Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jul 15, 2019
Open Peer Review Period: Jul 19, 2019 - Sep 14, 2019
Date Accepted: Oct 22, 2019
(closed for review but you can still tweet)
The True Colours remote symptom monitoring system: A decade of evolution
The True Colours remote mood monitoring system was developed over a decade ago by researchers, psychiatrists and software engineers at the University of Oxford to allow patients to report upon a range of symptoms via text messages, web interfaces, or smartphone applications. The system has evolved to encompass a wide range of measures including psychiatric symptoms, quality of life, and medication. Patients are prompted to provide data according to an agreed, personal schedule: weekly, daily, or at specific times during the day. The system has been applied across a number of different populations, for the reporting of mood, anxiety, substance use, eating and personality disorders, psychosis, self-harm, and ulcerative colitis. Over the past decade there have been over 36,000 registered True Colours patients and participants in the UK, with more than 20 deployments of the system supporting clinical service and research delivery. The system has been adopted for routine clinical care in mental health services, supporting more than 3000 adult patients in secondary care, and 27,263 adolescent patients currently registered within Oxfordshire and Buckinghamshire. The system has also proven an invaluable scientific resource: as a platform for research into mood instability and as an electronic outcome measure in randomized controlled trials. This paper reports upon the existing applications of the system, setting out lessons learned, and discusses the implications for tailored symptom monitoring, and the barriers to implementation at a larger scale.
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