Chloe Burke, a San Antonio resident, has lived with bipolar disorder most of her life. She was diagnosed a little more than 20 years ago, after the birth of her daughter. For Burke, learning the diagnosis helped confirm the reasons behind her daily challenges.

Burke is one of about 5.7 million adults or about 2.6% of the United States population age 18 and older living with bipolar disorder, also known as manic-depressive illness, according to the National Institute of Mental Health. This brain disorder causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks, impacting every facet of daily life.

Living with bipolar disorder improves when the person has accurate information about his or her changing mental states, to allow for proactive management of symptoms.

Dr. Charles Bowden developed the KIOS bipolar app to help patients stay in control of their symptoms.
Dr. Charles Bowden developed the KIOS bipolar app to help patients manage their symptoms. Credit: Courtesy photo.

Dr. Charles Bowden is a psychiatrist at UT Health San Antonio who saw the need for an easy-to-use tool for patients to manage bipolar symptoms better. He is one of the co-developers/investigators of the KIOS Bipolar app created in 2015 with funding from the National Institute of Mental Health. The app provides real time behavioral advice matched to an individual’s changing mental condition.

Bowden is an expert on bipolar disorder and the only scientist to receive all three of the top U.S. awards for mood disorder research: the Gerald L. Klerman Award of Depressive and Bipolar Support Alliance (2000): the NAMI Mind of American Scientific Research Award (2006); and the Falcone Prize for Outstanding Research in Mood Disorders (2008).

The study trial for the KIOS Bipolar app ended in Dec. 2016. Of 120 patients using it, about 50 are here at UT Health San Antonio. The year-long trial tested how well the app helped patients track bipolar symptoms to help them manage their mental states proactively.

Bowden has submitted the study’s results for review for the first assessment from independent reviewers. Burke was one of the patients in the KIOS Bipolar app study trial.

“The app would suggest you use meditation or try yoga, or it would recommend better sleep habits,” Burke said. “In short, the app encouraged me to become more aware of myself.”

Bowden was reasonably cautious about the app’s results and availability.

“The availability of this would be through a research and commercial biomedical development,” Bowden said. “The National Institute of Mental Health funded the pure research [for the study]; there is some follow up research that the Biomedical Development Corporation will do.”

Bowden will work with the corporation to help finish the development of the KIOS Bipolar app in 2017. Preliminary results for the app look promising.

The San Antonio-based Biomedical Development Corporation was founded in 1984 to work on innovative approaches to new medical technologies all the way from the development process into commercialization, in partnerships with researchers like Bowden on the KIOS Bipolar app.

Phyllis Siegel is CEO of Biomedical Development Corporation.
Phyllis Siegel is CEO of Biomedical Development Corporation. Credit: Courtesy photo.

“We’re aiming to get the software as a service (SaaS) on the market sometime in July,” said Phyllis Siegel, CEO of Biomedical Development Corporation. “This (SaaS) allows us to safeguard the patient’s data that gets collected as that person uses the app. We also have strong cybersecurity protocols included, of course, as this is considered a medical device.

“We’re also aware of the need for and are committed to the quality systems.”

Siegel emphasized the collaborative work behind the bipolar app. Dr. Richard Priesmeyer teaches strategic management and marketing in the Greehey School of Business at St. Mary’s University. Priesmeyer worked with Bowden and his team to develop the underlying algorithm.

“The trial with patients using the app went so well that 95% of the patients are willing to use the app once it’s available for commercial use,” Bowden said.

Bowden is a world-renowned professor and researcher in mood and anxiety disorders, and among the most seminal contributors to research methodologies for clinical research in bipolar disorder over the past quarter century. His research group developed the Bipolar Inventory of Symptoms Scale (BISS), a 42-item comprehensive rating scale of symptoms for bipolar disorder.

How Kios Bipolar Helps Patients

The KIOS Bipolar app differentiates itself from other available bipolar tracking apps such as Mood Tracking Diary by its unique algorithm, which provides better targeted tracking coupled with a streamlined app user experience.

Bowden explained how bipolar disorder is different from other general mood disorders such as depression.

“Bipolar disorder has a subset of symptoms with signs that manifest early on,” Bowden said. “If you can manage the condition when someone shows symptoms early, the outcomes are better for the patient.”

Typically, during an office visit, a medical professional would ask a patient 50 or 60 different questions as part of a diagnostic assessment, which then takes time to assess and track for that one point in time capture of a patient’s mental condition.

“In reality you get most of your information from less than 10 items to track,” Bowden said. “We thought to get experts’ input on where to look and what to track. Rather than overwhelm patients with 50 or 60 different questions in repeated assessments administered by medical staff, patients could use an app to track these indicators.”

KIOS’ algorithm allows users to track multiple interactions concurrently by answering three questions inherent to assessing a patient’s current status with a chronic disease. The app prompts the patient to answer, “Is it getting better? Is it getting worse? Is it staying the same?” to track the changes in mental conditions. The app’s algorithm provides level of precision not currently available with traditional statistical techniques used for patient assessments.

“The enthusiasm from participants reflected how much they felt better and functioned better,” Bowden said. “We didn’t use any research medications; [instead] we tracked patients more regularly than is typical.”

“I’ve tried other apps, but this one was much easier to use,” Burke said. “It was a more streamlined experience using it. I didn’t have to enter so much information.”

“By helping patients track their anxiety, worry, and sleep patterns, they can see that it’s not beyond their control and understanding,” Bowden said. “[This app helps] put the patients in a more powerful position by giving them the knowledge to make decisions, like taking a different approach in managing sleep conditions.”

In short, the app helps “put the patient in a position of more self-control rather than being in a state of out of control,” Bowden said.

Burke is eagerly looking forward to using the KIOS Bipolar app once it’s readily available.

“The app helps me deal better with my emotional states,” Burke said. “It’s portable so I can use it everywhere I go.”

Iris Gonzalez writes about technology, life science and veteran affairs.