Iltifat Husain MD reviewed and contributed to this article
Research has demonstrated that cognitive behavioral therapy (CBT) is an effective way to treat patients with binge eating disorder (BED), but too few therapists are trained in both CBT and BED, leaving many patients with no place to turn. One option is clinician-guided self-help CBT. A recent feasible study suggests that a mobile application that uses this approach by connecting therapists with BED patients may help them get control of their disorder.
Adrienne Juarascio of Drexel University and her colleagues came up with a concept for a mobile app that would include self-help information and that would monitor patients’ behavior, as well as have the capacity to allow clinicians to offer “in-the-moment interventions,” i.e., talk therapy provided during a stressful moment that might tempt patients to overeat. They then showed the app to 10 BED specialists and 11 individuals with the disorder. As Juarascio and her associates explain it in their paper in the International Journal of Medical Informatics, “participants were asked to discuss customization, user burden, terminology, attrition, data visualization, comprehensiveness, reminders, feasibility, acceptability, and perceived effectiveness of the proposed app.”
The app was well received by both clinicians and the potential patients, though they did have some reservations. The practitioners were eager to use the tool in their practices and many asked how much it would cost and when it would be available. Patients and clinicians both said the app had the strong potential to help reduce binge eating. Clinicians in particular concluded that “components of the proposed app would enhance treatment delivery and effectiveness, specifically in the areas of compliance with self-monitoring, CBT-based self-help, and utilization of coping strategies.”
Among the reservations expressed during the feasibility study was a concern about data privacy and security, with some participants suggesting that the program offer the option of not sharing the information gathered in the app with clinicians. Clinicians and users also recommended that the proposed app include built-in reminders and alerts, including a reminder to record data.
Juarascio AS, Goldstein SP, et al. Perceptions of the feasibility and acceptability of a smartphone application for the treatment of binge eating disorders: Qualitative feedback from a user population and clinicians. Int. J Med Inform. 2015; in press.