The Momentum Trial: How digital tools can support patient-centered care & shared decision-making

The Momentum Trial: How digital tools can support patient-centered care & shared decision-making

In the delivery of mental health services, shared decision-making (SDM) is increasingly becoming more important [1]. SDM can be defined as a collaborative process between patient and health care provider, enabling joint treatment decisions and patient-centered care [2]. Research suggests that in mental healthcare, SDM could “contribute to recovery-oriented care by inviting the patient to have more control and be more involved in their treatment decisions” [2]. 

However, many mental health care providers are still reluctant to incorporate SDM into their treatment offers, as they believe it to be unfit for individuals suffering from severe mental illness, as well as to be time-consuming and thus a burden [3,4]. To overcome these challenges of incorporating SDM into daily practices, healthcare professionals have been encouraged to utilize “tools to support the SDM process” [2]. 

Increased focus has thus been placed on how digital interventions could support SDM in mental healthcare [2]. The Momentum Trial is a study investigating how using a smartphone app as a support tool could help “individuals suffering from schizophrenia-spectrum disorders in an outpatient treatment setting” [5]. 

During the trial, 194 participants were randomized either to receive “specialized early intervention treatment with the Momentum app” (intervention group) or to receive regular treatment without a smartphone app (control group) [5]. The Monsenso digital health solution, consisting of a patient app and a clinical web portal, was used for the intervention group. The Monsenso solution provided tools such as psychoeducational material, daily self-assessments, and action plans in the patient app, as well as patient insights in the clinical web portal [2].

As a primary outcome, it was investigated whether the individuals from the two groups would show a difference in self-perceived patient activation. Patient activation can play an important role in successful SDM processes, as patients who are more active and engaged in their treatment “feel confident when collaborating with their provider, and have the knowledge and skills to manage their condition” [2]. 

As secondary outcomes, it was investigated whether the individuals from the two different groups would show a difference in the self-perceived feeling of hope and optimism, self-efficacy, confidence in communicating with their provider, therapeutic alliance between the patient and provider, feeling prepared to make a treatment decision, and satisfaction with treatment [2]. 

Results were evaluated at baseline, as well as 3 and 6 months post-baseline. Promisingly, the Momentum Trial showed a significant effect of a digital SDM tool on the subjective level of patient activation, confidence in communicating with one’s provider, and feeling prepared for decision-making at the postintervention time point [2]. 

Though no statistically significant effects could be found related to the digital SDM intervention’s effect on working alliance, treatment satisfaction, clinical outcomes, and hope, the results from the Momentum Trial “confirm [the] hypothesis that a digital SDM tool may promote patient activation by supporting the collaborative process between patients and their providers” [2]

Monsenso CEO Thomas Lethenborg says: “The Momentum Trial shows how promising digital tools are in supporting shared decision-making. At Monsenso, we are proud to have been involved in this research project, and look forward to empowering individuals and clinicians even more on the treatment pathway”.
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About Monsenso
Monsenso is an innovative technology company offering a digital health solution used for decentralised trials, remote patient monitoring and treatment support. Our mission is to contribute to improved health for more people at lower costs by supporting treatment digitally and leveraging patient-reported outcomes data. Our solution helps optimise the treatment and gives a detailed overview of an individual’s health through the collection of outcome, adherence, and behavioural data. It connects individuals, carers, and health care providers to enable personalised treatment, remote care, and early intervention. We collaborate with health and social care, pharmaceuticals, and leading researcher worldwide in our endevaours to deliver solutions that fit into the life of patients and health care professionals. To learn more visit  www.monsenso.com

References:
[1] Alguera-Lara, V., Dowsey, M., Ride, J., Kinder, S. & Castle, D. (2017). Shared decision making in mental health: the importance for current clinical practice. Australas Psychiatry, 25(6), 578-582. 

