Clinitouch-360: A digital health platform enabling robust end-to-end care of patients in Primary Care with depression and anxiety

公共描述在英国，有1000万18岁以上的人(占成年人口的16.7%)患有抑郁症(每年因失去工作9100万天而损失700亿GB，外加医疗和社会护理费用)。800万人患有焦虑症。尽管这些疾病和共同的治疗方式(谈话治疗、药物治疗、自我支持)很普遍，但出现焦虑和抑郁的患者在护理方面可能会遇到严重问题：*由于初步评估不足而导致的错误诊断(在抑郁症或焦虑的初级保健中服用抗抑郁药物的患者中，未被识别的双相情感障碍的患病率为10%)。*在等待治疗开始的延误期间精神健康恶化(谈话治疗等待名单为3-5个月；2022年皇家精神病学学会的一份报告指出，43%的患者在等待开始治疗时病情下降)。*只有40%的患者在NICE指南中建议的时间范围内接受药物审查，导致患者服用无效药物或经历严重的副作用。*研究表明，30%-60%的长期抗抑郁药处方是不合适的。*56%的减少抗抑郁药的人出现停药症状。其中46%的患者称他们的症状严重，持续数周或数月。逐步和夸张地逐步停止服药可以缓解这种情况，但患者没有得到专家的支持。*临床医生在停用抗抑郁药或抗焦虑药时，经常遇到难以区分戒断症状和疾病复发的情况。对支持精确医学的数字工具的需求尚未得到满足，并改善了初级保健中这些患者的端到端管理，以实现更好的结果。解决方案：SPIRIT数字公司已将“Clinitouch”远程患者监控平台商业化。SPIRIT将创建一个新的模块(Clinitouch-360)，以更好地管理焦虑和抑郁患者从最初的演示。Clinitouch-360将自动执行NICE指导的耗时元素，防止最佳实践被遵循，并部署技术创新，在患者的治疗过程中支持他们。

Public descriptionIn the UK \\\>10 million people aged 18+ (16.7% of the adult population) have depression (costing £70 billion/year from 91 million days of lost work, plus health and social care costs) and \\\>8 million have an anxiety disorder.Despite the prevalence of these conditions and shared treatment modalities (talking therapy, medication, self-support) patients presenting with anxiety and depression can experience significant problems with their care:* Incorrect diagnosis due to insufficient initial assessment (the prevalence of unrecognised bipolar disorder is 10% amongst patients prescribed antidepressants in primary care for depression or anxiety).* Deteriorating mental health during delays waiting for treatment initiation (talking therapy waitlists are 3-5 months; a 2022 Royal College of Psychiatrists report stated 43% of patients experience decline whilst waiting to start treatment).* Only 40% of patients receive medication reviews within time frames recommended in NICE guidelines, resulting in patients taking ineffective medications, or experiencing serious side effects.* Studies indicate that 30--60% of long-term antidepressant prescriptions are inappropriate.* 56% of people reducing antidepressants experience withdrawal symptoms. 46% of these patients describe their symptoms as severe and lasting for weeks or months. Gradual and hyperbolic tapering to medication cessation can mitigate this, but patients do not receive specialist support for this.* Clinicians frequently experience difficultly differentiating withdrawal symptoms from disease re-emergence when withdrawing antidepressants or anxiolytics.There is an unmet need for a digital tool supporting precision medicine and improved end-to-end management of these patients in primary care to achieve better outcomes.Solution: Spirit Digital has commercialised the 'Clinitouch' remote patient monitoring platform. Spirit will create a new module (Clinitouch-360) to better manage patients with anxiety and depression from their initial presentation.Clinitouch-360 will automate time-consuming elements of NICE guidance that prevent best practice being followed and deploy technological innovations that support patients across their treatment pathway.