For my senior project, I decided to create an app called Biply. Biply is an app that encourages people with bipolar disorder to take their medication as advised. It does so through gamification. When adhering to their medication schedule, users will get rewarded with discounted Lyft's to their therapy appointments, discounts at stores, or they can make a charitable donation.
It’s often difficult for those with bipolar disorder to self-initiate treatment & wellness strategies, especially during manic or depressed episodes.
Bipolar disorder accounts for:
• The highest suicide rate of any psychiatric condition.
• Over £342 million per year in the UK alone in direct healthcare.
Over 40% of bipolar patients are estimated to not be treatment compliant. For those patients, this leads to:
• Nearly 40% increase in cost of care per patient per year (£10,231 vs £7,379).
• Significantly increased risk of suicide compared to treated patients.
To understand the problem better, I asked myself the following questions:
Why is this problem important to solve?
Being treatment compliant means an increased likelihood of lessened or completely gone symptoms. With symptoms no longer present, those with the condition are able to participate in day-to-day activities without a compromised living experience.
What is the cause of the problem?
The main culprit of the problem is lack of medication adherence. According to the National Library of Medicine (NLM), only 50% of patients diagnosed with bipolar disorder adhere to medication requirements long term. Medication is the primary form of treatment for those with bipolar disorder, so it's important for patients to take their medication as advised.
Who is affected by this problem?
Both men and women are roughly equal to being diagnosed with the disorder. However, most cases of bipolar disorder start when individuals are aged 15–19 years. The second most frequent age range of onset is 20–24 years.
I took to Facebook and Reddit to ask people who have been diagnosed with bipolar disorder on why they haven't stuck to taking medication long term. The main reasons mentioned were:
• They simply just don't want to do it.
• They are worried about the stigma associated with taking medication.
• They haven't seen any immediate benefits.
• They don't like the side effects they experience when taking the medication.
• They forget to take their medication on time.
I also asked people with bipolar disorder that do take medication on how they have continued to take their medication long term. The main responses I got were:
• They use a pill box.
• They use a pill reminder app.
What I gathered after conducting these user interviews is that there isn't a strong incentive to continue taking medication. In order to see benefits in one's mental health, patients need to take their medication long term. However, when dealing with initial side effects, having to integrate taking medication into one's daily schedule and dealing with the stigma from others, adhering to medication requirements might not seem worth it.
I took a look to see what other pill reminder apps are doing to solve this problem. I looked for the top three pill reminder apps. The main goal when conducting the analysis was to identify strengths and good practices I could adopt as well as weakness and usability issues to avoid.
• Easy navigation.
• Auto Fill prescription list search.
• Can add caregivers who will be alerted if you don’t take a dose.
• Has a diary to track medication side effects.
• Import medication from pharmacy.
• Lots of bugs. When I added a friend to send them an alert, they didn’t receive one. When I add a new medication and save it, it saves an incorrect dosage.
• No autofill
• Messaging is not clear. It says go on the medication page to add medication but the toast looks like a button. I thought the page i was on was the medication page.
• Navigation tab had 10 things on it. The structure of the information wasn’t clear.
• Reminds users when prescription is running low
• Autofill prescription list search
• Text is too small
• Drop down calendar doesn’t have any dates
• Unclear how to schedule time to take medication. The common imagery of the app is this circular rainbow gradient. Although it may be pretty, it’s not clear how it functions. After some trial and error, I learned that you tap and drag in a circle to schedule time. I think it's a bad design because it’s an uncommon pattern. If I had trouble understanding that as a person who is trying out a variety of apps and familiar with different patterns, older people will really struggle with it.
• Feels sterile. Other than the gradient, I don’t see any enjoyment with this app.
Overall, I noticed they had one big issue in common: they feel sterile. Nothing about the apps it felt encouraging or welcoming to users. For people who struggle to take their medication, it's important that they feel motivated to take their medication as advised.
Questions to Answer
After conducting my research, I thought about the questions that I needed to answer before designing my product which are:
1. How might I design a welcoming app experience?
2. How might I incentivize users to take their medication despite the side effects and social stigma?
I brainstormed potential solutions to each of the questions formed above:
How might I design a welcoming app experience?
• Welcome users when they open the app.
• Use warm and inviting colors.
• Rounded elements (e.g. buttons, cards, icons).
How might I incentivize users to take their medication despite the side effects and social stigma?
• Include a daily questionnaire and diary where users can report how they're feeling. This information will be reported to a doctor. If the information inputted is concerning, the doctor will be notified.
• Reward users for taking their medication. They can earn points to redeem rewards like discounted Lyft's to their doctors appointments, exclusive GoodRx coupons for their medication, and make charitable donations.
• Allow users to form groups with other users. Group members can remind each other to take their medication and help each other feel less alone and ashamed by being together. When all group members take their medication as scheduled, they can all earn additional points as well as a daily streak.
The MVP of this product is an app that reminds users with bipolar disorder to take their medication through the use of social gamification. Users will be able to form groups with other users to encourage each other to take their medication on time. As a reward, users will earn points which can later be redeemed for rewards. In addition, users can add doctors to report their experiences while being on medication.
Creating An Account
When creating an account, users must verify their phone number to insure that their information is secure. Once their number is verified, they can finish creating an account by adding their name and password.
Adding Medication and Doctors
Users continue with the onboarding process by adding a medication and doctor. Doctors are added with a unique ID code to ensure proper security. Once the user completes these steps, they will be taken to the homepage and informed that they can now start earning points.
Once the user is finished with the onboarding process, they will be taken to the homepage. From here, users are able to view their points, what rewards are available and their medication schedule.
Users can form teams with friends as a way to support each other. In addition to earn points individually. If all team members take their medication on time, they will earn additional points. When taking medication on time each consecutive day, team members can earn a daily streak.
Once a user levels up, they are prompted with a list of rewards to choose from. Once the user selects a reward, they are given the details on how to redeem it.
If a user doesn't take their medication on time, they will get a reminder from a team member.
Once a user returns to the app for the next day, they will be prompted to complete a questionnaire and journal entry. If the response from the questionnaire is concerning, their doctor will be notified.
I had a fun time working on this project. I learned a lot about how tech is being used to help promote a positive mental wellbeing. In a future iteration of this product, I would like to include an insights feature. The way it would work is it would track the questionnaire and diary entries and look for repeated keywords and phrases. With that information, it provide insights on if the user is entering a manic or depressive episode and what steps they can take to alleviate those episodes.