Improvements in or relating to cognitive behavioural therapy to help manage the menopause

Abstract

In the field of menopause symptom management there is a need for improvements in the delivery of cognitive behavioural therapy (CBT) to help manage those symptoms. A computer implemented method (10) of selecting a predetermined cognitive behavioural therapy pathway (36, 40, 44, 48), to help manage the menopause, comprises the steps of: receiving (12) personal data (14) relating to a user; assessing (16) the received personal data (14) to establish (18) a menopause presentation type (34, 38, 42, 46) from a plurality of predetermined menopause presentation types (34, 38, 42, 46); allocating (20) a predetermined cognitive behaviour therapy pathway (36, 40, 44, 48) according to the established menopause presentation type (34, 38, 42, 46); and generating data for presenting the allocated predetermined cognitive behaviour therapy pathway in a user interface (80).

Description

[0001] IMPROVEMENTS IN OR RELATING TO COGNITIVE BEHAVIOURAL THERAPY TO HELP MANAGE THE MENOPAUSE

[0002] This invention relates to a computer implemented method of selecting a predetermined cognitive behavioural therapy pathway to help manage the menopause, a data processing device configured to carry out such a method, a computer program comprising instructions which, when the program is executed by a computer, cause the computer to carry such a method, and a computer-readable storage medium comprising instructions which, when executed by a computer, cause the computer to carry out such a method.

[0003] Millions of people currently experience significant menopausal symptoms, including hot flushes, night sweats, anxiety, fatigue and sleep problems. For many people, this has a negative impact on their mental health, as well as affecting them at work.

[0004] Cognitive behavioural therapy (CBT) can help people experiencing such symptoms, but access to CBT remains poor, not least due to a lack of qualified clinicians able to design, implement and manage a CBT treatment programme, as well as a lack of funding.

[0005] According to a first aspect of the invention there is provided a computer implemented method of selecting a predetermined cognitive behavioural therapy pathway to help manage the menopause, the method comprising the steps of: receiving personal data relating to a user; assessing the received personal data to establish a menopause presentation type from a plurality of predetermined menopause presentation types; allocating a predetermined cognitive behaviour therapy pathway according to the established menopause presentation type; and generating data for presenting the allocated predetermined cognitive behaviour therapy pathway in a user interface.

[0006] Assessing a user's personal data and establishing a predetermined menopause presentation type from a plurality of menopause presentation types allows for the provision of a common core of pathway steps applicable to all users with menopause symptoms, as well as a manageable number of tailored pathway steps specifically aimed at a particular presentation type. As a consequence, the method of the invention is able to provide curated therapy pathways that are better-suited to, and therefore more effective for, users, but which are not so numerous that their effectiveness cannot be validated across a manageable user cohort.

[0007] This is in contrast to both (i) conventional linear-based cognitive behavioural therapy programmes with a single therapy pathway which force on often ill-suited one-size- fits-all approach on users, and (ii) Just In Time Adaptive Interventions ("JITAIs") that, while being able to modify support corresponding to a real-time need, are all but impossible to validate because of the thousands of potential therapy pathways available for each user within a given user cohort.

[0008] Preferably the plurality of predetermined menopause presentation types have menopause expectation characteristics.

[0009] The menopause expectation characteristics may include a menopause expected characteristic and a menopause unexpected characteristic.

[0010] The inclusion of such menopause expectation characteristics is advantageous because it allows for a distinction to be made between users that may or may not have additional challenges, e.g. because of the shock and stress of an unexpected, i.e. "early", menopause. Thus the method of the invention is able to provide specific tailoring of cognitive behaviour therapy pathways to help tackle such additional challenges, such as an unexpected loss of fertility and isolation that may accompany an unexpected, early menopause.

[0011] Optionally the received personal data includes physiological age data in the form of a user's chronological age, and the method identifies: a menopause expected characteristic when the user's chronological age is equal to or greater than a first threshold; and a menopause unexpected characteristic when the user's chronological age is less than the first threshold.

