Reducing the rate of psychiatric re-admissions in bipolar disorder using smartphones - The RADMIS trial

Maria Faurholt-Jepsen*, Morten Lindbjerg Tønning, Mads Fros, Klaus Martiny, Nanna Tuxen, Nicole Rosenberg, Jonas Busk, Ole Winther, Daniel Thaysen-Petersen, Kate Andreasson Aamund, Lizzie Tolderlund, Jakob Eyvind Bardram, Lars Vedel Kessing

*Corresponding author for this work

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Abstract

Objectives: The MONARCA I and II trials were negative but suggested that smartphone-based monitoring may increase quality of life and reduce perceived stress in bipolar disorder (BD). The present trial was the first to investigate the effect of smartphone-based monitoring on the rate and duration of readmissions in BD. Methods: This was a randomized controlled single-blind parallel-group trial. Patients with BD (ICD-10) discharged from hospitalization in the Mental Health Services, Capital Region of Denmark were randomized 1:1 to daily smartphone-based monitoring including a feedback loop (+ standard treatment) or to standard treatment for 6 months. Primary outcomes: the rate and duration of psychiatric readmissions. Results: We included 98 patients with BD. In ITT analyses, there was no statistically significant difference in rates (hazard rate: 1.05, 95% CI: 0.54; 1.91, p = 0.88) or duration of readmission between the two groups (B: 3.67, 95% CI: −4.77; 12.11, p = 0.39). There was no difference in scores on the Hamilton Depression Rating Scale (B = −0.11, 95% CI: −2.50; 2.29, p = 0.93). The intervention group had higher scores on the Young Mania Rating Scale (B: 1.89, 95% CI: 0.0078; 3.78, p = 0.050). The intervention group reported lower levels of perceived stress (B: -7.18, 95% CI: −13.50; −0.86, p = 0.026) and lower levels of rumination (B: −6.09, 95% CI: −11.19; −1.00, p = 0.019). Conclusions: Smartphone-based monitoring did not reduce rate and duration of readmissions. There was no difference in levels of depressive symptoms. The intervention group had higher levels of manic symptoms, but lower perceived stress and rumination compared with the control group.

Original languageEnglish
JournalActa Psychiatrica Scandinavica
Volume143
Issue number5
Pages (from-to)453-465
Number of pages13
ISSN0001-690X
DOIs
Publication statusPublished - 2021

Keywords

  • bipolar disorder
  • RADMIS
  • randomized controlled trial
  • readmission
  • smartphone
  • the Monsenso system

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