Frequently Asked Questions

What is attune™?

Attune is the first and only prescription digital therapy app designed to treat symptoms of anxiety and depression among cancer patients. In partnership with patients and leading cancer experts, we built attune on the foundation of lived patient experiences and the science-backed principles of cognitive behavioral stress management (CBSM). It is available by prescription and intended to be used with other treatment modalities.

What is a prescription digital therapeutic (PDT)?

Prescription digital therapeutics (PDTs) like attune are a new class of medical devices that use software to treat medical diseases. PDTs require a medical prescription and may be reimbursable through health insurance.

PDTs utilize clinically validated therapeutic protocols, demonstrate safety and efficacy in randomized controlled trials, are regulated by the FDA, and directly treat medical diseases and measure improvement.

Why is attune™ a medical device?

The FDA regulates software that treats diseases as a "medical device". Since attune is indicated to improve the symptoms of anxiety and depression in adults with cancer, it is regulated by the FDA as a medical device.

How does attune™ work?

Attune will guide you through 10 sessions, each one building on the one before it. You’ll have the ability to record stress ratings, monitor your sleep, engage in relaxation exercises, and complete additional activities on a regular basis. Attune also includes a group feed, a community feature that allows you to connect with peers and share your experiences with the app. Attune will provide gentle notifications to assist you in forming new habits.

What will I gain from using attune™?

Attune helps you hone the skills necessary to cope with cancer-related stress and symptoms of anxiety and depression. The skills taught during sessions also build on a library of relaxation and meditation practices. You will learn to shift negative self talk, improve your sleep habits, and cultivate healthy coping skills that last beyond treatment through survivorship.

Who is attune™ for?

Attune is intended for adult cancer patients who are experiencing symptoms of anxiety and depression related to their cancer.

Is attune™ appropriate for any type and stage of cancer?

Attune will benefit adults experiencing any type of cancer at any stage, from diagnosis through survivorship.

Does attune™ replace outpatient therapy?

Attune is not intended to replace outpatient therapy. There will always be a need for traditional therapy and the healing benefits of human connection. We encourage using attune alongside regular check-ins with your oncologist and traditional in-person therapy.

Who makes attune™? Are medical professionals involved in attune's content creation?

Blue Note Therapeutics developed attune in collaboration with leading psycho-oncologists and patients to ensure the program is effective, engaging and easy for patients to complete. All content has been co-created with or reviewed by psychology and medical professionals and people who have experienced cancer firsthand.

Who is Blue Note Therapeutics?

Blue Note Therapeutics is a prescription digital therapeutics company dedicated to helping cancer patients live better. Our team aims to make therapy available to any patient, at any time, on patients’ own mobile devices. If you are interested in learning more about Blue Note Therapeutics, visit www.bluenotetherapeutics.com.

Is attune™ FDA approved?

Attune has not yet been reviewed by the U.S. Food and Drug Administration (FDA) and is currently the subject of ongoing clinical trials. Due to the ongoing public health emergency as a result of COVID-19, the FDA recognizes the urgent need to support cancer patients now more than ever and has enabled the attune’s immediate release to the public.

What is cognitive behavioral stress management (CBSM)?

Cognitive behavioral stress management (CBSM) is a proven therapy approach for cancer patients. Its key learnings include actionable coping tools, positive reframing strategies and relaxation exercises. Leading psycho-oncologists and trusted cancer advocacy groups recommend CBSM to boost emotional wellbeing while pursuing cancer treatment. CBSM was originally developed by clinical psychologist Michael Antoni, Ph.D. and has been studied since the early 1990s. The proven effects of CBSM have been published in multiple clinical studies, many of which can be found here.

How is CBSM typically administered?

Patients who receive CBSM therapy have historically attended face-to-face appointments with specially trained psychologists in ten, 90-120 minute sessions. Attune delivers the same therapeutic benefits in 10 digital sessions that take approximately 40 minutes each to complete. Exercises and homework are also assigned between sessions to strengthen newly learned skills and form habits.

