Utilizing technology to optimise ADHD care

Summary Real world clinical outcomes for ADHD fall far below those delivered in clinical trials. This project explores the use potential for improving outcomes through the use of wearable technologies and phones.

Project Details

This project explores the use of real time activity monitoring to improve the detection and treatment of ADHD. Current outcomes for ADHD fall far short of those seen in clinical trials. Recent work from our clinic has demonstrated that the use of measurement based outcomes in day to day clinical practice can result in significant clinical improvements. However current approaches to measurement depend on individual interpretations of observed behavior and these are subject to several limitations and biases. We will use a combination of wearable technology (Fitbit) and a mobile phone app (Unforgetableme) to collect real time activity data across a range of different modalities (e.g. sleep, movement, phone use etc.).

The project is already approved by RCH Ethics

We will first use this data to compare three groups of adolescents 1) Typically developing young people; 2) Young people accepted as referrals to RCH Mental Health but without ADHD and 3) Young people  accepted by RCH Mental Health Neurodevelopmental Disorders Team with ADHD and who are not currently treated with medication. Participants will wear a fitbit and use the phone app for 4 weeks. These data will be analyzed with support from the University of Melbourne Complex Human Data Hub focusing on those aspects of the data that most effectively separate the three groups. The data from the ADHD group will also be used to define the baseline for these young people.

The ADHD group will continue to wear the fitbit and carry the app for another 8 weeks during which time they will be titrated onto medication for their ADHD.  These data, along with more traditional measures of response will be analyzed to identify 1) do they accurately measure response to medication? 2) are they able to reliably track the pharmacodynamic response to medication across the day?

Summary of questions and objectives

Research Questions

1) Can ESM be used to identify predictable patterns of activity across the day that distinguish between children with ADHD and a clinical comparison group of children with other mental health difficulties, who do not have ADHD?

2) Are changes in activity patterns observable in children with ADHD receiving routine clinical care?Objectives

The primary objective of this pilot study is to develop a monitoring system based on passive ESM that can provide objective measures of clinical status. This will be done in 3 stages.

1) Determine whether using ESM we can distinguish between children with ADHD and a clinical comparison group of children with other mental health disorders, who do not have ADHD.

2) Determine whether using ESM we can distinguish activity patterns between children with and without mental health problems.

3) Determine whether ESM can be used to accurately monitor changes in ADHD over time.