What can actually be monitored between ADHD appointments?
More than services usually collect, and less than the phrase remote monitoring implies. Between visits a patient can record dose events and times, daily focus and sleep ratings, side effects with dates and intensity, wear off timing, and blood pressure and heart rate from a home monitor. What cannot be captured is anything requiring a clinician, a lab or a controlled setting.
A record of the schedule as it actually ran, rather than as it was prescribed.
Observations, and subjective ones. Useful as a weekly trend, not as a number.
Tagged with dates and intensity, so they line up against the dose change that preceded them.
The patient's own report of when the effect faded, which is the part a remote appointment cannot see.
A real measurement, taken in uncontrolled conditions on consumer equipment.
A home blood pressure reading is a real measurement taken in uncontrolled conditions on consumer equipment. A focus rating is an observation, and a subjective one. Both are useful in a titration review, for different reasons, and treating them as the same kind of evidence is where remote monitoring earns a bad name.
Used honestly, the value is not precision. It is coverage. A single clinic reading is one point; thirty home readings across a dose period is a shape.
Does remote monitoring need new hardware?
For ADHD titration, mostly no. The inputs that matter are dose timing, symptom response, side effects and cardiovascular readings. The first three need nothing but the patient's phone. The fourth needs a home blood pressure monitor, which many patients already own and which is inexpensive to buy.
Covers dose timing, symptom response, side effects and wear off. The patient already has one.
The only piece of equipment involved, and the one place a service could choose to help.
That matters commercially as well as clinically. Any monitoring programme that depends on issuing devices carries procurement, logistics, breakage and a support burden, and it puts a floor under how small a cohort can be worth running. A phone based diary has none of that, which means a service can try it with twenty patients rather than committing to two hundred. That low floor matters, because demand is not the constraint here: our page on NHS ADHD waiting times sets out the numbers behind the pressure, including the second queue for titration that sits behind the assessment one.
What is patient generated data worth in a review?
It is worth the reconstruction time it removes. Patient generated health data does not replace clinical judgement and it is not a measurement of anything the clinician could not otherwise ask about. What it does is arrive dated, consistent and complete, so the review opens with the interval already described rather than spending its first minutes assembling one.
In remote care that is a bigger deal than it sounds. An in person service gets incidental signal: how the patient looks, how they arrived, what the waiting room noticed. A video appointment gets very little of that. The interval between appointments is the entire clinical picture, and it is exactly the part that historically arrives as a shrug and an apology.
If the clinician still has to ask the questions the data was meant to answer, it is decoration. If the review opens with the answers on screen and the conversation starts at interpretation, it is doing its job.
Where does remote monitoring fall down?
At the point where it is treated as clinical measurement. Self reported ratings carry the biases of the person reporting them. Home blood pressure readings come from consumer equipment used in uncontrolled conditions. Any modelled concentration curve is built from published population parameters, not from a plasma sample, and individuals vary from a population.
There are two failure modes worth naming, and both are avoidable.
Over collection
Asking a patient with ADHD to complete a long daily form is asking them to fail, and a dataset with a compliance cliff in week two is worse than no dataset, because it looks like non adherence when it is really abandonment of the tool.
Over reading
Taking a pattern in self reported data and treating it as a finding rather than a question worth asking in the room.
The fix for the first is to keep the daily ask down to seconds. The fix for the second is to present every pattern as a question rather than a conclusion, which is a design decision rather than a disclaimer.
A diary that survives the second week.
ADHDose is a consumer medication diary for adults on ADHD medication, covering UK, EU and US formulations. Patients log doses, sleep, focus, side effects, blood pressure and heart rate on their own phone, with sleep optionally synced from the phone's health platform, and the app compiles a structured report they bring to their next appointment. Every entry is the patient's own record, logged as it happened rather than remembered in the room, and prescribing decisions stay with the clinician. Data stays on the device by default.
For the patient, the daily ask is small enough to keep up with and the payoff is arriving at a remote appointment with something to point at. For the clinician, it is a defensible record of the interval, grouped by dose period, with notable patterns phrased as questions rather than conclusions. No hardware, no portal, no integration, nothing for your team to run.
What remote services ask us first
ADHDose is a consumer medication diary, not a regulated medical device. It does not diagnose, dose or advise, and its output is not clinically validated. All inputs are self reported, home blood pressure readings come from consumer equipment in uncontrolled conditions, and the modelled concentration curve is derived from published population pharmacokinetic parameters rather than from a plasma measurement. Report figures shown here are from a demonstration report built on demo data. This page is general information, not clinical advice. Written by ADHDOSE LTD, a UK company registered in England and Wales.