Understanding the subjective experience of long-term remote measurement technology use for symptom tracking in people with depression: a multisite, longitudinal qualitative analysis

Background Remote Measurement Technologies (RMTs) have the potential to revolutionise major depressive disorder (MDD) disease management by offering the ability to assess, monitor and predict symptom changes. However, the promise of RMT data depends heavily on sustained user engagement over extended periods of time. Here we report a longitudinal qualitative study of the subjective experience of people with MDD engaging with RMTs, to provide insight into system usability and user experience and to provide the basis for future promotion of RMT use in research and clinical practice. Objective We aimed to understand the subjective experience of long-term engagement with RMTs, through qualitative data collected throughout a longitudinal study of RMTs in MDD. The objectives were (1) to explore key themes associated with long-term RMT use, and (2) to identify recommendations for future system engagement. Methods In this multisite, longitudinal qualitative research study, 124 semi-structured interviews were conducted with 99 participants across the United Kingdom, Spain, and The Netherlands at 3-month, 12-month, and 24-month timepoints during a study exploring RMT use (the Remote Assessment of Disease and Relapse- Major Depressive Disorder study). Data was analysed using thematic analysis; interviews were audio recorded, transcribed, and coded in the native language, with resulting quotes translated into English. Results There were five main themes regarding the subjective experience of long-term RMT use: 1) research-related factors, 2) utility of RMTs for self-management, 3) technology-related factors, 4) clinical-related factors, and 5) system amendments and additions. Conclusions The subjective experience of long-term RMT use can be considered from two main perspectives: a) experiential factors (how participants construct their experience of engaging with RMTs), and b) system factors (direct engagement with the technologies). A set of recommendations based on these strands is proposed, for both future research and the real-world implementation of RMTs into clinical practice. Future exploration of experiential engagement with RMTs will be key to successful use of RMTs in clinical care.