Adhärenz zu E-Tagebuch-Abfragen im Rahmen einer 6-monatigen Studie mit Ecological Momentary Assessment bei Teilnehmern mit Schizophrenie, depressiver Störung und gesunden Kontrollen

ZUSAMMENFASSUNG

Menschen mit schweren psychiatrischen Erkrankungen (SMI), wie Schizophrenie und schweren Depressionen, haben oft Schwierigkeiten, Zugang zu adäquater Gesundheitsversorgung zu erhalten. Negative Symptome wie Antriebslosigkeit und sozialer Rückzug stellen dabei besondere Herausforderungen dar. Digitale Tools, insbesondere das Ecological Momentary Assessment (EMA), ermöglichen es, durch Smartphone-basierte elektronische Tagebücher (E-Tagebücher) Echtzeitdaten im Alltag der Patienten zu erfassen. In einer prospektiven Studie (INDICATE-N) wurde die Adhärenz zu einem mit täglichen Abfragen E-Tagebuch-Protokoll über 6 Monate bei Patienten mit Schizophrenie (SZ), depressiven Störungen (MDD) und gesunden Kontrollpersonen (HC) untersucht. Es zeigte sich, dass die Adhärenz der Patienten bei etwa 72 % lag, während gesunde Kontrollen eine höhere Adhärenz von etwa 84 % aufwiesen. Interessanterweise war die Teilnahme an den Abfragen unabhängig von der Schwere der Krankheit (gemessen am Clinical Global Impression Scale, CGI), außer bei sehr schwer kranken Patienten, bei denen die Adhärenz etwas geringer war. Diese Ergebnisse zeigen, dass EMA eine praktikable Methode zur Erfassung von Symptomen im Alltag von Patienten mit SMI ist, wobei die kontinuierliche Betreuung und Motivation der Teilnehmer entscheidend für den Erfolg ist.

ABSTRACT

People with severe mental illness (SMI), such as schizophrenia and major depression, often face challenges in accessing adequate healthcare. Negative symptoms like lack of motivation and social withdrawal present specific challenges. Digital tools, particularly Ecological Momentary Assessment (EMA), enable the collection of real-time data from patients’ daily lives using smartphone-based electronic diaries (e-diaries). In a prospective study (INDICATE-N), adherence to a daily e-diary protocol over 6 months was evaluated in patients with schizophrenia (SZ), major depressive disorder (MDD), and healthy controls (HC). The study found that patient adherence was approximately 72 %, while healthy controls had a higher adherence rate of around 84 %. Interestingly, adherence was generally independent of illness severity (measured by the Clinical Global Impression Scale, CGI), except for very severely ill patients, whose adherence was somewhat lower. These findings demonstrate that EMA is a viable method for tracking symptoms in the daily lives of SMI patients, with continuous support and motivation being key to success.

Schlüsselwörter

Schwere psychische Erkrankungen (SMI) - Ecological Momentary Assessment (EMA) - Elektronische Tagebücher (E-Tagebücher) - Digital Mental Health, Schizophrenie

Key words

Severe mental illness (SMI) - ecological momentary assessment (EMA) - e-diaries - digital mental health - schizophrenia

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