[2] Vitger, T., Hjorthøj, C., Austin, S.F., Petersen, L., Tønder, E.S., Nordentoft, M. & Korsbek, L. (2022). A Smartphone App to Promote Patient Activation and Support Shared Decision-making in People With a Diagnosis of Schizophrenia in Outpatient Treatment Settings (Momentum Trial): Randomized Controlled Assessor-Blinded Trial. Journal of Medical Internet Research, 24(10), e40292.
https://www.jmir.org/2022/10/e40292

[3] Hamann, J. & Heres, S. (2014). Adapting shared decision making for individuals with severe mental illness. Psychiatric Services, 65(12), 1483-1486.
https://ps.psychiatryonline.org/doi/full/10.1176/appi.ps.201400307

[4] Waldemar, A.K., Esbensen, B.A., Korsbek, L., Petersen, L. & Arnfred, S (2019). Recovery-oriented practice: participant observations of the interactions between patients and health professionals in mental health inpatient settings. International Journal of Mental Health Nursing, 28(1), 318-329. https://onlinelibrary.wiley.com/doi/10.1111/inm.12537

[5] Korsbek, L. (n.d.). The Momentum Trial: The efficacy of using a smartphone application to support shared decision making for people with a diagnosis of schizophrenia in an outpatient treatment setting. Open Patient data Explorative Network.
https://open.rsyd.dk/OpenProjects/openProject.jsp?openNo=451&lang=da

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DIPNOT: A Research Project to Improve Psychotherapeutic Treatment for People with Depression

DIPNOT: A Research Project to Improve Psychotherapeutic Treatment for People with Depression

Monsenso is proud to be part of the Development of an Intervention for Persistent Not On Track (DIPNOT) research project that aims to improve psychotherapeutic treatment offered to people with depression in psychiatry.

Though often said to be one of the “happiest countries on earth”, depression is no rare illness in Denmark. Did you know, that approximately 15-25% of all females and 7-12% of all males living in Denmark experience depression at least once in their life? [1].

After diagnosis, patients with depression are often offered group-based cognitive behavioural therapy (CBT) in outpatient psychiatry in Denmark [2]. However, around 50% of depressed patients participating in group-based CBT do not actually feel their symptoms improving, or even worsening during the therapy [2].

The DIPNOT research project, which was started in 2021 and continues until 2024, hence aims to design an intervention for patients with depression who are not improving during the course of their therapy. The idea is to monitor patients and the progression of their symptoms via a digital health application (e.g., using clinical questionnaires) and identify the patients who are not doing well during the therapy [2].

The Monsenso digital health solution is currently being used for this purpose in the DIPNOT project conducted by ph.d. student Jasmin Rejaye Gryesten. It facilitates the identification of worsening depressive symptoms and offers various possibilities for clinicians to provide their patients with digital tools that can help their recoveries – such as exercises and psychoeducational content.

At Monsenso, we are proud to be part of this exciting journey toward offering better mental health to more people by being able to cater to patients’ needs more individually.

If you want to learn more about the DIPNOT project, watch this video!
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About Monsenso
Monsenso is an innovative technology company offering a digital health solution used for decentralised trials, remote patient monitoring and treatment support. Our mission is to contribute to improved health for more people at lower costs by supporting treatment digitally and leveraging patient-reported outcomes data. Our solution helps optimise the treatment and gives a detailed overview of an individual’s health through the collection of outcome, adherence and behavioural data. It connects individuals, carers and health care providers to enable personalised treatment, remote care and early intervention. We collaborate with health and social care, pharmaceuticals and leading researcher worldwide in our endevaours to deliver solutions that fit into the life of patients and health care professionals. To learn more visit  www.monsenso.com

References:
[1] Kessing, L.V. (2021). ​​Depression, forekomst. Sundhed.dk.
https://www.sundhed.dk/borger/patienthaandbogen/psyke/sygdomme/depression/depression-forekomst/

[2] DIPNOT (n.d.). Development of an Intervention for Persistent Not On Track.
https://www.dipnot.dk

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World Mental Health Day 2022

World Mental Health Day 2022

October 10th is World Mental Health Day, aiming at shining light on the prevalence of mental ill health globally and the need to “strengthen mental health care so that the full spectrum of mental health needs is met” [1].

