Testing an mHealth momentary assessment Routine Outcome Monitoring application: a focus on restoration of daily life positive mood states.

Abstract Background: Routine Outcome Monitoring (ROM) is used as a means to enrichthe process of treatment with feedback on patient outcomes, facilitating patientinvolvement and shared decision making. While traditional ROM measures focuson retrospective accounts of symptoms, novel mHealth technology makes itpossible to collect real life, in-the-moment ambulatory data that allow for anecologically valid assessment of personalized and contextualized emotional andbehavioural adjustment in the flow daily life (mROM).Method: In a sample of 34 patients with major depressive disorder, treated withantidepressants, the combined effect of treatment and natural course wasexamined over a period of 18 weeks with Ecological Momentary Assessment(EMA). EMA consisted of repeated, within-subject, mini-measurements ofexperience (eg positive affect, negative affect, medication side effects) and context(eg stressors, situations, activities) at 10 unselected semi-random moments perday, for a period of six days, repeated three times over the 18-week period(baseline, week 6 and week 18).Results: EMA measures of emotional and behavioural adjustment were sensitiveto the effects of treatment and natural course over the 18-week period, particularlyEMA measures focussing on positive mood states and the ability to use naturalrewards (impact of positive events on positive mood states), with standardizedeffect sizes of 0.4–0.5. EMA measures of activities, social interaction, stress-sensitivity and negative mood states were also sensitive to change over time.