Constant innovation and technological advancement across healthcare applications from use of AI, ML to health monitoring have been helping stakeholders of the industry address the vast data pool while providing them with valuable insights.
Individuals with chronic health conditions have always required a regular interaction with doctors/health care providers & healthcare systems. Patients are constantly on the lookout for digitally enabled solutions that can help provide personalized and on-demand care. While the providers are implementing various digital tools for real-time monitoring and improved patient-platform engagement at affordable pricing, the Pandemic has accelerated the adoption of virtual care with a rising focus on affordable and preventive care digital solutions.
Digital Therapeutics (DTx) is one such growing subspeciality of digital healthcare, which denotes a collection of products, technologies and services across healthcare and wellness industries.
The value of the global DTx market is estimated at USD 1.8 billion in 2018, which is expected to reach USD 7.1 billion by 2025. A recent report estimates the biggest applications for DTx to be for diabetes and weight loss programs, with other applications likely to be observed in conditions such as chronic obstructive pulmonary disorder (COPD), developmental disorders, with the use of computer games, as well as post- traumatic stress disorder (PTSD), with the use of virtual reality (VR).
Difference and Benefits
The fundamental difference between DTx and general wellness applications is that the DTx applications are developed for a specific disease condition, particularly chronic diseases such as diabetes, cardiovascular conditions such as hypertension and pulmonary diseases like COPD.
DTx comprises a system of applications that help treat diseases through management in patient’s lifestyle activities or behavior and monitoring remotely to get a positive health outcome.
These systems of applications are devised to achieve positive health outcomes; for example, they can motivate patients to adhere to a particular lifestyle such as diet and exercise routines or drug regimens.
A number of DTx applications are emerging for the treatment of mental health conditions. The digital application of cognitive-behavioral therapy (CBT) is showing promising results in the management of depression and anxiety disorders. Products for treatment of conditions such as schizophrenia and insomnia are also under development. For example, one of the online self-care programs based on CBT for insomnia has demonstrated improvement in both insomnia symptoms and mental well-being.
DTx is also utilising VR technology to help reduce costs. It has shown an important use as a key application in providing exposure therapy for PTSD. Evidence based studies to assess its potential use in other areas, including depression, anxiety, phobias, obsessive-compulsive disorder (OCD), eating disorders, addiction, and psychosis, are also underway. The VR technology in DTx uses simulation to enable people to learn by getting an experience of real-world situations. For example, through VR, patients experience a situation and learn how to think, feel, and act differently.
Importance of DTx adoption in Traditional Healthcare
DTx has the potential to improve health care practice. A major advantage of DTx is that it offers physicians an option to provide treatment remotely, in real time and at scale, removing the physical borders of a clinic or a hospital. It aids health care professionals / physicians to make timely, informed, and accurate clinical diagnoses and patient care decisions to prevent future complications. Its ability to monitor and track response to the prescribed therapies, provide an opportunity for individualised/personalized treatment.
The American Diabetes Association recently reported on the efficacy of one such app using digital therapeutics in imparting behavioral adjustments necessary for diabetes lifestyle treatment. Similarly, for conditions such as depression and anxiety, DTx can assist physicians in personalizing therapy and monitoring outcomes.
Couple of real life examples will help in understanding the positive health outcomes after using the DTx.
A 40 year individual, overweight with unhealthy dietary pattern & sedentary lifestyle got a surprise with his blood reports (FBS 184, PPBS 245) with HbA1c 8.5 & a deranged lipid profile. The individual received a prescription of LSM (Diet+Exercise) along with oral anti diabetic medications for his physician. Post enrolling in a LSM program (based on a DTx) he got educated about various healthy dietary patterns along with appropriate exercises personalised for his health situation along with monitoring of blood sugar through digital device of glucometer. Over a period of 6-8 months, by virtue of his adherence to personalised LSM (diet & exercises) along with medications was able to improve his sugar control.
Another such instance was a 55 year person with a case of T2DM (diagnosed over the last 5 years) with multiple oral anti-diabetic medications. Post his enrolment in a LSM DTx program, he got educated about various dietary patterns and exercise modules along with various stress reduction techniques/meditation etc. Remote monitoring of blood glucose, personalised LSM techniques (healthy balanced diet + exercise) led to improvement in his sugar control.
The point here is that by virtue of diabetes education, remote monitoring of health parameters, better adherence to LSM (diet + exercise), these individuals were able to achieve better disease control which led to better quality of life along with prevention of future complications.
Limitations of DTx
The solutions provided by DTX to certain medical / clinical situations and early evidence have proved their clinical value, yet, DTx entities have not significantly entered the mainstream healthcare system. The two main obstacles to broader adoption of DTx we see are:
1. Difficulty in separating DTx from the more general health applications in the digital health market
2. Uneven incentives in the healthcare environment
Today, DTx offers a variety of information and modifications to the workflows of a healthcare provider, thus adding to the physician’s burden by an overload of data and required interpretation.
Rigorous evidence based investigation is required through randomized clinical trials (RCTs) to get reliable supporting evidence on the safety and efficacy of DTx. Apart from regulatory approvals, there is also a need for defining the standards of safety and efficacy for collaboration among stakeholders.
DTx is an emerging approach in the management of health conditions, ready to tackle chronic and other clinical / medical conditions. DTx is here to stay and grow. Though it is expected to influence healthcare delivery and its consumption across the globe, the widespread adoption of DTx may take longer than the industry had hoped for. Solutions to the main challenges are still evolving and growing R&D investment will definitely show the enormous potential impact of DTx soon.