A Mobile App Designed to Promote Shared Decision-Making in the Treatment of Psychotic Disorders: Feasibility and Acceptability Study

Abstract BackgroundStrengthening shared decision-making in mental health care may improve the quality of services and treatment outcomes, but its implementation in services for severe mental disorders is currently lacking. ObjectiveThis study aims to explore the fe...

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Main Authors: Mari Skoge, Sofie Ragnhild Aminoff, Elizabeth Ann Barrett, Gina Engen Bryhni, Kristine Kling, Kari Jorunn Kværner, Ingrid Melle, Erlend Mork, Carmen Simonsen, Linn Nathalie Støme, Josina Vink, Tor Gunnar Værnes, Kristin Lie Romm
Format: Article
Language:English
Published: JMIR Publications 2025-07-01
Series:JMIR Human Factors
Online Access:https://humanfactors.jmir.org/2025/1/e68813
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author Mari Skoge
Sofie Ragnhild Aminoff
Elizabeth Ann Barrett
Gina Engen Bryhni
Kristine Kling
Kari Jorunn Kværner
Ingrid Melle
Erlend Mork
Carmen Simonsen
Linn Nathalie Støme
Josina Vink
Tor Gunnar Værnes
Kristin Lie Romm
author_facet Mari Skoge
Sofie Ragnhild Aminoff
Elizabeth Ann Barrett
Gina Engen Bryhni
Kristine Kling
Kari Jorunn Kværner
Ingrid Melle
Erlend Mork
Carmen Simonsen
Linn Nathalie Støme
Josina Vink
Tor Gunnar Værnes
Kristin Lie Romm
author_sort Mari Skoge
collection DOAJ
description Abstract BackgroundStrengthening shared decision-making in mental health care may improve the quality of services and treatment outcomes, but its implementation in services for severe mental disorders is currently lacking. ObjectiveThis study aims to explore the feasibility and acceptability of iTandem (University of Oslo), a mobile app designed to promote shared decision-making in the treatment of psychotic disorders. In addition, the study aims to investigate mechanisms that potentially contribute to the intended effect of the app. iTandem is a therapy supplement that facilitates patient involvement in decisions regarding treatment goals and focus areas. It is designed for personalized use and contains 8 optional modules: sleep, medication, recovery, mood, psychosis, activity, substance use, and feedback concerning therapy. MethodsPatients undergoing assessment or treatment for psychotic disorders and their clinicians were recruited for the study. Patients and clinicians jointly used iTandem as part of standard treatment in a 6-week trial. We used a mixed-methods study design with a clear emphasis on qualitative methods. Feasibility and acceptability were assessed through descriptive statistics based on preintervention and postintervention questionnaires and app usage data, in addition to text responses to open-ended items. We conducted a reflexive thematic analysis of postintervention interviews to elaborate these measures and to explore mechanisms potentially contributing to achieving shared decision-making when using iTandem. ResultsA total of 9 patients and 8 clinicians completed the trial. The participants evaluated iTandem as a user-friendly and acceptable tool, but there were considerable variations in how the app was integrated into treatment and in perceptions of its clinical value. The thematic analysis suggests that iTandem has the potential to facilitate shared decision-making through supporting cognition and shifting the patient’s role. We also identified scaffolding structures, an analogy of personalized support, as a precondition for these mechanisms and for the overall feasibility and acceptability of iTandem. ConclusionsiTandem was generally perceived as a feasible and acceptable tool in the treatment of patients with psychotic disorders. Our findings suggest that nonclinical aspects, such as support structures, are important to the feasibility and acceptability of such digital interventions and patients’ aptness for digitalized treatment in general. Future research should explore related nonclinical aspects further instead of defining potential target groups based on diagnoses and symptom severity alone.
