Abstract
The True Colours remote mood monitoring system was developed over a decade ago by researchers, psychiatrists, and software engineers at the University of Oxford to allow patients to report on a range of symptoms via text messages, Web interfaces, or mobile phone apps. The system has evolved to encompass a wide range of measures, including psychiatric symptoms, quality of life, and medication. Patients are prompted to provide data according to an agreed personal schedule: weekly, daily, or at specific times during the day. The system has been applied across a number of different populations, for the reporting of mood, anxiety, substance use, eating and personality disorders, psychosis, self-harm, and inflammatory bowel disease, and it has shown good compliance. Over the past decade, there have been over 36,000 registered True Colours patients and participants in the United Kingdom, with more than 20 deployments of the system supporting clinical service and research delivery. The system has been adopted for routine clinical care in mental health services, supporting more than 3000 adult patients in secondary care, and 27,263 adolescent patients are currently registered within Oxfordshire and Buckinghamshire. The system has also proven to be an invaluable scientific resource as a platform for research into mood instability and as an electronic outcome measure in randomized controlled trials. This paper aimed to report on the existing applications of the system, setting out lessons learned, and to discuss the implications for tailored symptom monitoring, as well as the barriers to implementation at a larger scale.
Highlights
The advancement of digital technology will gradually continue to shape how we measure, monitor, and manage health
A wide range of digital symptom monitoring tools exist, but there is a lack of evidence regarding their effectiveness in a health care context, in the area of mental health
Digital tools for patient-reported outcome measures (PROMs) are becoming standard practice in randomized controlled trials (RCTs) in many areas [1], and meta-analyses [2,3] have confirmed their equivalence with paper-based approaches
Summary
The advancement of digital technology will gradually continue to shape how we measure, monitor, and manage health. All services eventually implemented FWwTC, but the time at which they were trained to implement FWwTC was randomized to compare outcomes in treatment services before and after the introduction of FWwTC The aim of this phase of OXTEXT was to apply True Colours to other patient populations (including those experiencing depression, anxiety, psychosis, alcohol and drug use, and BD) and test the feasibility and cost-effectiveness of such a tool in a larger scale secondary care setting. As of January 10, 2019, almost 3000 patients with any psychiatric condition and more than 700 clinicians have registered with True Colours in adult community mental health treatment service clinics across Oxfordshire and Buckinghamshire The uniqueness of this application of remote monitoring of symptoms is in the individualized approach. This project aims to engage different services (primary and secondary care clinicians) in the collaborative treatment of patients through the sharing of True Colours symptom ratings
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