How common are mental illnesses?
970 million individuals worldwide, or 1 in every 8 people, had a mental illness in 2019 [2]. Due to the COVID-19 pandemic, these numbers have been even more on the rise during the past two years [1]. Anxiety and depression disorders, for example, are estimated to have increased by more than 25% among the global population during the first year of the pandemic [1].

Economic costs of mental disorders
Statistics show that in 2010, mental diseases cost the global economy US$2.5 trillion in direct and indirect costs, and mental and drug use disorders made up 10.4% of the total global illness burden [3]. By 2030, it is anticipated that the direct and indirect costs of mental illnesses will have doubled – without taking into account expenses related to mental problems that originate outside of the healthcare system, such as legal expenses brought on by the consumption of illegal drugs [3].

Stigmatization of ill mental health
More than half of those suffering from mental illness do not obtain treatment. People often put off or postpone getting therapy out of fear of being treated “differently or […] losing their jobs and livelihood” [4]. This is due to the fact that stigma, discrimination, and prejudice toward those who have mental illnesses are still major issues in today’s global society.
Often, experiencing external stigmatization can lead to greater self-stigma for individuals, which was linked to worse recovery from mental illness in scientific studies [4].

The growing treatment gap
The COVID-19 pandemic has sparked a global mental health crisis, causing millions of people to experience short- and long-term stress and jeopardizing their mental health. During COVID-19, the gap in treatment for mental health disorders has expanded significantly, while mental health services have been severely disrupted at the same time [1]. Resources in mental health services are thus limited and often not sufficient to meet the treatment needs for poor mental health [5].

What needs to change?
Mental disorders are more common than one might think, and prejudices surrounding poor mental health unfortunately only further increase the burden of the diseases on people suffering from them. It is therefore important to raise awareness about mental health problems, destigmatize mental illness, and help to ensure that individuals struggling with their mental health are not facing discrimination.
Given the high economic costs of mental disorders, it is also important to continuously work on improving the treatment support provided. Especially with lacking resources in mental health services and a growing treatment gap, this includes seeking new ways to help individuals suffering from mental health conditions.

How digital solutions for mental health can help
The use of digital platforms for remote patient monitoring and health assessment, as well as real-time patient analytics, could enable personalised treatment and improved quality of care [6]. Digital solutions for mental health could therefore offer the potential to empower and engage individuals with mental disorders to better manage their mental health, facilitating treatment for clinical professionals and empowering family caregivers to help drive down economic costs and increase productivity.
At Monsenso, we have worked with a variety of mental health disorders in both research and clinical settings. Our digital mental health solution has helped many individuals struggling with their mental health to better understand their conditions and live a more independent life, as well as helped clinicians to better support their patients. We are proud to support the World Mental Health Day and will continue to spread knowledge about mental health conditions and offer our support to individuals affected and clinicians providing treatment for mental illness.

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About Monsenso
Monsenso is a digital health company that enables better outcomes for patients and clinicians through data-driven decisions. We are focused on mental health and user-centred in designing our solutions for patients and clinicians. Our cloud-based platform is a CE-marked medical device (Class 1, pending Class 2a and MDR certification) that is HIPAA compliant, with certifications in ISO 13485, ISO 27001, Cyber Essentials and TGA. Our solution has been clinically and scientifically validated by over 70+ peer-reviewed studies and can be configured for applications across mental health conditions. We work with healthcare systems, life sciences and research organisations globally. Book a demo to learn more.

References:
[1] World Health Organization (n.d.). World Mental Health Day 2022.
https://www.who.int/campaigns/world-mental-health-day/2022

[2] World Health Organization (2022). Mental disorders.
https://www.who.int/news-room/fact-sheets/detail/mental-disorders

[3] Trautmann, S., Rehm, J. & Wittchen, H. (2016).  The economic costs of mental disorders. EMBO reports 17(9).
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5007565/

[4] American Psychiatric Association (n.d.). Stigma, Prejudice and Discrimination Against People with Mental Illness.
https://www.psychiatry.org/patients-families/stigma-and-discrimination#:~:text=Public%20stigma%20involves%20the%20negative,have%20about%20their%20own%20condition.

