ABSTRACT
Objectives
Smartphone apps facilitate the dissemination of resources to help people with bipolar disorder (BD) implement self-management strategies. However, current apps do not address all treatment outcomes valued by people with BD, nor are they designed with scalability in mind. This study evaluated the feasibility and preliminary efficacy of an alpha version of the co-designed PolarUs app, a self-guided intervention developed to support quality of life (QoL) self-monitoring and self-management in BD.
Methods
North American residents with a confirmed diagnosis of BD used the iOS PolarUs app for 12 weeks. To assess feasibility, adherence rates were assessed, operationalized by completion of weekly in-app Brief Quality of Life in BD (QoL.BD) scores. Linear mixed modeling was used to test the hypothesis that QoL (primary outcome) would improve over the intervention period and explore secondary outcomes (i.e., mood symptoms, self-efficacy, subjective recovery, self-compassion). Hierarchical cluster analysis was used to investigate associations between app adherence and primary outcomes.
Results
In 170 participants (70% women, mean age 39 years SD = 12.1) there was a steady decline in app adherence over the intervention period, with 37% of participants completing their final weekly assessment. However, significant improvements were observed overall for QoL, mood symptoms, and self-compassion. Four distinct app adherence clusters were observed, displaying varying relationships with baseline QoL and trajectories of QoL improvement.
Conclusions
Preliminary adherence and efficacy data for the PolarUs app are positive and demonstrate how the inclusion of lived experience perspectives in app development supports intervention acceptability and impact.