Predictors of adherence to electronic self-monitoring in patients with bipolar disorder: a contactless study using Growth Mixture Models.
Predictors of adherence to electronic self-monitoring in patients with bipolar disorder: a contactless study using Growth Mixture Models.
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DOI：
10.1186/s40345-023-00297-5
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发表时间：
2023-05-17
影响因子：
4
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中科院分区：
文献类型：
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几项研究报告了使用计算机或智能手机对精神障碍（包括双相情感障碍）患者进行电子（e-）监测的可行性。虽然电子监测研究已经考察了人口因素的作用，例如年龄、性别或社会经济地位以及健康应用程序的使用，但据我们所知，没有研究考察可能影响双相情感障碍患者电子监测依从性的临床特征。我们分析了参与正在进行的电子监测研究的双相情感障碍患者对电子监测的依从性，并评估了人口统计和临床因素是否可以预测依从性。包括 87 名处于疾病不同阶段的双相情感障碍参与者。对可穿戴设备的坚持模式、15 个月内每日和每周的自我评分量表进行了分析，以使用生长混合模型 (GMM) 确定坚持轨迹。拟合多项式逻辑回归模型来计算预测变量对 GMM 类别的影响。可穿戴设备的总体遵守率为 79.5%；每周自我评分为 78.5%；每日自我评分为 74.6%。 GMM 确定了三个潜在类别亚组： (i) 完美的参与者； (二) 良好； (iii) 依从性差。平均而言，34.4% 的参与者表现出“完美”的依从性； 37.1% 的人表现出“良好”的依从性； 28.2% 的人对所有三项措施的遵守情况较差。女性、有自杀未遂史的参与者以及有住院史的参与者更有可能属于完全依从性的群体。疾病负担较高（例如入院史、自杀未遂史）的参与者对电子监测的依从率较高。他们可能会将电子监测视为更好地记录症状变化和更好地管理疾病的工具，从而激励他们的参与。在线版本包含可在 10.1186/s40345-023-00297-5 获取的补充材料。
Several studies have reported on the feasibility of electronic (e-)monitoring using computers or smartphones in patients with mental disorders, including bipolar disorder (BD). While studies on e-monitoring have examined the role of demographic factors, such as age, gender, or socioeconomic status and use of health apps, to our knowledge, no study has examined clinical characteristics that might impact adherence with e-monitoring in patients with BD. We analyzed adherence to e-monitoring in patients with BD who participated in an ongoing e-monitoring study and evaluated whether demographic and clinical factors would predict adherence. Eighty-seven participants with BD in different phases of the illness were included. Patterns of adherence for wearable use, daily and weekly self-rating scales over 15 months were analyzed to identify adherence trajectories using growth mixture models (GMM). Multinomial logistic regression models were fitted to compute the effects of predictors on GMM classes. Overall adherence rates were 79.5% for the wearable; 78.5% for weekly self-ratings; and 74.6% for daily self-ratings. GMM identified three latent class subgroups: participants with (i) perfect; (ii) good; and (iii) poor adherence. On average, 34.4% of participants showed “perfect” adherence; 37.1% showed “good” adherence; and 28.2% showed poor adherence to all three measures. Women, participants with a history of suicide attempt, and those with a history of inpatient admission were more likely to belong to the group with perfect adherence. Participants with higher illness burden (e.g., history of admission to hospital, history of suicide attempts) have higher adherence rates to e-monitoring. They might see e-monitoring as a tool for better documenting symptom change and better managing their illness, thus motivating their engagement. The online version contains supplementary material available at 10.1186/s40345-023-00297-5.
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影响因子：
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作者：
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