@Article{info:doi/10.2196/11160,
author="Fletcher, Kathryn
and Foley, Fiona
and Murray, Greg",
title="Web-Based Self-Management Programs for Bipolar Disorder: Insights From the Online, Recovery-Oriented Bipolar Individualised Tool Project",
journal="J Med Internet Res",
year="2018",
month="Oct",
day="24",
volume="20",
number="10",
pages="e11160",
keywords="Web-based intervention; bipolar disorder; self-management",
abstract="Background: Bipolar disorder (BD) is a complex, relapsing mood disorder characterized by considerable morbidity and mortality. Web-based self-management interventions provide marked opportunities for several chronic mental health conditions. However, Web-based self-management programs targeting BD are underrepresented compared with programs targeting other psychiatric conditions. Objective: This paper aims at facilitating future research in the area of self-management of BD and draws insights from the development of one such intervention---the Online, Recovery-Oriented Bipolar Individualised Tool (ORBIT)---that is aimed at improving the quality of life of people with BD. Methods: We have discussed the opportunities and challenges in developing an engaging, evidence-based, safe intervention within the context of the following three nested domains: (1) intervention development; (2) scientific testing of the intervention; and (3) ethical framework including risk management. Results: We gained the following insights across the three abovementioned overlapping domains: Web-based interventions can be optimized through (1) codesign with consumers with lived experience to ensure relevance and appropriateness to the target audience; (2) novel content development processes that iteratively combine evidence-based information with lived experience perspectives, capitalizing on multimedia (eg, videos) that the digital health space provides; and (3) incorporating Web-based communities to connect end users and promote constructive engagement by access to a Web-based coach. Conclusions: Self-management is effective in BD, even for those on the more severe end of the spectrum. While there are challenges to be aware of, guided self-management programs, such as those offered by the ORBIT project, which are specifically developed for Web-based delivery provide highly accessible, engaging, and potentially provocative treatments for chronically ill populations who may otherwise have never engaged with treatment. Key questions about engagement, effectiveness, and cost-effectiveness will be answered by the ORBIT project over the next 18 months. ",
issn="1438-8871",
doi="10.2196/11160",
url="http://www.jmir.org/2018/10/e11160/",
url="https://doi.org/10.2196/11160",
url="http://www.ncbi.nlm.nih.gov/pubmed/30355553"
}