Approximately 5 million people in the European Union suffer from psychotic disorders. The largest group among them is that of schizophrenic patients, of which between 30-50% can be considered resistant to treatment. Standard intervention in patients with treatment resistant schizophrenia (TRS) is complex: i.e. presence of persistent positive symptomatology, extensive periods of hospital care, and greater risk of multi-morbidity. Up to date, standard treatment has not proven to be sufficient to achieve remission in resistant schizophrenic patients. Therefore, an improved understanding of TRS and the development of innovative evidence-based interventions adjunctive to pharmacological and psychosocial treatment are necessary.
The main objective of m-RESIST has been to develop an innovative disease management solution based on a mobile ICT system and an intervention program addressed to: i) integrate psychiatric and psychological assistance with other medical health-carers; ii) better monitors patients with resistant schizophrenia through a personalized and optimized therapeutic process; iii) promote acceptance and self-management of the disease and its co-morbidities; and iv) encourage the involvement of patients and their caregivers in the therapeutic process.
During the project, requirements have been collected from patients, caregivers and professionals in Spain, Israel and Hungary. Design, development and testing has been performed to reach a final version of the m-RESIST system, which provides a new therapeutic process for TRS supported by a set of tools addressed to patients, caregivers and health professionals, which rely on a mobile app connected to a smartphone for patients, a web dashboard for clinicians, and one back-end system for management of data. This solution considers specific mHealth intervention modules specially designed for patients with TRS, divided in “basal modules” (Treatment Adherence, Healthy Lifestyle, and Symptom Management-CBTp) and “risk modules” (Symptom Management-Risk).
The conclusion of the m-RESIST project shows that new therapeutic interventions based on the use of mobile technologies have clearly a positive impact in the improvement of self-management of treatment-resistant schizophrenia, and the engagement of patients, caregivers and professionals. Acceptability and usefulness of the interventions and tools developed has been confirmed by the overall good results of piloting activities and the engagement of users. Furthermore, some areas of improvement have been identified, mainly related to the use of technology (smartwatches), the consistency of large dataset for further research, and the need for more rewarding feedback from the system to patients.