What clinical data supports the use of CBSM?

CBSM has been studied extensively since the early 1990s and has been published in multiple clinical studies. Find key research and studies on this page.

How can I get attune™?

Attune is only available by prescription. Please consult with your physician if you would like to use attune.

Why does attune™ require a prescription?

According to the FDA, attune is a prescription digital therapy app and Class II medical device that is designed to treat anxiety and depression symptoms. Under FDA guidelines, attune requires a prescription.

Is attune™ available outside the United States?

Attune is currently only available to patients in the United States.

In what languages is attune™ available?

Attune is currently only available in English and will soon be available in Spanish. A similar but over-the-counter (OTC) app called attune ensemble™ is available in Spanish here: https://bluenotetherapeutics.com/ensemble/es/.

How much does attune™ cost?

During the COVID public health emergency, Blue Note is working with oncologists and cancer centers to provide attune™ at no cost to patients. In the longer term, attune will be reimbursed by payers such as insurance companies.

How do I use attune™?

After receiving a prescription for attune, you will receive a text message containing an access code and instructions on how to download the app and activate your prescription. Once activated, attune will guide you through 10 sessions, each one building on the one before it. Exercises and homework are assigned between sessions to strengthen newly learned skills. Future sessions will be revealed as you continue to make progress in attune.

How often should I use attune™?

One of the greatest benefits of attune is the flexibility you have to complete treatment on your own schedule. Though you’re welcome to pursue the program at your own pace, we recommend you complete one session every week and set aside time in your schedule to practice the relaxation techniques you’ve learned. Attune is most effective when your practice your learnings consistently.

Do I have to complete each session in one sitting?

Not at all! While you are welcome to complete each session in one sitting, you will be able to pick up where you left off should you be unable to complete it all at once

How long does it take to complete each treatment session?

Each session takes about 40 minutes to complete. Then after each session, you will be assigned accompanying exercises that will take about 30 minutes per day for 3 to 4 days. You must complete these tasks before beginning the next session. We recommend that patients complete each session and its accompanying exercises in a quiet location without disturbances.

Why do the sessions take so long? I’ve used relaxation apps that only take 10 minutes.

Attune’s sessions offer patients more than relaxation and meditation exercises. Our clinically validated treatment program delivers a digitized version of cognitive behavioral stress management (CBSM), a proven and effective therapeutic method specific for cancer patients. Each session takes about 40 minutes to maintain the clinical integrity of the CBSM method.

Am I required to complete all sessions of attune™ in a sequential order?

Yes, all 10 sessions must be completed in order, including the required exercises and homework accompanying each session. You are welcome to revisit any sessions or exercises that you have already completed in any order you’d like. You can access the content (articles, videos, and relaxation exercise audios unlocked from your progress) anytime in the Resource Library.

What are the functions of the Help feature?

The Help feature provides technical support and contact information to numerous support organizations, both online and in real time. You may also use this function to report any issues you’re experiencing with the app. The Help feature is available in the lower right-hand corner of every screen while running the program.

For additional assistance troubleshooting, you can also contact the Blue Note Therapeutics Help Center at 415-200-3697 or .

Please note that the Help feature is not an emotional support hotline or counseling service. If you are feeling suicidal, have thoughts of harming yourself, or are experiencing a life-threatening medical or psychiatric emergency, we urge you to call 911 and get emergency help right away.

What is the purpose of the Resource Library?

The Resource Library houses all the tools available to you, including informational content related to the sessions and exercises (e.g., relaxation exercises and meditation practices). Content in the library is unlocked as you progress through attune and is accessible anytime during the progress. You do not have to wait until you complete the attune program to view unlocked content.

What is the purpose of the Stress History feature?

