Feasibility and Acceptability of a Mobile Intervention to Improve Treatment Adherence in Bipolar Disorder: A Pilot Study.
A two-week Palm Pilot program got bipolar patients to answer 92 % of medication and mood prompts, showing pocket devices can deliver high-dose remote support.
01Research in Context
What this study did
The team gave the adults with bipolar disorder a Palm Pilot. The device beeped four times a day for two weeks. Each beep asked the person to rate mood, stress, and whether they took their medicine.
The Palm also gave short tips about sticking with meds. Staff showed each person how to use the device once, then left them alone.
What they found
People answered 92 % of the beeps. Most said the prompts were helpful and easy. Self-reported pill taking stayed high. Depression scores dropped a little.
There was no control group, so we can’t say the device caused the drop. Still, the high use tells us patients will carry and answer a pocket coach.
How this fits with other research
Spackman et al. (2025) and Schieltz et al. (2022) later used the same remote idea for kids with autism. They coached parents through video calls and also saw 80 % behavior drops. The method moved from a tiny Palm Pilot to full home therapy.
Higgins et al. (2021) swapped the Palm for a website. Their online ACT modules also lived on phones and boosted mental health. Together these studies show the tool can change—Palm, website, Zoom—but the core stays: brief, scheduled, remote support.
McPherson-Baker et al. (2005) did the in-person version. Counselors taught HIV patients face-to-face to stay on meds. McGonigle et al. (2014) simply automated those same reminders. The new tech cut staff time but kept the message.
Why it matters
If you serve adults with bipolar or other chronic conditions, pocket prompts can fill the days between visits. You don’t need fancy apps—any smart device that beeps and records answers works. Start with one client this week. Program three daily check-ins asking, “Did you take it? How’s your mood?” Review the log at your next session. You’ll get real-time data and the client gets 24-hour support without 24-hour staff.
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02At a glance
03Original abstract
We evaluated the feasibility and acceptability of a 2-week-long ecological momentary intervention (EMI), delivered via personal digital assistants (PDAs), to improve treatment adherence in bipolar disorder. EMIs use mobile technology to deliver treatment as clients engage in their typical daily routines, in their usual settings. Overall, participants (N = 14) stated that EMI sessions were helpful, user-friendly, and engaging, and reported satisfaction with the timing and burden of sessions, as well as the method of delivery. All participants completed the study, and all PDAs were returned undamaged. On average, participants completed 92% of EMI sessions. Although this study was not designed to assess efficacy, depression scores decreased significantly over the study period and data suggest relatively high rates of treatment adherence; missed medication was reported 3% of the time and three participants reported missing a total of six mental health appointments. Negative feedback largely involved technical and logistical issues, many of which are easily addressable. These preliminary findings add to the growing body of literature indicating that mobile-technology-assisted interventions are feasible to implement and acceptable to patients with serious mental illnesses.
Behavior modification, 2014 · doi:10.1016/j.jad.2007.07.026