[5] Saraceno, B. (2004). Mental health: scarce resources need new paradigms. World Psychiatry 3(1): 3–5.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1414651/

[6] Elsevier Health (2022). Clinician of the Future Report 2022.
https://www.elsevier.com/connect/clinician-of-the-future

Patients will help document treatment efficacy in innovative, decentralised trials project

Patients will help document treatment efficacy in innovative, decentralised trials project

In collaboration with leading researchers and the pharmaceutical industry, the PhaseV innovation project will set new standards for how the effects of treatment can be documented so that patients are offered the right treatment. Patients and healthcare professionals will thus provide data that can help shed light on whether the treatment is working when Monsenso’s digital platform is used to support decentralised trials in the project.

To date, medical treatments have been tested primarily in long-term, randomised clinical trials to determine treatment effects and side-effects, with limited measurement of long-term effects when treatment is provided in clinical practice.

Often, drug trials take 6-15 years before a new drug can be released on the market, and 80 percent of trials fail to recruit and retain a sufficient number of patients in the trials within the set timeframe. This means that the benefits for patients and healthcare systems are often delayed. However, with digital developments, it is possible for clinics, hospitals, and patients alike to play a more active role in documenting the impact of treatments.

The new PhaseV (Phase five) innovation project, in which Innovation Fund Denmark is investing DKK 24 million (of which DKK 8,3 million goes to Monsenso), aims to develop and validate a scalable digital platform for efficient, decentralised patient recruitment, patient data collection and study execution. This is done by engaging patients and clinicians in the monitoring of treatment effects over longer periods of time based on patients’ own feedback, digital biomarkers from smartphones and wearables, as well as registry data.

With this project, we want to show that it is possible to engage and motivate patients and healthcare professionals to collect continuous data from patients over time. PhaseV will set new standards for how the efficacy and safety of new treatments can be documented in a scalable way in the future, so that patients are offered the right treatment“, says Thomas Lethenborg, CEO of Monsenso.

Digitizing the effect of patient treatments can be of decisive importance for our insight into the effects of the treatment of severely overweight people as well as for future clinical studies, where the goal is to make it easier for both patients and healthcare personnel to participate“, says Daniel Vega Møller, Vice President Medical & Science Obesity, NASH and Devices Novo Nordisk A/S.

Country Manager for Novartis in Denmark, Peter Drøidal, also sees great potential in the PhaseV project: “The healthcare system lacks resources and therefore we all need to think in new ways. This project’s combination of public and private partners offers unique opportunities to develop new digital solutions that can help improve patient care and free up personnel time“.

Severe obesity, urticaria and diabetic foot ulcers
The PhaseV project will develop a platform with three apps to collect data on patients with severe obesity, diabetic foot ulcers and urticaria – all of which are costly chronic conditions. For example, annual treatment costs for severe obesity alone are estimated to exceed DKK 15 billion for Danish municipalities and regions.

More than 800,000 Danes live with severe obesity, and associated diseases are very common. As severe obesity causes both direct and indirect costs to society, there is a significant need for good and well-documented weight loss treatments“, says Jens Meldgaard Bruun, clinical professor at Aarhus University and Steno Diabetes Center Aarhus and part of PhaseV.

Urticaria affects 15-20 percent of the population, and in about 1 percent it occurs chronically and causes a severely reduced quality of life.

Thorough monitoring and efficient data collection on symptom development are crucial for correct and effective future treatment“, says Simon Francis Thomsen, Professor and Chief Physician at Bispebjerg Hospital.