The Stress History feature shows a graph of your stress levels as you progress through attune. You may access it via Profile > Progress. Even if you notice fluctuating stress patterns or don’t see an immediate reduction in your stress ratings, it is important to keep practicing the skills and relaxation exercises to experience the greatest long-term benefits of the program.

What is the purpose of the Sleep Monitoring feature?

The Sleep Monitoring feature is used to monitor your sleep quality between sessions. You’ll fill in the time you go to bed and the estimated time you fall asleep. On the backend, the Sleep Monitoring feature will calculate the minutes you take to fall asleep.

After completing a session, you will be asked to complete three or four sleep entries, including total hours of sleep, minutes to fall asleep, number of times awoken, and your quality of sleep. These assigned entries must be completed before advancing to the next session, but you’re welcome to add additional sleep monitoring entries at any time.

What is the purpose of the Group feature?

The attune Group feature is a virtual support community exclusive for attune patients. Users can connect with other attune patients for support and learn how they utilize the stress management and coping skills that are introduced in attune.

Why do I have to complete skills exercises, sleep monitoring entries and relaxation practice before I have access to the next session?

The success of cognitive behavioral stress management (CBSM) depends on the ability to practice modifying behaviors over time until those behaviors become habitual. The more you practice each skill and learn to recognize thought patterns, stress responses, and changes in sleep quality, the more you will benefit from attune.

Why can’t I access the next session?

After completing a session, you will be assigned required tasks that must be completed before moving on to the next one. If you cannot access your next session, check the My Exercises section of the Menu to verify that you have completed all required tasks from the previous module.

Will I receive notifications from attune™?

Attune will send you notifications to remind you to complete assigned exercises and tasks associated with sessions, as well as notifications based on your planned activities. You may also receive nudges to encourage you to continue your progress through the treatment program. If you prefer to not receive notifications, you can disable notifications in the Settings section of the menu.

How can I enable or disable notifications from attune™?

If you would like to enable or disable notifications from attune, visit the Settings section of the Menu. From there, you can enable or disable notifications by touching the toggle switch next to ‘Notifications.’

Am I required to record my responses in attune™ using an audio recording?

You are welcome to capture audio responses via the mobile native voice-to-text conversion capability, but this is not required. You can choose audio or text format for your responses.

Do I need internet access to use attune™?

Yes. You will need internet access or data coverage to complete sessions within attune.

When I use attune™ on a mobile device, will it affect my data usage?

If your mobile device is connected to a Wi-fi network, it will not affect your data usage. However if you are not connected to Wi-fi, data rates will apply.

How do I get an access code for attune™?

To receive an access code for attune, you first need to receive a prescription from your physician. Once a prescription is submitted, you will receive a text message with an access code and instructions to guide you through the process of downloading and activating attune.

I lost my access code. Can I get a new one?

Of course! If you lose your access code, please call the Blue Note Therapeutics Help Center at 415-200-3697 or email help@bluenotetx.com to receive a new access code.

My access code doesn’t work. What should I do?

Access codes expire after 9 days. If your access code doesn’t work, you may need to request a new access code to activate your prescription. Please contact the Blue Note Therapeutics Help Center at 415-200-3697 or email help@bluenotetx.com to receive a new access code.

My doctor prescribed me with attune™ but I never received an access code. How do I activate my prescription?

If it has been more than 9 days since you received your prescription and you never received a text message containing an access code, please contact the Blue Note Therapeutics Help Center at 415-200-3697 or email help@bluenotetx.com to receive a new access code.

When I tried to activate my account, my birthday was not valid. How do I activate my account?

If the birthday you enter during attune activation does not match the birthday on your prescription, you will not be able to activate your account. If you receive an alert that your birthday is not valid, please contact the Blue Note Therapeutics Help Center at 415-200-3697 or email help@bluenotetx.com for help with activating your account.

Will my prescription expire?

Your prescription will expire 180 days after prescription activation. If you would like to continue using attune, you can request that your health care team provide an updated prescription.

Can attune™ be re-prescribed?

