CLINICAL QUESTION

Can a self-guided phone-based app reduce depression symptoms and induce remission in adults who are willing to use it?

BOTTOM LINE

A quick search of the Apple app store identified many apps aimed at tracking or improving mood. In this study, one of these apps—Mental Health Coach: Moodivate—produced a fairly good reduction of symptoms and induced remission in patients with moderate depression (Patient Health Questionnaire-9 score of at least 10 out of 27) compared with usual care. It tracks large amounts of patient-entered data, so patients have to be willing to use it consistently. (Level of Evidence = 1b−)

SYNOPSIS

Using electronic health records (EHRs) from 22 primary care offices, the investigators enrolled 649 English-speaking adults (76% female) who had at least moderate symptoms of depression without suicidal ideation and had a smartphone. Participants were randomized using concealed allocation to receive usual care or to download and use a self-guided “digital mental health intervention” called Mental Health Coach: Moodivate. The app group was assigned to standalone use or integration with their EHR. The app's development was supported by the National Institute of Mental Health and informed by brief behavioral activation treatment for depression. In participants using the app, 58% to 62% experienced clinically significant improvement compared with 51% receiving usual care (P < .001). In participants assigned to the app groups, with or without EHR integration, 33% to 36% achieved remission compared with 28% in the usual care group (P < .001). Only a few clinicians with access to data provided by the app to the EHR documented the data using a provided SmartPhrase.