Yasser Khazaal 1,2. J'AI RENDEZ-VOUS AVEC MON APP

Transcription

1 J'AI RENDEZ-VOUS AVEC MON APP Yasser Khazaal 1,2 1.Département de Psychiatrie, Université de Genève 2. Département de Santé Mentale et Psychiatrie, Hôpitaux Universitaires de Genève

2 E-mental health: «mental health services and information delivered or enhanced through the Internet and related technologies» Christensen 2002;; World Health Organization and International Telecommunication Union 2012; Cotton 2013; Schultz 2013; E-Mental Health in Canada: Transforming the Mental Health System Using Technology. (2014). Ottawa, ON: Mental Health Commission of Canada

3 E-Mental Health in Canada: Transforming the Mental Health System Using Technology. (2014). Ottawa, ON: Mental Health Commission of Canada

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5 Trefflich et al.2015

6 e-health search is used by 80% of Internet consumers in high income countries Berger 2005; Pew 2006; Powell 2006; Khazaal 2008; Bell 2010; Burns 2010; Reavley 2011; Proudfoot 2010; Horgan 2010; Commonwealth Fund 2012; Eichenberg 2013;Van De Belt 2013

7 Smit 2010; Bergström; 2010; Gainsbury 2011; Cuijpers 2011; Richards 2012; Haug 2012; Andersson 2014; Healthcaredegrees.com

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9 Most studies have been done in populations with mild to moderate illnesses Often recruited from the Internet, or through advertisements in newspapers It is then unnclear whether online therapies could be helpfull for the patients treated in psychiatric facilities Low completion rates of online treatments (26-76%) Many conditions for which guided ICBT has not been compared to face-to-face treatment. Bennett et al. 2009; Griffiths et al., 2006; Richards et al 2012; Spinzy et a.2012; Lal et al. 2013; Andersson et al 2014

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12 Lynette East 2015;

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20 Arnhold 2014 Annual release figures for diabetes apps.

21 Martinez-Perez 2013

22 App smartphone

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33 Group Differences on Risky Drinking Days and by Month

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43 Brief DISCERN 16 Specificity: 0.95 Sensibility: 0.36 detection of good content quality websites (score > 14/20) 1. Does it describe how each treatment works? 2. Does the publication describe the benefits of each treatment? 3. Does it describe the risks of each treatment? 4. Does it describe how the treatment choices affect overall quality of life 5. Is it clear what sources of information were used to compile the publication (other than the author or producer)? 6. Is it clear when the information used or reported in the publication was produced?

44 Khazaal 2008 a,b,c,d,e Khazaal 2009 Morel 2008 Zermatten 2010 Klila 2014 Stuart 2014 Grohol 2014 DISCERN < 40 < 40 > 40 > 16 > 16 > 16 > 40 In spite of some divergent findings, there has been an improvement in information quality as reported in the last studies Khazaal 2008a, Khazaal 2008b, Khazaal 2008c, Khazaal 2008d, Morel 2008; Zermatten 2010; Athanasopoulou 2013; Grohol 2014; Stuart 2014

45 Interactivity: Audio or video support Electronic assessment and feedback Supporting bodies (forums..) Interactivity scores mean (SD) (0-6) Study 1.7 (1.2) Khazaal, (1.2) Morel, (1.5) Zermatten, (1.4) Klila, 2014 Negative association between content quality and interactivity

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47 Screening and brief intervention Personnalization Automated coach Social network: Tribu Ecological momentary intervention (EMI) based on cognitive and behavioral therapy treatments. Ryan 2000; Deci 2000; Donoghue 2014

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51 Launched: February 2013 Users characteristics N= years 41% Downloaded > times 700 active users last week Weekly cannabis use 33% Use the App at least once a day 70% Helpfull or very helpfull to reduce or stop cannabis use 80%

52 190 FREE COMMENT

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54 > 3000 Participants, 82% At risk Depression

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60 u 16-18% completion rates of the sessions u Median number of completed sessions 1-2

61 APAP Augmentation des effets de la Psychothérapie par Amorçage Préconscient Borgeat et al. 2016

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70 Juniorhockey.com; Can Stock Photo First hybrid model : stepped care approach General model: Electronic reproduction of what we already do offered as a first step

71 Juniorhockey.com; Can Stock Photo Second hybrid model : interactive model General model: Traditionnal treatments and e-mental health are interconnected

72 Juniorhockey.com; Can Stock Photo Third Hybrid model oriented towards the innovation of new treatments or on the fostering of existing ones Specific model: with focus on particular training or assessments