Yes! Please consult your physician about renewing your attune prescription.

My attune prescription has almost ended. Can I keep the program on my phone afterward?

When your prescription expires 180 days after activation, you will no longer have access to attune content. Please consult your physician about re-prescribing attune.

Device Support

What devices are supported? What are the technology requirements for attune™?

Attune is compatible with most current iOS and Android phones or tablets from most manufacturers running:

• iOS version 14.0 or higher
• Android version 11.0 or higher

Please note that if you do not have auto-updates set up on your advice, you will need to manually update the app to use the latest version of attune.

Will my progress sync if I use both a phone and a tablet device?

Yes, your progress through attune is securely stored on Blue Note Therapeutics servers. If you would like to continue using attune on a new device, simply download the app and log in with your username and password. You will be able to pick up right where you left off.

Login Support

How do I change the username or password I use to log in to attune™?

If you would like to change your username and password, visit the Menu within attune, click on the Settings icon, and select Personal Information.

Do I have to log in each time I use attune™?

To keep your personal information secure, you will need to sign in each time you access the app.

I lost my password. How do I retrieve it?

If you lost your password and can no longer access attune, visit the login screen and click on “Forgot your password.” After you enter your username and click “continue,” we will use the email address stored on your account to send you a password reset code. Once you enter the reset code, you will have to choose and confirm a new password.

I lost my username. How do I retrieve it?

If you lost your username and can no longer access attune, contact the Blue Note Therapeutics Help Center at 415-200-3697 or email help@bluenotetx.com for assistance resetting your username and password.

Other

How can I enable/disable microphone access?

Visit Settings within the Menu, and click on the Preferences tab. From the Preferences tab, you can click on the toggle next to Microphone Access to enable or disable access.

Why can’t I hear the videos? I turned up my volume and everything!

On an iPhone, you may need to flip the Ring/Silent switch on the left-hand side of the phone. If that doesn’t work, tap the video and then tap the speaker icon in the upper-right corner to unmute.

How do I delete attune from my phone?

You can delete attune from your phone the same way you delete other apps from your phone. If you are using an iPhone or iPad, press and hold down the attune application icon on your screen. Once the application icon wiggles, you can click the “x” in the upper corner to delete the application.

If you are using an Android device, open the Google Play store application and tap on the Menu. Visit My Apps and Games, find and select the attune application, and then tap Uninstall.

Your data will still exist on cloud servers after you delete the application from your device, so if you delete it by accident, you will be able to re-download the program, log in, and pick up where you left off.

What happens to my information? Is it kept confidential?

Your information is stored securely on Blue Note Therapeutics servers and will not be shared with anyone without your explicit consent.

We want you to be aware of what information we do and do not collect, why we collect it, what we use it for, and how we store it. We believe strongly in patients’ ability to control the use of their information.

To learn more about our privacy policy, click here.

Where is my data stored?

Your data will be stored on a secure cloud server.

Is attune™ HIPAA compliant? Is attune™ secure?

Attune is HIPAA compliant and secure. To learn more about our privacy policy, click here.

What information from attune™ is sent to my clinician?

None of your information stored in attune will be shared with your clinician without your permission.

Who else can see the information entered into attune™?

Your information is stored securely on Blue Note Therapeutics servers and will not be shared with anyone without your explicit consent. To learn more about our privacy policy, click here.

Can I request that Blue Note delete my data?

Yes, you may request that Blue Note delete your data. Contact the Blue Note Therapeutics Help Center at 415-200-3697 or email help@bluenotetx.com.

What is attune™’s Privacy Policy?

You will have to agree to the terms of our Privacy Policy before you can use attune. You can access the Privacy Policy here.

Where can I find the Terms of Use for attune™?

Terms of Use for attune™ can be found here.

Still have an unresolved question? Contact the Blue Note Therapeutics Help Center at 415-200-3697 or email help@bluenotetx.com.