[0012] Including physiological data in the form of a user's chronological age is beneficial because it provides a reliable and readily deployable way of determining when a user would usually be expected to have naturally entered the menopause, e.g. as part of ageing, and thereby make a determination as to whether the onset of menopause is likely to be expected or unexpected. In a preferred embodiment of the invention the received personal data additionally includes psychiatric data in the form of whether a user self identifies as undergoing an unexpected menopause, and when a user does not self-identify as undergoing an unexpected menopause the method reduces the first threshold to a lower second threshold and identifies: a menopause expected characteristic when the user's chronological age is equal to or greater than the second threshold; and a menopause unexpected characteristic when the user's chronological age is less than the second threshold.

[0013] Such steps desirably permit a tuning of the identification of menopause expectation characteristics according to a user's lived experience.

[0014] Preferably the plurality of predetermined menopause presentation types have medical causation characteristics.

[0015] The medical causation characteristics may include a relevant medical history characteristic and a no relevant medical history characteristic.

[0016] The inclusion of medical causation characteristics is advantageous because it allows for a distinction to be made between users that may have had a medically induced menopause and those that have not, and so similarly allows for specific tailoring of cognitive behaviour therapy pathways to help tackle the additional challenges that, e.g. users which have experienced a medically induced menopause might have. For example, someone who has entered menopause as a result of chemotherapy treatment for cancer, may find themselves suddenly dealing with a range of issues and concerns. This could include a sudden, abrupt onset of menopause symptoms. Further, for those people entering menopause earlier than expected, loss of fertility and broader concerns around their health may require additional consideration and support.

[0017] Optionally the received personal data includes physiological medical data in the form of whether a user has undergone one or more menopause-inducing medical procedures

[0018] Such a step beneficially provides a reliable way of determined whether there has been a medical cause of the menopause. In another preferred embodiment of the invention the step of assessing the received personal data to establish a menopause presentation type from a plurality of predetermined menopause presentation types includes checking whether one or more menopausal symptoms are present and establishing a no-menopause presentation type if not.

[0019] A benefit of additionally checking whether one or more menopausal symptoms are present is that is allows a user's suitability for, and more importantly their likelihood of benefiting from, an allocated cognitive behavioural therapy pathway to be assessed before embarking on the pathway.

[0020] Preferably the received personal data includes physiological symptom data in the form of whether vasomotor symptoms are present and / or whether a user's periods are disrupted, and the method establishes a no-menopause presentation type only if vasomotor symptoms are not present and a user's periods are not disrupted.

[0021] Such physiological symptom data advantageously indicate in a reliable manner the presence or otherwise of menopausal symptoms, and thus permit the ready establishment of a no-menopause presentation type, e.g. in circumstances where a user is unlikely to benefit from embarking on an allocated cognitive behavioural therapy pathway. Consequently it can be suggested to such users that there would be little merit in continuing.

[0022] In another preferred embodiment of the invention, the method further comprises receiving the physiological symptom data in the form of user-entered data from a user interface.

[0023] Optionally the method further comprises receiving, via the user interface, user-entered data in the form of at least one physical parameter of or corresponding to the user, the at least one physical parameter associated with whether the vasomotor symptoms are present and / or whether the user's periods are disrupted.

[0024] In this way, the user can provide physiological symptom data to the method of this preferred embodiment of the invention in an effective manner, thereby improving method useability.

[0025] In a further preferred embodiment of the invention, absent the establishment of a nomenopause presentation type at least one of the following occurs: a first menopause presentation type is established when the menopause expected characteristic and the no relevant medical history characteristic are both identified, and thereafter a first cognitive behavioural pathway is allocated to the user; a second menopause presentation type is established when the menopause unexpected characteristic and the no relevant medical history characteristic are both identified, and thereafter a second cognitive behavioural pathway is allocated to the user; a third menopause presentation type is established when the menopause expected characteristic and the relevant medical history characteristic are both identified, and thereafter a third cognitive behavioural pathway is allocated to the user; and a fourth menopause presentation type is established when the menopause unexpected characteristic and the relevant medical history characteristic are both identified, and thereafter a fourth cognitive behavioural pathway is allocated to the user.