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spelling doaj-art-642ab47e7639467cbd3e4ce5bc251c1e2025-08-20T03:12:43ZengJMIR PublicationsJMIR Human Factors2292-94952025-07-0112e68813e6881310.2196/68813A Mobile App Designed to Promote Shared Decision-Making in the Treatment of Psychotic Disorders: Feasibility and Acceptability StudyMari Skogehttp://orcid.org/0009-0007-0786-576XSofie Ragnhild Aminoffhttp://orcid.org/0000-0001-9882-5681Elizabeth Ann Barretthttp://orcid.org/0000-0001-6433-7137Gina Engen Bryhnihttp://orcid.org/0009-0009-8712-7058Kristine Klinghttp://orcid.org/0000-0002-4274-4695Kari Jorunn Kværnerhttp://orcid.org/0000-0003-2268-3191Ingrid Mellehttp://orcid.org/0000-0002-9783-548XErlend Morkhttp://orcid.org/0000-0002-8295-9316Carmen Simonsenhttp://orcid.org/0000-0002-5083-5706Linn Nathalie Stømehttp://orcid.org/0000-0001-5153-2865Josina Vinkhttp://orcid.org/0000-0002-1068-6398Tor Gunnar Værneshttp://orcid.org/0000-0002-2177-1512Kristin Lie Rommhttp://orcid.org/0000-0003-1007-8664 Abstract BackgroundStrengthening shared decision-making in mental health care may improve the quality of services and treatment outcomes, but its implementation in services for severe mental disorders is currently lacking. ObjectiveThis study aims to explore the feasibility and acceptability of iTandem (University of Oslo), a mobile app designed to promote shared decision-making in the treatment of psychotic disorders. In addition, the study aims to investigate mechanisms that potentially contribute to the intended effect of the app. iTandem is a therapy supplement that facilitates patient involvement in decisions regarding treatment goals and focus areas. It is designed for personalized use and contains 8 optional modules: sleep, medication, recovery, mood, psychosis, activity, substance use, and feedback concerning therapy. MethodsPatients undergoing assessment or treatment for psychotic disorders and their clinicians were recruited for the study. Patients and clinicians jointly used iTandem as part of standard treatment in a 6-week trial. We used a mixed-methods study design with a clear emphasis on qualitative methods. Feasibility and acceptability were assessed through descriptive statistics based on preintervention and postintervention questionnaires and app usage data, in addition to text responses to open-ended items. We conducted a reflexive thematic analysis of postintervention interviews to elaborate these measures and to explore mechanisms potentially contributing to achieving shared decision-making when using iTandem. ResultsA total of 9 patients and 8 clinicians completed the trial. The participants evaluated iTandem as a user-friendly and acceptable tool, but there were considerable variations in how the app was integrated into treatment and in perceptions of its clinical value. The thematic analysis suggests that iTandem has the potential to facilitate shared decision-making through supporting cognition and shifting the patient’s role. We also identified scaffolding structures, an analogy of personalized support, as a precondition for these mechanisms and for the overall feasibility and acceptability of iTandem. ConclusionsiTandem was generally perceived as a feasible and acceptable tool in the treatment of patients with psychotic disorders. Our findings suggest that nonclinical aspects, such as support structures, are important to the feasibility and acceptability of such digital interventions and patients’ aptness for digitalized treatment in general. Future research should explore related nonclinical aspects further instead of defining potential target groups based on diagnoses and symptom severity alone.https://humanfactors.jmir.org/2025/1/e68813
spellingShingle Mari Skoge
Sofie Ragnhild Aminoff
Elizabeth Ann Barrett
Gina Engen Bryhni
Kristine Kling
Kari Jorunn Kværner
Ingrid Melle
Erlend Mork
Carmen Simonsen
Linn Nathalie Støme
Josina Vink
Tor Gunnar Værnes
Kristin Lie Romm
A Mobile App Designed to Promote Shared Decision-Making in the Treatment of Psychotic Disorders: Feasibility and Acceptability Study
JMIR Human Factors
title A Mobile App Designed to Promote Shared Decision-Making in the Treatment of Psychotic Disorders: Feasibility and Acceptability Study
title_full A Mobile App Designed to Promote Shared Decision-Making in the Treatment of Psychotic Disorders: Feasibility and Acceptability Study
title_fullStr A Mobile App Designed to Promote Shared Decision-Making in the Treatment of Psychotic Disorders: Feasibility and Acceptability Study
title_full_unstemmed A Mobile App Designed to Promote Shared Decision-Making in the Treatment of Psychotic Disorders: Feasibility and Acceptability Study
title_short A Mobile App Designed to Promote Shared Decision-Making in the Treatment of Psychotic Disorders: Feasibility and Acceptability Study
title_sort mobile app designed to promote shared decision making in the treatment of psychotic disorders feasibility and acceptability study
url https://humanfactors.jmir.org/2025/1/e68813
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