出版社：Utrecht University, Maastricht University, Groningen University
摘要：PURPOSE: The purpose of this study is to design a functional platform for on line psych-education to treat of bipolar disorder. The platform should be user-friendly and should contain different modules providing advanced communication channels and interaction tools to treat, monitor and support patients and their families. CONTEXT: Bipolar disorder causes changes in the patients´ mood that goes from deep depression to more uncontrolled euphoria without external events that justify these variations. It has a fairly early age of onset, with the first episode usually occurring before the age of 301. Treatment of bipolar disorder is based not only in drug therapy but also in educational programs such as psycho-education programs, which aim to provide information to patients and their families about the disease and the importance of avoiding negative habits2. On line psycho-education is becoming more common due to technological advances3. This method offers advantages compared to the usual treatment based on face to face consultations: it facilitates access to psycho-education (avoids displacement of patients and offers the possibility for the patients to choose the best time to do the activity), and the anonymity is guaranteed, which is an important issue in mental disorders. METHOD: We have designed a functional platform for on line psycho-education within the Fi-Star European project. Following the result of a literature review and after multidisciplinary discussions with clinicians and IT professionals, the application was developed including the following modules: psych-education, psych-therapy, health state monitoring, and treatment adherence. The solution has been developed to allow secure multi-channel interaction between patients and health care professionals, to ensure secure information exchange and to provide integration features with existing infrastructures through standards. RESULTS AND DISCUSSION: The technical solution has been evaluated in a clinical trial with 13 patients using the platform. The clinical trial was performed from September to January and we are now gathering all the information from patients and professionals. The on line platform offers patients and their families a new way to learn about how to manage the disease and how to identify symptoms, risk situations or unstable clinical conditions. It also provides health professionals with means to register, share, and access relevant quantitative and qualitative status information, treatment adherence, and potentially unwanted side effects and finally it gives relevant feedback for psychotherapy (i.e. information to the patient about the evolution of his/her disease, motivational messages, and comments from his/her therapist). From a clinical point of view, we have piloted a model of non-face to face service, based on the combination of traditional consultations, self-training and on line monitoring of information send by the patient. This new model is expected to result in benefits such as cost savings, efficiency of resources and improvement of the quality of care. If the final results confirm our expectations, we intend to continue to experience the model with a greater number of patients in order to achieve stronger evidence on the validity of on line psych-education and psycho-therapy. From a technological perspective, we have obtained the first version of an on line care platform for patients with mental illness, which can be useful in other diseases. REFERENCE Bipolar Disorder: The Management of Bipolar Disorder in Adults, Children and Adolescents, in Primary and Secondary Care.NICE Clinical Guidelines, No. 38. 2006. Bipolar Disorder: The Management of Bipolar Disorder in Adults, Children and Adolescents, in Primary and Secondary Care. National Collaborating Centre for Mental Health (UK). Hidalgo-Mazzei D, Mateu A, Reinares M, Murru A, Del Mar Bonnín C, Varo C, Valentí M, Undurraga J, Strejilevich S, Sánchez-Moreno J, Vieta E, Colom F. Psychoeducation in bipolar disorder with a SIMPLe smartphone application: Feasibility, acceptability and satisfaction. J Affect Disord. 2016 Aug;200:58-66.