[0026] Such steps provide a desirable number of curated, individual therapy pathways, each of which is best-suited to the particular corresponding menopause presentation type and therefore especially effective for such a corresponding presentation type, with it being readily possible also to validate such effectiveness across a given user cohort.

[0027] The received personal data may include user wellbeing information, and preferably such user wellbeing information is updated while a user is following an allocated cognitive behavioural therapy pathway.

[0028] Receiving user wellbeing information permits, at the very least an initial benchmark to be set against which changes in user wellbeing can be measured as a user works along a given allocated cognitive behavioural therapy pathway.

[0029] Additionally, updating such information while a user is working along a therapy pathway allows for a monitoring of user wellbeing as they move along a given therapy pathway.

[0030] Optionally the number of predetermined menopause presentation types and corresponding number of cognitive behavioural therapy pathways is increased in response to changes in monitored user wellbeing information. Increasing the number of predetermined menopause presentation types allows users to be more accurately classified in the future, with the corresponding increase in the number of cognitive behavioural therapy pathways providing even more tailoring, and therefore even more effective outcomes, all while remaining readily verifiable.

[0031] In a further preferred embodiment of the invention, the method further comprises presenting the allocated predetermined cognitive behaviour therapy pathway in a user interface according to the generated data.

[0032] In turn, the user (or person associated with the user, such as a therapist) may view the predetermined cognitive behaviour therapy on a convenient device, e.g., a mobile device or other user device.

[0033] According to a second aspect of the invention there is provided a data processing device configured to carry out the method described hereinabove.

[0034] According to a third aspect of the invention there is provided an apparatus comprising the data processing device of the second aspect and a user interface, the apparatus configured to carry out the corresponding preferred method(s) described hereinabove.

[0035] According to a fourth aspect of the invention there is provided a computer program comprising instructions which, when the program is executed by a computer, cause the computer to carry out the method described hereinabove.

[0036] According to a fifth aspect of the invention there is provided a computer-readable storage medium comprising instructions which, when executed by a computer, cause the computer to carry out the method described hereinabove.

[0037] The second, third, fourth and fifth aspects of the invention share the benefits of the corresponding steps of the method of the invention.

[0038] It will be appreciated that the use of the terms "first" and "second", and the like, in this patent specification is merely intended to help distinguish between similar features, and is not intended to indicate the relative importance of one feature over another feature, unless otherwise specified.

[0039] Within the scope of this application it is expressly intended that the various aspects, embodiments, examples and alternatives set out in the preceding paragraphs, and the claims and / or the following description and drawings, and in particular the individual features thereof, may be taken independently or in any combination. That is, all embodiments and all features of any embodiment can be combined in any way and / or combination, unless such features are incompatible. The applicant reserves the right to change any originally filed claim or file any new claim accordingly, including the right to amend any originally filed claim to depend from and / or incorporate any feature of any other claim although not originally claimed in that manner.

[0040] There now follows a brief description of preferred embodiments of the invention, by way of non-limiting examples, with reference being made to the following figures in which:

[0041] Figure 1 which shows a schematic view of a computer implemented method of selecting a predetermined cognitive behavioural therapy pathway to help manage the menopause according to a first embodiment of the invention;

[0042] Figure 2 shows a schematic view of an example level within such a predetermined cognitive behavioural therapy pathway; and

[0043] Figure 3 shows a schematic view of example progress tracking within the level shown in Figure 2.

[0044] A computer implemented method of selecting a predetermined cognitive behavioural therapy pathway to help manage the menopause is designated generally by reference numeral 10, as shown in Figure 1.

[0045] As shown schematically the method of the invention 10 comprises the following main steps: receiving 12 personal data 14 relating to a user (not shown); assessing 16 the received personal data 14 to establish 18 a menopause presentation type from a plurality of predetermined menopause presentation types; allocating 20 a predetermined cognitive behaviour therapy pathway to a user according to the established menopause presentation type; and generating data for presenting the allocated predetermined cognitive behaviour therapy pathway in a user interface 80.

[0046] In the embodiment method shown, there are five predetermined menopause presentation types, as will described in more detail below. Other embodiments may have fewer than or more than five predetermined menopause presentation types, however. In any event the predetermined menopause presentation types have menopause expectation characteristics, and more particularly have a menopause expected characteristic 22 and a menopause unexpected characteristic 24.

