Using mHealth to Optimize Pharmacotherapy Regimens
Condition: Schizophrenia; First-Episode Psychosis
MeSH terms: Schizophrenia
Study type: Interventional

Summary: 
      This project will use a smartphone technology to improve medication prescribing for
      individuals with FEP. We will collect real-time symptom and functioning data via smartphones
      to provide prescribers and other clinical team members with clinically relevant and
      time-sensitive information that will inform and promote shared decision making (SDM) and
      personalized interventions. The result will be a time-sensitive, data-driven, collaborative
      process to optimize medication regimens in order to maximize benefits, minimize harms, and
      promote adherence.
    

Detailed description: 
      Comprehensive early treatment of individuals experiencing schizophrenia has the potential to
      alter the course of illness and improve long-term outcomes. Psychotropic medications are a
      critical component of early treatment strategies. First-episode psychosis (FEP) is a critical
      time to optimize prescribing but evidence suggests that prescribing for this population is
      suboptimal.

      A contributing factor to these difficulties is thought to be the lack of accurate information
      about the effects of medications on symptoms, their side effects, as well as their
      behavioral, cognitive, and emotional correlates. At medication management appointments,
      prescribers typically rely on patients' recollection of how they were doing over periods of
      weeks. Such retrospective assessments are problematic as they are vulnerable to the influence
      of memory difficulties, cognitive biases including recency effects and frequency illusions,
      and reframing. Recent advances in smartphone technologies (mobile Health; mHealth) may help
      to overcome many of the limitations of retrospective assessments.

      This pilot study will be a collaboration with OnTrackNY, an innovative coordinated specialty
      care (CSC) program for individuals aged 16-30 who are experiencing FEP. OnTrackNY originated
      as part of the NIMH Recovery After an Initial Schizophrenia Episode (RAISE) Implementation
      and Evaluatoin Study. The initial phase of this project will use input from stakeholders
      including patients, front-line providers, clinical leaders, and members of the research team
      to adapt and refine the mHealth intervention to improve feasibility and clinical utility. A
      pilot study at 3 OnTrackNY sites will then examine its feasibility and effectiveness by
      comparing the management and outcomes of 60 patients randomly assigned to the mHealth
      application or usual care.
    

Intervention name(s): mHealth Intervention
Intervention type(s): Other
Intervention description(s): Participants will download the app onto their smartphone and complete ecological momentary assessements
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Prospective cohort with comparison group
Masking: Single (Outcomes Assessor)
Primary purpose: Other
Keywords: mHealth; Schizophrenia; EMA