval is given to class III medical devices that pass a premarket approval process to “demonstrate that the device is safe and effective when used.” Class III medical devices are ones that pose the highest risk. They “sustain or support life, are implanted, or present potential high risk of illness or injury.” FDA clearance: Class I or II medical devices pose minimal or moderate risk of harm. Unlike class III devices, they are not required to undergo premarket approval. FDA clearance can be obtained through the premarket notification, or 510(k), process to “demonstrate that the device is substantially equivalent to a device already placed into one of the three device classifications before it is marketed.” Internet of Things: The network of everyday physical objects that are embedded with sensors and software that are inter- connected and can exchange data through the Internet. Medical device: According to the Food, Drug, and Cosmetic Act, a medical device is “an instrument ... or other similar or related article [that is] intended for use in the diagnosis of disease or other conditions, or in the cure, mitigation, treatment, or prevention of disease ... and which does not achieve any of its primary intended purposes through chemical action within or on the body ... and which is not dependent upon being metabolized for the achievement of any of its primary intended purposes.” Metadata: Data that describe and give information about other data — for example, the author of a document, the size of an image, or the device that generated a reading. Mobile health: The application of wearable and ambient sensors, mobile apps, social media, and location-tracking technology singly or in combination to obtain data pertinent to wellness and disease diagnosis, prevention, and management. Patient-generated health data: Health-related data that are created, recorded, or gathered by or from patients. Patient-reported outcome: A report of the status of a patient’s health condition that comes directly from the patient. Software as a medical device: Software that is intended to be used for medical purposes and that performs these purposes without being part of a hardware medical device. Folie 66 | App auf Rezept: Was sind digitale Pillen und braucht es sie in der Psychotherapie? © Universität St.Gallen und & ETH Zürich
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