Developing mHealth Remote Monitoring Technology for Attention Deficit Hyperactivity Disorder: A Qualitative Study Eliciting User Priorities and Needs.

Lucy Simons,David Daley,Caroline J Falconer,Althea Z Valentine,Chris Hollis,Michael P Craven,Madeleine Groom,Charlotte Hall,Zoe Young

doi:10.2196/mhealth.5009

Abstract

BackgroundGuidelines in the United Kingdom recommend that medication titration for attention deficit hyperactivity disorder (ADHD) should be completed within 4-6 weeks and include regular reviews. However, most clinicians think that weekly clinic contact is infeasible, and audits have shown that this timeline is rarely achieved. Thus, a more effective monitoring and review system is needed; remote monitoring technology (RMT) may be one way to improve current practice. However, little is known about whether patients with ADHD, their families, and clinicians would be interested in using RMT.ObjectiveTo explore patients’, parents’, and health care professionals’ views and attitudes toward using digital technology for remote monitoring during titration for ADHD.MethodsThis was a qualitative study, and data were collected through 11 focus groups with adults and young people with ADHD, parents of children with ADHD, and health care professionals (N=59).ResultsAll participant groups were positive about using RMT in the treatment of ADHD, but they were also aware of barriers to its use, especially around access to technology and integrating RMT into clinical care. They identified that RMT had the most potential for use in the ongoing management and support of ADHD, rather than during the distinct titration period. Participants identified features of RMT that could improve the quality of consultations and support greater self-management.ConclusionsRMT has the potential to augment support and care for ADHD, but it needs to go beyond the titration period and offer more to patients and families than monitoring through outcome measures. Developing and evaluating an mHealth app that incorporates the key features identified by end users is required.

Highlights

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental syndrome characterized by 3 core behaviors—inattention, hyperactivity, and impulsivity—and affects approximately 5% of school-aged children [1]
There was a wide spread of ages, apart from young people with ADHD (YP), who were all aged 12 or 13 years
While few currently used these devices in relation to attention deficit hyperactivity disorder (ADHD), we found widespread support for augmenting ADHD treatment and support with remote monitoring technology (RMT), eHealth, and mHealth apps

Summary

Introduction

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental syndrome characterized by 3 core behaviors—inattention, hyperactivity, and impulsivity—and affects approximately 5% of school-aged children [1]. Certain features of digital technologies target specific deficiencies for people with ADHD, such as automated reminders and task scheduling to support organizational skills and immediate access to avoid delay and waiting. They offer the potential to increase access to resource-intensive, and scarce, psychosocial interventions. Results: All participant groups were positive about using RMT in the treatment of ADHD, but they were aware of barriers to its use, especially around access to technology and integrating RMT into clinical care They identified that RMT had the most potential for use in the ongoing management and support of ADHD, rather than during the distinct titration period. Developing and evaluating an mHealth app that incorporates the key features identified by end users is required

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Discussion

Conclusion