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Lee JS, Browning E, Hokayem J, Albrechta H, Goodman GR, Venkatasubramanian K, Dumas A, Carreiro SP, O'Cleirigh C, Chai PR. Smartphone and Wearable Device-Based Digital Phenotyping to Understand Substance use and its Syndemics. J Med Toxicol 2024; 20:205-214. [PMID: 38436819 PMCID: PMC10959908 DOI: 10.1007/s13181-024-01000-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 02/08/2024] [Accepted: 02/20/2024] [Indexed: 03/05/2024] Open
Abstract
Digital phenotyping is a process that allows researchers to leverage smartphone and wearable data to explore how technology use relates to behavioral health outcomes. In this Research Concepts article, we provide background on prior research that has employed digital phenotyping; the fundamentals of how digital phenotyping works, using examples from participant data; the application of digital phenotyping in the context of substance use and its syndemics; and the ethical, legal and social implications of digital phenotyping. We discuss applications for digital phenotyping in medical toxicology, as well as potential uses for digital phenotyping in future research. We also highlight the importance of obtaining ground truth annotation in order to identify and establish digital phenotypes of key behaviors of interest. Finally, there are many potential roles for medical toxicologists to leverage digital phenotyping both in research and in the future as a clinical tool to better understand the contextual features associated with drug poisoning and overdose. This article demonstrates how medical toxicologists and researchers can progress through phases of a research trajectory using digital phenotyping to better understand behavior and its association with smartphone usage.
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Affiliation(s)
- Jasper S Lee
- Department of Emergency Medicine, Brigham and Women's Hospital, 75 Francis St, Boston, MA, 02115, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, USA
- The Fenway Institute, Fenway Health, Boston, USA
| | - Emma Browning
- The Fenway Institute, Fenway Health, Boston, USA
- Department of Community Health, Tufts University, Boston, USA
| | | | | | - Georgia R Goodman
- Department of Emergency Medicine, Brigham and Women's Hospital, 75 Francis St, Boston, MA, 02115, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, USA
- The Fenway Institute, Fenway Health, Boston, USA
| | | | - Arlen Dumas
- Department of Computer Science and Statistics, University of Rhode Island, Kingston, USA
| | - Stephanie P Carreiro
- Department of Emergency Medicine, University of Massachusetts Chan Medical School, Boston, USA
| | - Conall O'Cleirigh
- Department of Psychiatry, Massachusetts General Hospital, Boston, USA
- The Fenway Institute, Fenway Health, Boston, USA
| | - Peter R Chai
- Department of Emergency Medicine, Brigham and Women's Hospital, 75 Francis St, Boston, MA, 02115, USA.
- The Fenway Institute, Fenway Health, Boston, USA.
- Department of Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute, Boston, USA.
- The Koch Institute for Integrated Cancer Research, Massachusetts Institute of Technology, Boston, USA.
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Goodman GR, Carnes TC, Albrechta H, Alpert P, Hokayem J, Goldfine C, Lee JS, Boyer EW, Rosen R, Mayer KH, O'Cleirigh C, Chai PR. Real-World Implementation Challenges Associated with a Digital Pill System to Measure Adherence to HIV Pre-Exposure Prophylaxis from Two Studies of Men Who Have Sex With Men. Proc Annu Hawaii Int Conf Syst Sci 2024; 57:3211-3221. [PMID: 38213843 PMCID: PMC10783042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
Abstract
Once-daily oral pre-exposure prophylaxis (PrEP) is highly effective for HIV prevention, but its efficacy is dependent on adherence, which can be challenging for men who have sex with men (MSM) with substance use. Digital pill systems (DPS) represent a novel tool for directly measuring adherence through ingestible radiofrequency sensors that confirm ingestions in real-time. We examined operational challenges across two studies involving DPS to measure PrEP adherence. While most participants successfully operated the system, a number of technological and sociobehavioral challenges requiring intervention were identified across both studies. Technological issues were both system- and participant-related, and were primarily addressed with technical updates and participant re-education, while sociobehavioral issues, including health and housing changes and issues with technology access, warranted innovative solutions. Future research leveraging DPS technology should develop robust supportive infrastructure and mitigation procedures to promptly identify and resolve operational issues to optimize the potential benefits of DPS use.
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Affiliation(s)
| | | | | | | | | | | | - Jasper S Lee
- Department of Psychiatry, Massachusetts General Hospital
| | - Edward W Boyer
- Department of Emergency Medicine, Ohio State University, Wexner Medical Center
| | | | | | | | - Peter R Chai
- Department of Emergency Medicine, Brigham and Women's Hospital
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Goldfine CE, Albrechta H, O'Cleirigh C, Standley A, Mohamed Y, Hokayem J, Lee JS, Carnes TC, Goodman GR, Mayer KH, Alpert P, Chai PR. Preliminary feasibility of a wrist-worn receiver to measure medication adherence via an ingestible radiofrequency sensor. Int Conf Wearable Implant Body Sens Netw 2023; 2023:10.1109/BSN58485.2023.10330912. [PMID: 38155876 PMCID: PMC10753620 DOI: 10.1109/bsn58485.2023.10330912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2023]
Abstract
Adherence to medications is a complex task that requires complex biobehavioral support. To better provide tools to assist with medication adherence, digital pills provide an option to directly measure medication taking behaviors. These systems comprise a gelatin capsule with radiofrequency emitter, a wearable Reader that collects the radio signal and a smartphone app that collects ingestion data displays it for patients and clinicians. These systems are feasible in measuring adherence in the real-world, even in stigmatized diseases like HIV treatment adherence. While the current iteration of the digital pill system utilizes a wearable Reader worn like a necklace, preliminary feedback demonstrated that a miniaturized system that was worn on the wrist could be more functional in the real-world. This paper therefore describes the development and preliminary field testing of a wrist-borne wearable Reader to facilitate acquisition of oral HIV pre-exposure prophylaxis (PrEP) adherence data among individual prescribed PrEP.
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Affiliation(s)
| | | | - Conall O'Cleirigh
- Department of Psychiatry, Massachusetts General Hospital, Boston, USA
| | | | | | | | - Jasper S Lee
- Department of Psychiatry, Massachusetts General Hospital, Boston, USA
| | | | - Georgia R Goodman
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, USA
| | | | | | - Peter R Chai
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, USA
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