ICD Coach App: Interview With Samuel Sears, PhD

EPLD speaks with Dr. Sears about his interactive mobile phone “ICD Coach” app. Dr. Sears is a Professor in the Departments of Psychology and Cardiovascular Sciences at East Carolina University and the East Carolina Heart Institute in Greenville, North Carolina. He is a licensed psychologist in North Carolina and Florida..   

Tell us about the creation of the “ICD Coach” app, which is a product of a spin-off company called QOL (Quality of Life) Apps Inc. When was it launched?

ICD Coach was created to readily disseminate to ICD patients the psychological strategies and information that we use every day in our clinical work. These strategies have been examined in research trials and demonstrated value to patients in addressing their anxieties and worries. However, very few ICD patients around the world have access to mental health providers who are familiar with the ICD-specific challenges that our patients face. We sought to put our clinical work “in a bottle” using this format  for broader distribution in ICD Coach. It was launched in the Summer of 2012 on the Apple Store, and is priced at $4.99. 

What is the purpose of the app?

ICD Coach was designed to help ICD recipients cope with and overcome the psychosocial side effects associated with their device. The great advantage of a smartphone app is that it makes psychological information and strategies distributable and affordable to almost any patient in the developed world — with a smartphone. Effectively addressing these issues could dramatically improve overall patient quality of life and patient acceptance of ICD technology. 

Describe the components/features of the app. Tell us about some of the information available on the app.

• ICD Coach components include:
• Game Plans offer coping strategies for day-to-day issues, including strategies for confident thinking, confident behavior, and confident relationships.
• Coach’s Desk provides current interpretations of relevant medical topics.
• Self-Assessment allows ICD users to gauge their progress over time.
• Media delivers multimedia-based support and advice from coaches.
• Shock Plan gives patients steps to follow in the event of their device firing.
• Critical Events provides guidance on specific situations such as end-of-life protocols or product recalls.
• Nearby Clinics allows patients to locate medical facilities and doctors.

How many people have downloaded the app thus far? How often is the app updated?

I am unsure about how many copies have been downloaded. Our plan was to continue to provide updates on key research findings and breaking news in the field, but it has been difficult to maintain that plan due to very limited financial investment. We simply do not have the financial capital to keep programmers working with our current business plan. For now, the app is available as it has been developed, unless or until, we receive some capital investment. 

Who is this app best suited for (e.g., the ICD patient, patients considering an ICD, spouses, etc.)?

ICD Coach is written with primary attention to ICD patients, but ICD spouses are likely to find it equally engaging to understand the typical challenges and suggested strategies for managing issues for ICD patients. 

Why was it important to offer this type of solution to patients? What is the potential for this?

I wanted to create ICD Coach as a virtual “ICD life coach” for key challenges. We think we made a good first step at this goal. However, I am a psychologist and professor, and the business sides of this have been an eye-opening and humbling process. We succeeded in producing this alpha version, but the “sky is still the limit” if we were able to get more resources or form closer collaborations with key associations or patient groups. 

You’re known as a world authority on a nationally unique expertise: cardiac psychology. Do you think we’ll see more of a focus on cardiac psychology in the future? 

Thank you for your kind words. I think that cardiac psychology will continue to grow because the challenges of technologies will always include patient perceptions of risks and benefits. Patients will be able to be live longer, but they will also have to cope longer. The stressors are novel with technologies such as ICDs and LVADs, and the psychological and patient supports will have to innovate to be helpful as well. 

Tell us about the “Cardiac Comeback Clinic.” 

Our clinic at the East Carolina Heart Institute at East Carolina University is nationally unique because my clinic work is entirely integrated into the EP service here. My clinic is embedded in the EP clinic so that all of my patients visit the clinic the exact same way they do to see the electrophysiologist and EP nurse. We wanted the experience of treating the psychological side of their cardiac condition to be “routine” just like a medical checkup. We have a full day of 30-minute or one-hour appointments that would be consistent with a more traditional clinical practice for a health psychologist. However, we also have a full day of integrated care with our CHF clinic where we see patients in 15- to 30-minute segments as part of the multidisciplinary team.  

Of the different roles you serve — psychologist, patient advocate, researcher, and professor — which is most meaningful to you?

This is a great question because each of these roles are exciting for me in turn. I think the blend of researching a problem with behavioral science and then translating that into useful, practical information for each of the stakeholders is the most challenging and exciting. The physician and nurse can utilize our research in one way, and then I can turn and present the meaning of the work to patients in an ICD support group somewhere in a very different manner. I just want to create practical information that is useful to maximize the patient experience with an ICD. 

Are you planning future apps with QOL Apps Inc.?

Yes. We have other apps that we aspire to create, but we are continuing to focus on ICD Coach at this time.