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      Developing mHealth Remote Monitoring Technology for Attention Deficit Hyperactivity Disorder: A Qualitative Study Eliciting User Priorities and Needs

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          Abstract

          Background

          Guidelines in the United Kingdom recommend that medication titration for attention deficit hyperactivity disorder (ADHD) should be completed within 4-6 weeks and include regular reviews. However, most clinicians think that weekly clinic contact is infeasible, and audits have shown that this timeline is rarely achieved. Thus, a more effective monitoring and review system is needed; remote monitoring technology (RMT) may be one way to improve current practice. However, little is known about whether patients with ADHD, their families, and clinicians would be interested in using RMT.

          Objective

          To explore patients’, parents’, and health care professionals’ views and attitudes toward using digital technology for remote monitoring during titration for ADHD.

          Methods

          This was a qualitative study, and data were collected through 11 focus groups with adults and young people with ADHD, parents of children with ADHD, and health care professionals (N=59).

          Results

          All participant groups were positive about using RMT in the treatment of ADHD, but they were also aware of barriers to its use, especially around access to technology and integrating RMT into clinical care. They identified that RMT had the most potential for use in the ongoing management and support of ADHD, rather than during the distinct titration period. Participants identified features of RMT that could improve the quality of consultations and support greater self-management.

          Conclusions

          RMT has the potential to augment support and care for ADHD, but it needs to go beyond the titration period and offer more to patients and families than monitoring through outcome measures. Developing and evaluating an mHealth app that incorporates the key features identified by end users is required.

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          Most cited references28

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          The Discovery of Grounded Theory

          <p>Most writing on sociological method has been concerned with how accurate facts can be obtained and how theory can thereby be more rigorously tested. In The Discovery of Grounded Theory, Barney Glaser and Anselm Strauss address the equally Important enterprise of how the discovery of theory from data--systematically obtained and analyzed in social research--can be furthered. The discovery of theory from data--grounded theory--is a major task confronting sociology, for such a theory fits empirical situations, and is understandable to sociologists and laymen alike. Most important, it provides relevant predictions, explanations, interpretations, and applications.</p><p>In Part I of the book, Generation Theory by Comparative Analysis, the authors present a strategy whereby sociologists can facilitate the discovery of grounded theory, both substantive and formal. This strategy involves the systematic choice and study of several comparison groups. In Part II, The Flexible Use of Data, the generation of theory from qualitative, especially documentary, and quantitative data Is considered. In Part III, Implications of Grounded Theory, Glaser and Strauss examine the credibility of grounded theory.</p><p>The Discovery of Grounded Theory is directed toward improving social scientists' capacity for generating theory that will be relevant to their research. While aimed primarily at sociologists, it will be useful to anyone Interested In studying social phenomena--political, educational, economic, industrial-- especially If their studies are based on qualitative data.</p></p>
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            mHealth for mental health: Integrating smartphone technology in behavioral healthcare.

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              Smartphone applications for pain management.

              Smartphone applications (or apps) are becoming increasingly popular. The lack of regulation or guidance for health-related apps means that the validity and reliability of their content is unknown. We have conducted a review of available apps relating to the generic condition of pain. The official application stores for five major smartphone platforms were searched: iPhone, Android, Blackberry, Nokia/Symbian and Windows Mobile. Apps were included if they reported a focus on pain education, management or relief, and were not solely aimed at health-care professionals (HCPs). A total of 111 apps met the inclusion criteria. The majority of apps reviewed claimed some information provision or electronic manual component. Diary tracking of pain variables was also a common feature. There was a low level of stated HCP involvement in app development and content. Despite an increasing number of apps being released, the frequency of HCP involvement is not increasing. Pain apps appear to be able to promise pain relief without any concern for the effectiveness of the product, or for possible adverse effects of product use. In a population often desperate for a solution to distressing and debilitating pain conditions, there is considerable risk of individuals being misled.
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                Author and article information

                Contributors
                Journal
                JMIR Mhealth Uhealth
                JMIR Mhealth Uhealth
                JMU
                JMIR mHealth and uHealth
                JMIR Publications Inc. (Toronto, Canada )
                2291-5222
                Jan-Mar 2016
                23 March 2016
                : 4
                : 1
                : e31
                Affiliations
                [1] 1NIHR MindTech Healthcare Technology Co-operative University of Nottingham NottinghamUnited Kingdom
                [2] 2Division of Psychiatry and Applied Psychology School of Medicine University of Nottingham NottinghamUnited Kingdom
                [3] 3NIHR Collaboration for Leadership and Applied Health Research and Care East Midlands University of Nottingham NottinghamUnited Kingdom
                Author notes
                Corresponding Author: Chris Hollis chris.hollis@ 123456nottingham.ac.uk
                Author information
                http://orcid.org/0000-0001-8333-3094
                http://orcid.org/0000-0003-2129-9278
                http://orcid.org/0000-0002-6707-5184
                http://orcid.org/0000-0002-5182-518X
                http://orcid.org/0000-0002-3597-0408
                http://orcid.org/0000-0001-5682-6360
                http://orcid.org/0000-0001-8736-877X
                http://orcid.org/0000-0002-5412-6165
                http://orcid.org/0000-0003-1083-6744
                Article
                v4i1e31
                10.2196/mhealth.5009
                4823590
                27009498
                9269502b-8542-4251-9ee4-397e4329d21a
                ©Lucy Simons, Althea Z Valentine, Caroline J Falconer, Madeleine Groom, David Daley, Michael P Craven, Zoe Young, Charlotte Hall, Chris Hollis. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 23.03.2016.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR mhealth and uhealth, is properly cited. The complete bibliographic information, a link to the original publication on http://mhealth.jmir.org/, as well as this copyright and license information must be included.

                History
                : 6 August 2015
                : 9 October 2015
                : 19 November 2015
                : 3 January 2016
                Categories
                Original Paper
                Original Paper

                attention deficit hyperactivity disorder,mhealth,emental health,remote monitoring technology,mental health services,qualitative methods,feasibility testing,user requirements

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