[0047] In addition, the received personal data 14 includes physiological age data in the form of a user's chronological age, and the method 10 identifies a menopause expected characteristic 22 when the user's chronological age is equal to or greater than a first threshold, which preferably is 45 years of age, although this need not necessarily be so. Also, the method 10 identifies a menopause unexpected characteristic 24 when the user's chronological age is less than the first threshold, e.g. less than 45 years of age.

[0048] The received personal data 14 also includes psychiatric data in the form of whether a user self identifies as undergoing an unexpected menopause, and when a user does not self-identify as undergoing an unexpected menopause the method reduces the first threshold to a lower second threshold, which preferably is 40 years of age, although this may be different in other embodiments of the invention.

[0049] Thereafter, i.e. in circumstances where a user does not self-identify as undergoing an unexpected menopause and the method 10 reduces the first threshold to the lower second threshold, e.g. 40 years of age, the method instead goes on to identify a menopause expected characteristic 22 when the user's chronological age is equal to or greater than the second threshold, e.g. 40 years, and to identify a menopause unexpected characteristic 24 when the user's chronological age is less than the second threshold, e.g. 40 years of age.

[0050] In addition to the foregoing, the plurality of predetermined menopause presentation types have medical causation characteristics which, more particularly, include a relevant medical history characteristic 26 and a no relevant medical history characteristic 28.

[0051] Moreover, the received personal data additionally includes physiological medical data in the form of whether a user has undergone one or more menopause-inducing medical procedures. Such menopause-inducing medical procedures include, but are not limited to, surgical-induced menopause procedures (such as an oophorectomy or a radical hysterectomy), radiation treatment, chemotherapy or hormone therapy. Additionally, the step of assessing 16 the received personal data 14 to establish 18 a menopause presentation type includes checking whether one or more menopausal symptoms are present and establishing a no-menopause presentation type 30 if not.

[0052] To facilitate this check the received personal data 14 includes physiological symptom data 32 in the form of whether vasomotor symptoms are present, e.g. hot flushes and / or night sweats, and / or whether a user's periods are disrupted, e.g. they have irregular periods or have had no periods for twelve months or more.

[0053] The method 10 may include a step of receiving the physiological symptom data 32 in the form of user-entered data from a user interface 80, and may include a further step of receiving, via the user interface 80, user-entered data in the form of at least one physical parameter of or corresponding to the user, the at least one physical parameter associated with whether the vasomotor symptoms are present and / or whether the user's periods are disrupted.

[0054] The user interface 80 improves method useability by allowing a user to effectively provide physiological symptom data. In example embodiments where user-entered data is in the form of at least one physical parameter of or corresponding to the user, the at least one physical parameter may be a temperature of the user when experiencing hot flushes, and / or the presence of sweat (e.g., when the user is experiencing night sweats).

[0055] Also, the method 10 establishes 18 the no-menopause presentation type 30 only if there is no physiological symptom data 32, i.e. only if vasomotor symptoms are not present and a user's periods are not disrupted. In other words, the method of the invention 10 will establish 18 a no-menopause presentation type 30 only if a user is not having hot flushes and / or night sweats, and their periods are essentially normal, i.e. only in the event that a user does not have any classical menopausal symptoms and as a result there is no physiological symptom data 32. Such establishment is therefore useful in subsequently suggesting to a user that they would probably not benefit for any allocated predetermined cognitive behavioural therapy pathway.

[0056] Thereafter, absent the establishment 18 of a no-menopause presentation type 30, i.e. providing some physiological symptom data 32 is present, in the embodiment method 10 shown each of the following occurs: a first menopause presentation type 34 is established when the menopause expected characteristic 22 and the no relevant medical history characteristic 28 are both identified, and thereafter a first cognitive behavioural pathway 36 is allocated; a second menopause presentation type 38 is established when the menopause unexpected characteristic 24 and the no relevant medical history characteristic 28 are both identified, and thereafter a different, second cognitive behavioural pathway 40 is allocated; a third menopause presentation type 42 is established when the menopause expected characteristic 22 and the relevant medical history characteristic 26 are both identified, and thereafter a further different, third cognitive behavioural pathway 44 is allocated; and a fourth menopause presentation type 46 is established when the menopause unexpected characteristic 24 and the relevant medical history characteristic 26 are both identified, and thereafter a stiff further different, fourth cognitive behavioural pathway 48 is allocated.

