A smartphone app is being developed to support patients to stay well and maintain their therapeutic gains following a course of psychological or talking therapy treatment for a common mental health disorder.
The digital application puts patients in control, storing all their treatment-related information in a single secure location that they can access easily and immediately when needed. Co-designed by patients and clinicians in the Oxford AHSN region, the app is called Paddle because it’s a tool to help people steer their way through life’s choppy waters.
The vast majority of patients do well during and after treatment. But one in three seek additional help in the six months after they are discharged.
Ineke Wolsey, Oxford AHSN Anxiety and Depression Network manager, said: “It can be difficult for patients to organise and store all of the information and knowledge they gained during therapy to help them stay well. The period immediately after treatment can be really challenging and going it alone can be scary. The Paddle app enables individually tailored support, empowering people to effectively manage their condition and reduce relapse rates. It brings benefits to the individual, clinicians and the wider health system.”
In the Thames Valley over 3,500 patients enter treatment for a common mental health disorder every month and all of them will be offered the app once piloting and evaluation are completed.
Paddle has been designed to help patients make the most of their therapy, and to continue to stay well afterwards by helping them to put knowledge gained during therapy to use after being discharged. Therapy for anxiety and/or depression helps patients to gain a better understanding of their difficulties. As part of this process, much of the information is recorded in written format, but this isn’t always stored systematically. Patients have said that trying to organise this information and keep it safe can be difficult – especially once treatment has ended (as papers are often lost or misplaced).
Paddle is therefore useful to patients as it allows them to:
- store and organise treatment notes and related information electronically and in one secure place (rather than having to keep lots of different pieces of paper together)
- have easy access to this information once therapy ends
Paddle has been designed to help patients keep information and learning from therapy sessions, work booklets and other related resources together in an organised fashion, enabling them to make the most of their treatment, and increasing the likelihood of referring to and using this information once treatment has ended.
Following a pilot with a small group of patients at the end of 2019, the Paddle app has been rolled out across Berkshire, Oxfordshire, Buckinghamshire and Milton Keynes. Phase 1 in 2020/21 involved rollout for people in the Oxford AHSN region who have started a course of psychological therapy (also known as NHS talking therapies or IAPT services).
This was followed in 2021/22 by a further pilot study looking at how long patients stay well following treatment. Both pilot studies were successful (based on patients using Paddle during treatment and in continuing to monitor their progress after treatment).
Feedback from the A&D network’s Patient Forum on the difficulties of maintaining therapeutic gains and staying well after discharge resulted in the network undertaking two patient surveys. Both showed that around 30% of patients looked for additional support in the first few months after treatment.
Phase 2 is focused on developing the next level of functionality within the app and electronic patient record systems, enabling patients to submit monthly clinical scores for six months after discharge in the same way that they did during treatment, keep tabs on their progress and reflect on what has gone well and what has been more challenging. This follow-up data can be used by patients to track their wellbeing and secure support to stay on track. It will also be used by the services to determine how long patients are maintaining their clinical gains following treatment and which patient groups may need more support prior to discharge to stay well.
The last patients to submit their clinical scores at the six-month point will do so in autumn 2022. It is hoped that this will provide good quality data around the longer term effectiveness of treatment and identify those patients who may benefit from brief additional support in a timely fashion post-discharge to prevent readmission.
Additional development work in 2022/23 will focus on gaining medical device approval to ensure it is fit for purpose for wider roll-out.