22.000 Danes live with diabetic foot ulcers and treatment costs society more than DKK 5 billion annually.

For a patient with diabetes, a foot ulcer can become critical within days, and in exceptional cases amputation may be necessary. Hence, time is of the essence, and we want to prevent serious complications“, says Klaus Kirketerp-Møller, senior physician at Bispebjerg Hospital and Steno Diabetes Center Copenhagen.

The PhaseV project is expected to bring value to patients, regions, and municipalities, as well as to the institutions and companies involved.

Attractive new market opportunity for Monsenso
“We are further developing Monsenso’s digital health platform to improve the support of decentralised trials across chronic conditions, where behaviour and ongoing follow-up play a major role in patients’ quality of life. We see both the development work and the partnerships as very interesting for Monsenso, because it opens up a new, attractive market opportunity“, says the CEO of Monsenso, Thomas Lethenborg.

The consortium behind the project, which is supported by the Innovation Fund, includes Novo Nordisk, Novartis, Aarhus University, the Research Unit for General Practice, Aarhus Municipality, Bispebjerg Hospital, the Danish Technological Institute, the Danish Life Science Cluster, Steno Diabetes Center Aarhus, the Copenhagen Institute for Future Studies and Monsenso.

Financial expectations
The project does not change Monsenso’s financial expectations for H2 2022 but is expected to contribute to increased growth in 2023 and beyond.

Facts
Innovation Fund investment: DKK 24.3 million (of which DKK 8.3 million is for Monsenso).
Total project budget: DKK 48.2 million.
Duration: 3 years
Official title: PhaseV

Further information
CEO, Monsenso
Thomas Lethenborg
Tel. +45 21 29 88 27
E-mail: lethenborg@monsenso.com

Chairman of the board, Monsenso
Peter Mørch Eriksen
Tel. +45 29 00 35
E-mail: petermorcheriksen@outlook.com

Certified Adviser, Monsenso
Norden CEF A/S
John Norden
Tel. +45 20 72 02 00
E-mail: jn@nordencef.dk
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About Monsenso
Monsenso is an innovative technology company offering a digital health solution used for decentralised trials, remote patient monitoring and treatment support. Our mission is to contribute to improved health for more people at lower costs by supporting treatment digitally and leveraging patient-reported outcomes data. Our solution helps optimise the treatment and gives a detailed overview of an individual’s health through the collection of outcome, adherence and behavioural data. It connects individuals, carers and health care providers to enable personalised treatment, remote care and early intervention. We collaborate with health and social care, pharmaceuticals and leading researcher worldwide in our endevaours to deliver solutions that fit into the life of patients and health care professionals. To learn more visit  www.monsenso.com

 
Digitalization could help tackle the issue of lacking resources in mental health services

Digitalization could help tackle the issue of lacking resources in mental health services

Did you know that over 500.000 Danish citizens currently live with one or multiple mental health disorders [1] and that approximately half of the Danish population will suffer from a mental illness at least once in their lifetime [2]?

Mental health is declining in Denmark [2]. However, treatments and services offered to people with mental disorders often lack quality compared to those offered to people with physical disorders [2]. One of the reasons is a clear shortage of resources. 

Lack of resources as a challenge in Danish mental health services
Recruiting and retaining mental health professionals, in social psychiatry, regional psychiatry, and specialised social services focusing on children and youths [2] has been a significant struggle in recent years.

In Region South, for example, only 8 out of 21 open job positions for psychologists could be filled at the beginning of the year. In Region Zealand, it was even less: 11 applicants for 22 advertised positions, and 6 suitable candidates hired [3].

There are several assumptions for why it is so challenging to recruit mental health professionals. One of them is that we are currently experiencing a generational shift, with many healthcare professionals retiring at the same time [3].

The insufficient capacity and availability led many individuals suffering from mental illness to not receive the right treatment at the right time [2]. The average waiting time to see a psychologist in Denmark is around 16 weeks – but in many cases, patients easily wait up to 20 weeks before their first treatment [4]. 

This limited capacity also reduces the possibility of early detection and interventions. Insufficient preventive measures are a major cause of high mortality rates amongst individuals suffering from severe mental illnesses in Denmark [2].

