Behandlungsassistenz durch elektronische Medien in der Schizophrenieversorgung
Ein Projekt der Zukunft für Patienten und Behandler?
Abstract
Zusammenfassung. Der Einsatz elektronischer Medien und Geräte im Gesundheitssektor, auch eHealth genannt, boomt. Auch in der psychiatrisch-psychotherapeutischen Versorgung werden zunehmend eHealth Anwendungen eingesetzt, die unter dem Überbegriff eMentalHealth zusammengefasst werden. Trotz nachgewiesener Effektivität von eHealth Anwendungen bezüglich Symptomreduktion in den Bereichen der Depressions-, Angst- und Suchtbehandlung bestehen noch einige Bedenken, ob eHealth Anwendungen auch bei Patienten mit psychotischen Erkrankungen eingesetzt werden können, da die Bedienung solcher Anwendungen aufgrund der Symptomatik (z.B. kognitive Defizite) nicht verlässlich genug sein könnte. Entgegen dieser Bedenken gibt es einige vielversprechende Projekte, die speziell für Patienten mit psychotischen Erkrankungen entwickelt wurden. Im Rahmen dieses Beitrags stellen wir das Spektrum der Anwendungsbereiche anhand von vier Beispielen vor. Die Smartphone-Applikation FOCUS zielt auf die Stärkung des Selbstmanagements von Krankheitsymptomen, ITAREPS stellt eine Form der Rezidivprophylaxe dar, PsyLog soll die Kommunikation über Nebenwirkungen zwischen Patient und Behandler fördern und vor allem Medikamentennebenwirkungen erfassen und die Avatar Therapie konzentriert sich auf die spezifische Behandlung von chronischem Stimmenhören. Erste Studien zeigen, dass eMentalHealth Anwendungen auch von Patienten mit einer psychotischen Erkrankung ohne Probleme bedienbar sind und die Akzeptanz auf Seiten der Patienten hoch ist. In Zukunft wird es darum gehen, eMentalHealth Anwendungen für Patienten mit psychotischen Erkrankungen auf ihre Effektivität zu untersuchen und Probleme der Implementierung (z.B. Übernahme der Kosten von Seiten der Krankenkasse) zu lösen.
Abstract. The use of modern communication and information technology in the health sector, eHealth, is rapidly expanding. eHealth applications, commonly referred to as eMentalHealth, are also increasingly used in psychiatric-psychotherapeutic health care. Despite empirical evidence supporting the effectiveness of eHealth applications in symptom reduction in the areas of depression, anxiety disorders and substance dependence, there are doubts whether eHealth applications can be implemented in the treatment of psychotic disorders where specific symptoms (e.g. cognitive impairment) may hinder the proper handling of these applications. Notwithstanding these concerns, there are promising projects which have been especially developed for patients with psychotic disorders. In the context of this article, we introduce the broad spectrum of areas of application of eHealth for patients with psychotic disorders by way of four examples of specific applications. The smartphone application FOCUS aims to increase the self-management of psychotic symptoms while PsyLog, another smartphone application, seeks to improve the communication on medication-induced side-effects between patient and practitioner by logging adverse side-effects. ITAREPS, which uses text-messaging systems (SMS), concentrates on relapse prevention, and the Avatar Therapy focuses on the specific treatment of auditory hallucinations. First studies imply that eMentalHealth applications are a feasible option also for psychotic patients and that patients' rate of acceptance is high. More research is needed to investigate the efficacy of eMentalHealth applications in the treatment of psychotic disorders and to find solutions to problems of implementation (e.g. meeting of costs by medical insurances).
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