Dr. Zsolt Unoka: "m-RESIST will become a step forward in improving and optimizing the clinical decision process"
La setmana passada (6-8 de Febrer) va celebrar-se la 5ª Assemblea General del projecte europeu m-Resist a Budapest (Hongria). L’objectiu d’aquesta trobada va ser avaluar l’estat actual del projecte, i definir l’agenda de l’últim any del mateix, tot establint les bases que permetran consolidar resultats i construir la versió final de la plataforma de serveis m-Resist per pacients amb esquizofrènia resistent, els seus cuidadors i els professionals sanitaris. En aquest punt, vam entrevistar al Dr. Zsolt Unoka, psiquiatra i psicoterapeuta cognitiu-conductual amb dilatada experiència en el desenvolupament, l'adaptació i les escales d'avaluació psiquiàtrica, qüestionaris i adaptació de nous mètodes psicoterapèutics, que ens va ampliar detalls sobre el projecte.
1. At what stage is the m-resist project?
We are in the last year of three years long project. At the end of February ‘17 we are going to start testing the m-resist platform with healthy users and in May ‘17 we’ll start the pilot with patients suffering from treatment resistant schizophrenia.
2. What are the challenges facing today?
On 6th, 7th & 8th of February, 2017, the EC co-funded project m-RESIST had its 5th Plenary Meeting in Budapest. The meeting was hosted by the Semmelweis University, Department of Psychiatry and Psychotherapy. Project partners came together in order to plan subsequent steps and align individual tasks and approaches. All partners attended this consortium meeting. The IT colleagues discussed the final tasks about the programming and other technological background of the m-Resist platform. Clinicians and IT experts had an intensive discussion about the present state of the project and further clarified the hopefully final misunderstandings between the two groups. It is a fruitful but intellectually very challenging work and planning apps together for both partners. Both clinicians and IT experts need to learn new concepts and paradigm of thinking to develop a common ground to understand each other. The first version of the m-Resist platform will be finalized in the next weeks. At the end of February the Hungarian group will start to test the whole platform with healthy users. The m-RESIST platform will be tested, checking that the data flow is correct and the user acceptability is good. Test cases will be executed to validate and verify concepts:
- User interaction and experience with the m-RESIST system (e.g. is interaction with the system intuitive, do the mechanisms available for interaction support all the relevant stakeholders)
- Usability of the m-RESIST system (e.g. ease of use, ease of learning, intuitiveness of interaction)
- User attitudes toward the m-RESIST system, user experience, likeability, motivation and acceptability.
A restricted group of users will use and evaluate the application to detect bugs in the system, to test the usability, to check the initial scenario in order to adapt the solution before it is deployed on a larger scale in the real-world. The objectives of testing the user experiences of m-Resist system are to give feed-back to the developers of the system. This evaluation strategy will focus on the experiences of the end users, conducting a laboratory and a field-trial in Hungary, where qualitative and quantitative measures will be used. Accordingly, it aims to identify the strengths and the weakness of the m-RESIST system for all end users. After the required modifications have done by the IT experts on the m-Resist system we start the pilot study with patients suffering from treatment resistant schizophrenia and with their caregivers. The pilot study will start in May and will end in July. The pilot study has three clinical center one in Spain, one in Israel and one in Hungary.
3. Given the current state of development, what do you predict will have the most impact on patients?
Around one percent of the population in Europe suffers from schizophrenia and around 30-50% patients are considered treatment-resistant and present persistent symptoms, requiring long periods of hospital care and being at greater risk of mortality and multi morbidity. There is no available complex treatment program that targets this specific group of people and there is not enough systematic research on their treatment possibilities. m-Resist project aims to develop an innovative disease management system, m-RESIST, a mobile ICT system addressed to empower patients suffering from resistant schizophrenia and their caregivers (family members, friends, partner), which will involve them to actively participate in the therapeutic process and will enable them to self-manage their condition. m-RESIST will become a step forward in improving and optimizing the clinical decision process. Our hope is that our project will contribute to the development of person specific complex treatment programs that not only targets pharmacological intervention but a complex psychosocial intervention from treatment adherence to healthy life-style and psychotherapeutic intervention for the patients and their caregiver. In our system it is built a symptom monitoring and a predicting modeling system that hopefully learn the patient specific early warning signs and later can predict a potential relapse in an early stage and so the clinical team and the family could intervene an earlier stage to prevent the development of a sever mental state in an earlier phase. .
4. How far mHealth is implemented in Hungary.
We are in an early stage of mHealth development in Hungary. There are plenty of mHealth program in their early phase of their development in many areas of Medicine. As I know m-Resist is one of the most innovative and complex application on the field.