Approaches to improve mental health services in Denmark
In order to make the quality and availability of mental health services a top priority, the Danish government decided to initiate working on a 10-year plan for the development of psychiatry in 2020, setting aside 600 million Danish Kroner annually for the improvement of mental health care in Denmark. [2].

Recommendations for the long-term plan include the expansion of easily accessible offers for mental health services in Danish municipalities (including improved offers for children and young adolescents), increased country-wide mental health promotion, and better early detection of mental illness [2]. 

None of these goals will be properly implemented if Denmark is still facing a lack of resources. But while the need to hire more trained professionals is undoubtedly critical to improve mental health services, this may also be an opportunity for scalable technologies to improve the reach of the current workforce to serve the needs of patients waiting to receive care.

Digitalization as the key to improved mental health services?
A large study by Elsevier Health (2022) shows that 77% of international clinicians expect tech companies to become “key stakeholders in managing healthcare systems in 10 years”, and that the majority of clinicians (70%) believe an increased use of digital technologies will transform healthcare positively [5].

Many healthcare professionals therefore expect that digital technologies and remote monitoring tools could help them to handle the growing patient data volumes they are currently feeling overwhelmed with [5]. 

The current recommendations for the psychiatric 10-year plan acknowledge that digital solutions can facilitate making better use of resources available in the future, and ensure the capacity meets the growing demand for mental health services. The use of digital technology offers the potential to address challenges in Danish mental health services. In particular, the use of digital platforms for remote patient monitoring and health assessment could improve access and speed to care, and real-time patient analytics could enable personalised treatment and improved quality of care [5]. 

Everyone deserves access to mental healthcare. The integration of digital solutions in healthcare bears huge potential, and it needs to happen timely. There is never a better time to act.
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About Monsenso
Monsenso is a digital health company that enables better outcomes for patients and clinicians through data-driven decisions. We are focused on mental health and user-centred in designing our solutions for patients and clinicians. At Monsenso, we focus on ensuring that the right service can be offered to the right patient at the right time by enabling stepped- and blended care. Our digital health solution can thus be a support to clinicians where resources are scarce and additionally ease healthcare professionals’ workload by providing them with a better overview of their patients’ data and conditions. The Monsenso solution also offers clinicians the possibility of early data collection for better diagnosis and treatment, as well as enabling early intervention by e.g., giving patients access to psychoeducation. Our cloud-based platform is a CE-marked medical device (Class 1, pending Class 2a and MDR certification) that is HIPAA compliant, with certifications in ISO 13485, ISO 27001, Cyber Essentials, and TGA. Our solution has been clinically and scientifically validated by over 70+ peer-reviewed studies and can be configured for applications across mental health conditions. We work with healthcare systems, life sciences, and research organisations globally. Book a demo to learn more.

References:

[1] EN AF OS (n.d.). About EN AF OS. Sundhedsstyrelsen.
http://www.en-af-os.dk/da/English/About-us#:~:text=Statistically%2C%201%20in%205%20Danes,they%20will%20get%20well%20again.

[2] Sundhedsstyrelsen (2022). Fagligt oplæg til en 10-årsplan.
https://www.sst.dk/da/Udgivelser/2022/Fagligt-oplaeg-til-en-10-aarsplan

[3] Kofoed (2022). Der er mangel på psykologer over hele landet – og det kan især gå ud over unge. DR.
https://www.dr.dk/nyheder/indland/der-er-mangel-paa-psykologer-over-hele-landet-og-det-kan-isaer-gaa-ud-over-unge

[4] Kofoed et al. (2022). Millioner til psykologhjælp forbliver ubrugte trods rekordlange ventetider. DR.
https://www.dr.dk/nyheder/politik/kommunalvalg/millioner-til-psykologhjaelp-forbliver-ubrugte-trods-rekordlange

[5] Elsevier Health (2022). Clinician of the Future Report 2022.
https://www.elsevier.com/connect/clinician-of-the-future