在重度抑郁障碍管理中，移动应用程序增强患者激活和患者-提供者沟通:卡塔尔世界杯8强波胆分析合作，随机对照试点研究%A McCue,Maggie %A Blair,Christopher %A Fehnert,Ben %A King,James %A Cormack,Francesca %A Sarkey,Sara %A Eramo,Anna %A Kabir,Christopher %A Khatib,Rasha %A Kemp,David %+ Takeda Pharmaceuticals USA, Inc, 95 Hayden Ave, Lexington, USA, 02421, USA, 1 224 554 2820，Maggie.McCue@takeda.com %K抑郁症%K重度抑郁症%K抑郁症管理%K患者参与%K患者满意度%K手机应用%K患者报告结果%K手机%D 2022 %7 27.10.2022 %9原始论文%J JMIR Form Res %G英文%X背景:增强患者-提供者参与可以改善慢性疾病患者的健康结果，包括重度抑郁症(MDD)。目的:我们评估了数字化护理移动应用程序Pathway的影响，该应用程序旨在提高MDD患者-提供者的参与。患者使用移动界面来评估治疗进展，并与初级保健提供者(pcp)共享这一信息。方法:在这项在初级保健诊所进行的为期52周的现实世界有效性和可行性研究中，40名最近被开出抗抑郁药物单一疗法的MDD患者被随机分为两组:使用手机应用程序配合常规护理(20/ 40,50%)或单独使用常规护理(20/ 40,50%)。应用程序组的患者每天使用该应用程序，持续了18周;每隔6周生成一份报告，并与pcp共享，以促进共享治疗决策讨论。患者在第18周停用该应用程序，并随访至第1年。通过研究访问评估的综合预后指标，包括在第18周时13项患者激活量表(PAM-13)和7项患者-提供者参与量表评分与基线相比的变化。 Additional outcome measures included depression severity (9-item Patient Health Questionnaire [PHQ-9]) and cognitive symptoms (5-item Perceived Deficits Questionnaire–Depression). Results: All 37 patients (app arm: n=18, 49%; usual care arm: n=19, 51%) who completed the 18-week follow-up period (n=31, 84% female, mean age 36, SD 11.3 years) had moderate to moderately severe depression. Improvements in PAM-13 and PHQ-9 scores were observed in both arms. Increases in PAM-13 scores from baseline to 18 weeks were numerically greater in the app arm than in the usual care arm (mean 10.5, SD 13.2 vs mean 8.8, SD 9.4; P=.65). At 52 weeks, differences in PAM-13 scores from baseline demonstrated significantly greater improvements in the app arm than in the usual care arm (mean 20.2, SD 17.7 vs mean 1.6, SD 14.2; P=.04). Compared with baseline, PHQ-9 scores decreased in both the app arm and the usual care arm at 18 weeks (mean 7.8, SD 7.2 vs mean 7.0, SD 6.5; P=.73) and 52 weeks (mean 9.5, SD 4.0 vs mean 4.7, SD 6.0; P=.07). Improvements in 7-item Patient-Provider Engagement Scale and WHO-5 scores were observed in both arms at 18 weeks and were sustained through 52 weeks in the app arm. Improvements in WHO-5 scores at 52 weeks were significantly greater in the app arm than in the usual care arm (41.5 vs 20.0; P=.02). Conclusions: Patients with MDD will engage with a mobile app designed to track treatment and disease progression. PCPs will use the data generated as part of their assessment to inform clinical care. The study results suggest that an app-enabled clinical care pathway may enhance patient activation and benefit MDD management. Trial Registration: ClinicalTrials.gov NCT03242213; https://clinicaltrials.gov/ct2/show/NCT03242213 %M 36301599 %R 10.2196/34923 %U https://formative.www.mybigtv.com/2022/10/e34923 %U https://doi.org/10.2196/34923 %U http://www.ncbi.nlm.nih.gov/pubmed/36301599