[0057] In other embodiments, however, fewer than all of the aforementioned steps may occur.

[0058] The method of the invention 10 may, additionally, distinguish between different vasomotor symptoms, e.g. the presence of hot flushes only, the presence of night sweats only, and the presence of both hot flushes and night sweats, and thereafter allocate further, different cognitive behavioural pathways (not shown) according to such distinctions. Also, the received personal data 14 may include physiological symptom data 32 in the form of the prevalence of such vasomotor symptoms, e.g. on a scale of 0 to 4.

[0059] Each cognitive behavioural pathway 36, 40, 44, 48 has six levels, each of which level approximates to one traditional in-person weekly session of cognitive behavioural therapy.

[0060] Each level, an example level 50 being illustrated schematically in Figure 2, has ten steps 52 (only five of which are shown in Figure 2) that may include one or more video steps, one or more audio steps, a written article step, one or more question and answer steps, and one or more reflection steps.

[0061] Optionally any remaining future steps 54 in a given level 50, i.e. not a completed step 56 or a current step 58, are locked out such that they cannot be accessed by a user until the preceding steps have been completed. Within each level 50 a user has access to additional resources 60, such as mindfulness meditations, guides to common symptoms and personal stories.

[0062] Also within each level 50 a user can access their notes 62, i.e. an automatically generated, individual note summarising each completed step, including their responses where appropriate. In this way a user is able to refresh and review their progress along a given cognitive behavioural therapy pathway 36, 40, 44, 48.

[0063] In addition to the foregoing, the received personal data 14 includes user wellbeing information, which as well as the frequency and severity of any vasomotor symptoms, may also include an indication of how well (or not) the user is sleeping, and also their mood. The latter information may be self-determined and / or determined by a medical professional.

[0064] Preferably the user wellbeing information is updated while a user is following a given allocated cognitive behavioural therapy pathway 36, 40, 44, 48, i.e. as well as the received personal data 14 including user well being information prior to starting a given cognitive behavioural therapy pathway 36, 40, 44, 48, the received personal data 14 includes user well being information collected throughout the given pathway 36, 40, 44, 48, e.g. at the start of each new level 50, as well as at the end 70 after completing the given pathway 36, 40, 44, 48.

[0065] In this way a user also has access to progress tracking 64 from within each level 50, e.g. in terms of a mood score 66 and a vasomotor symptom frequency and severity score 68.

[0066] Also, the number of predetermined menopause presentation types 34, 38, 42, 46 and corresponding number of cognitive behavioural therapy pathways 36, 40, 44, 48 may be increased in response to changes in monitored user wellbeing information, e.g. if a general decline or flatlining of user wellbeing is observed across a given user cohort then an increase in the number of predetermined menopause presentation types could be used to further increase the accuracy of user classification, and thereby permit even greater tailoring (and thereby even more effective outcomes) through a corresponding increase in the number of predetermined cognitive behavioural therapy pathways. The method 10 may include a further step of presenting the allocated predetermined cognitive behaviour therapy pathway in a user interface 80 (e.g., on a mobile phone or other convenient user device) according to the generated data.

Claims

CLAIMS:

1. A computer implemented method of selecting a predetermined cognitive behavioural therapy pathway to help manage the menopause, the method comprising the steps of: receiving personal data relating to a user; assessing the received personal data to establish a menopause presentation type from a plurality of predetermined menopause presentation types; allocating a predetermined cognitive behaviour therapy pathway according to the established menopause presentation type; and generating data for presenting the allocated predetermined cognitive behaviour therapy pathway in a user interface.

2. A computer implemented method according to Claim 1 wherein the plurality of predetermined menopause presentation types have menopause expectation characteristics.

