The most recent annual meeting for American Psychiatric Association (APA) — a physician-driven organization that provides medical leadership for mind, body, and brain — provided greater insight into recent advances in apps, wearables, and digital health devices.
MedCity News even proclaimed, “Psychiatry is starting to embrace wearables,” highlighting an APA TV video by Arshya Vahabzadeh, MD, APA’s Chairman on the Council of Communications.
But recent research has called into question the helpfulness of such apps. Could wellness and mental health apps, in fact, be harmful?
— Steven Chan, MD MBA (@StevenChanMD) May 18, 2015
John Torous, MD, a researcher and psychiatry resident at Harvard University, Beth Israel Deaconness Medical Center, Brigham and Women’s/Faulkner Hospitals, and the Massachusetts Mental Health Center, presented findings that highlighted how some apps could impact mental health in a detrimental way. “We have little evidence about the risks or benefits of smartphone use in clinical care,” said Torous.
Torous highlighted two such studies that underscore the risks. In a study funded by the Hutchinson Cancer Research Center and the National Institutes of Health (NIH), Heffner and colleagues write in the American Journal of Drug and Alcohol Abuse that “tracking smoking predicted a lower likelihood of quitting at 60-day follow-up,” although they note that this may have been confounded by requiring smokers to actively log in each smoking event. This has implications, as many apps that claim to work for “nicotine cessation” require users to log in smoking attempts. “There is now a substantial need for research to determine how…mobile technology can provide effective treatment,” write the authors, “to the sizable population of smokers who are now turning to their smartphones for assistance with cessation — i.e. 780,000 per month.”
In another study by Karolinska Institutet in Stockholm, Sweden, researchers found that a smartphone that purported to intelligently calculate a user’s blood alcohol level (BAC) to encourage reduction of alcohol intake actually had the reverse effect as intended. “The apps studied using eBAC calculation did not…seem to affect alcohol consumption among university students,” stated Mikael Gajecki and colleagues, “and one app may have led to a negative effect among men.”
— Dr. Simon A. Rego (@psyd) May 20, 2015
In a separate panel on smartphone apps, Simon Rego, PsyD, Director of Psychology Training and the CBT Training Program at New York-based Montefiore Medical Center and the Albert Einstein College of Medicine, was cautiously optimistic about smartphone apps, highlighting numerous apps that could be used for behavioral therapy, substance use, and meditation.
“Several…issues — safety, privacy, and ethical — continue to loom over the app market that need to be addressed,” Rego stated.
Rego summarized findings in studies from Donker, Powell, and colleagues: “Technology is outpacing the research. Many apps are promoted by illegitimate sources with a lot of misleading information. Most available reviews of mHealth apps have largely focused on personal impressions, rather than evidence-based, unbiased assessments of clinical performance and ata security.”
Rego advises, “Practitioners will have to keep up with the technology. Practitioners will need to get more involved in developing and evaluating apps.” The American Psychiatric Association‘s next meeting, the Institute on Psychiatric Services, highlights community psychiatric services and health care delivery. Workshops and panels will feature talks on telemedicine best practices, electronic prescribing, apps, data security, patient safety, and behavioral data monitoring. The meeting will be held in New York City, October 8-11, 2015.
Check out iPrescribeApps — a platform that will enable physicians to prescribe evidence based apps to patients.