title: Developing mHealth Remote Monitoring Technology for Attention Deficit Hyperactivity Disorder: A Qualitative Study Eliciting User Priorities and Needs.
abstract: BACKGROUND
  Guidelines in the United Kingdom recommend that medication titration for attention deficit hyperactivity disorder (ADHD) should be completed within 4-6 weeks and include regular reviews. However, most clinicians think that weekly clinic contact is infeasible, and audits have shown that this timeline is rarely achieved. Thus, a more effective monitoring and review system is needed; remote monitoring technology (RMT) may be one way to improve current practice. However, little is known about whether patients with ADHD, their families, and clinicians would be interested in using RMT.
  
  
  OBJECTIVE
  To explore patients', parents', and health care professionals' views and attitudes toward using digital technology for remote monitoring during titration for ADHD.
  
  
  METHODS
  This was a qualitative study, and data were collected through 11 focus groups with adults and young people with ADHD, parents of children with ADHD, and health care professionals (N=59).
  
  
  RESULTS
  All participant groups were positive about using RMT in the treatment of ADHD, but they were also aware of barriers to its use, especially around access to technology and integrating RMT into clinical care. They identified that RMT had the most potential for use in the ongoing management and support of ADHD, rather than during the distinct titration period. Participants identified features of RMT that could improve the quality of consultations and support greater self-management.
  
  
  CONCLUSIONS
  RMT has the potential to augment support and care for ADHD, but it needs to go beyond the titration period and offer more to patients and families than monitoring through outcome measures. Developing and evaluating an mHealth app that incorporates the key features identified by end users is required.
authors.affiliation: NIHR MindTech Healthcare Technology Co-operative, University of Nottingham, Nottingham, United Kingdom.
authors.forename: Lucy
authors.identifier: http://orcid.org/0000-0001-8333-3094
authors.initials: L
authors.lastname: Simons
authors.forename: Althea Z
authors.identifier: http://orcid.org/0000-0003-2129-9278
authors.initials: AZ
authors.lastname: Valentine
authors.forename: Caroline J
authors.identifier: http://orcid.org/0000-0002-6707-5184
authors.initials: CJ
authors.lastname: Falconer
authors.forename: Madeleine
authors.identifier: http://orcid.org/0000-0002-5182-518X
authors.initials: M
authors.lastname: Groom
authors.forename: David
authors.identifier: http://orcid.org/0000-0002-3597-0408
authors.initials: D
authors.lastname: Daley
authors.forename: Michael P
authors.identifier: http://orcid.org/0000-0001-5682-6360
authors.initials: MP
authors.lastname: Craven
authors.forename: Zoe
authors.identifier: http://orcid.org/0000-0001-8736-877X
authors.initials: Z
authors.lastname: Young
authors.forename: Charlotte
authors.identifier: http://orcid.org/0000-0002-5412-6165
authors.initials: C
authors.lastname: Hall
authors.forename: Chris
authors.identifier: http://orcid.org/0000-0003-1083-6744
authors.initials: C
authors.lastname: Hollis
keywords: attention deficit hyperactivity disorder; eMental Health; feasibility testing; mHealth; mental health services; qualitative methods; remote monitoring technology; user requirements