A Self-monitoring App for Those Recovering from an ED

Patient reactions were mixed in one Danish study.

By 2017, more than 325,000 health-related apps were available to mobile phone users worldwide. Apps available for eating disorders patients might help normalize eating patterns and weight, especially in early treatment phases, and for those who are resistant to filling in traditional pen and paper diaries. The apps also fit in with blended treatment, where using digital tools and traditional face-to-face treatment combine to save costs and increase geographical outreach.

Recently a Danish team reported the results of their study of Recovery Record (RR), a self-monitoring app for ED management. RR issues log questions on the user’s meals, behavior, feelings and thoughts. Clinicians use the clinician interface of the app. RR includes “nudging” features, such as meal reminders and affirmations after a meal log, encouraging users to monitor themselves and to eat regularly. The app also includes personalized goals and coping strategies in an in-app meal photos. In another feature, the app includes game-like principles in a non-game setting.

In what the authors believe is the first in-depth study of patients using an eating disorders treatment app, Pil Lindgreen, MSc and colleagues at Aarhus University Hospital, Risskov, Denmark, recruited 41 participants from a specialty  eating disorders treatment center at Aarhus University Hospital (JMIR Mhealth. 2018; 6(6): e10253). This facility treats patients with moderate-to-severe EDs in outpatient and inpatient departments. The researchers used individual interviews, 1 focus group meeting and one face-to-face interview (83 minutes). Each individual was shown a screen shot of each RR feature, and asked to comment on the relevance of the feature to their treatment. Most Interviews were conducted at the study center; 11 patients preferred being interviewed at home.

While overall the patients were positive about using the app, and found it supportive in their everyday life and their eating disorders treatment, some found parts of the app program obstructive and counterproductive.  The message, according to the authors, was for patients and clinicians to collaborate and determine how the individual app best fit the preference and treatment needs of individual patients.

The authors stressed the need for thorough and clear guidelines on the use of such apps in ED treatment. Also, much more research is needed to better design the content and design of such apps, and the authors suggest patients and clinicians explicitly discuss how to apply a specific app in treatment and to the patient’s everyday life.

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