3. A computer implemented method according to Claim 2 wherein the menopause expectation characteristics include a menopause expected characteristic and a menopause unexpected characteristic.

4. A computer implemented method according to Claim 3 wherein the received personal data includes physiological age data in the form of a user's chronological age, and the method identifies: a menopause expected characteristic when the user's chronological age is equal to or greater than a first threshold; and a menopause unexpected characteristic when the user's chronological age is less than the first threshold.

5. A computer implemented method according to Claim 4 wherein the received personal data additionally includes psychiatric data in the form of whether a user self identifies as undergoing an unexpected menopause, and when a user does not selfidentify as undergoing an unexpected menopause the method reduces the first threshold to a lower second threshold and identifies: a menopause expected characteristic when the user's chronological age is equal to or greater than the second threshold; and a menopause unexpected characteristic when the user's chronological age is less than the second threshold.

6. A computer implemented method according to any preceding claim wherein the plurality of predetermined menopause presentation types have medical causation characteristics.

7. A computer implemented method according to Claim 6 wherein the medical causation characteristics include a relevant medical history characteristic and a no relevant medical history characteristic.

8. A computer implemented method according to Claim 7 wherein the received personal data includes physiological medical data in the form of whether a user has undergone one or more menopause-inducing medical procedures.

9. A computer implemented method according to any preceding claim wherein the step of assessing the received personal data to establish a menopause presentation type from a plurality of predetermined menopause presentation types includes checking whether one or more menopausal symptoms are present and establishing a no-menopause presentation type if not.

10. A computer implemented method according to Claim 9 wherein the received personal data includes physiological symptom data in the form of whether vasomotor symptoms are present and / or whether a user's periods are disrupted, and the method establishes a no-menopause presentation type only if vasomotor symptoms are not present and a user's periods are not disrupted.

11. A computer implemented method according to Claim 10, further comprising: receiving the physiological symptom data in the form of user-entered data from a user interface.

12. A computer implemented method according to Claim 11, further comprising: receiving, via the user interface, user-entered data in the form of at least one physical parameter of or corresponding to the user, the at least one physical parameter associated with whether the vasomotor symptoms are present and / or whether the user's periods are disrupted.

13. A computer implemented method according to Claims 3 and 7, or any claim dependent thereon, wherein absent the establishment of a no-menopause presentation type at least one of the following occurs:a first menopause presentation type is established when the menopause expected characteristic and the no relevant medical history characteristic are both identified, and thereafter a first cognitive behavioural pathway is allocated to the user; a second menopause presentation type is established when the menopause unexpected characteristic and the no relevant medical history characteristic are both identified, and thereafter a second cognitive behavioural pathway is allocated to the user; a third menopause presentation type is established when the menopause expected characteristic and the relevant medical history characteristic are both identified, and thereafter a third cognitive behavioural pathway is allocated to the user; and a fourth menopause presentation type is established when the menopause unexpected characteristic and the relevant medical history characteristic are both identified, and thereafter a fourth cognitive behavioural pathway is allocated to the user.

14. A computer implemented method according to any preceding claim wherein the received personal data includes user wellbeing information, and preferably such user wellbeing information is updated while a user is following an allocated cognitive behavioural therapy pathway.

15. A computer implemented method according to Claim 14 wherein the number of predetermined menopause presentation types and corresponding number of cognitive behavioural therapy pathways is increased in response to changes in monitored user wellbeing information.

16. A computer implemented method according to any preceding claim, further comprising presenting the allocated predetermined cognitive behaviour therapy pathway in a user interface according to the generated data.

17. A data processing device configured to carry out the method of any of claims 1 to 11 and 13 to 15.

18. An apparatus comprising the data processing device of Claim 17 and a user interface, wherein the data processing device is configured to perform the method according to Claim 12 and / or Claim 16.

19. A computer program comprising instructions which, when the program is executed by a computer, cause the computer to carry out the method of any of claims 1 to 11 and 13 to 15.

20. A computer-readable storage medium comprising instructions which, when executed by a computer, cause the computer to carry out the method of any of claims 1 to 11 and 13 to 15.

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