Digital therapeutics are particularly well suited to the management of chronic disease, like IBD, rheumatoid arthritis and dermatitis.
What is DTx?
DTx is short for digital therapeutics. This refers to the use of software applications that are used to manage, prevent or otherwise treat a medical condition.
Is DTx the same as a health app?
Digital therapeutics differ from simpler health tracking apps. Health apps typically function as a tool for recording and viewing particular symptoms or behaviours, for example recording medication intake or sleep.
DTx on the other hand, is an evidence-based therapeutic intervention that has a proven clinical benefit.
For example, at Ampersand Health we offer digital therapeutics in the form of courses that have been designed specifically for those living with long-term inflammatory conditions such as inflammatory bowel disease (IBD) and arthritis.
These courses are provided for free to users of the My IBD Care and My Arthritis apps, to help them learn more about their condition, manage different aspects of their health such as medication adherence, sleep, exercise (among others) and can act as an important part in their self-management journey.
An example of effective DTx: How the My IBD Care app reduced general anxiety disorder
Amongst users of the My IBD app, we have found that users have been able to reduce their anxiety by taking the courses offered within the app. Taking more courses generally showed reductions in anxiety levels.
Ampersand Health’s Head Data Scientist, David Pollock explains:
“We investigated the engagement of My IBD Care users answering the General Anxiety Disorder (GAD) PROM (Patient Reported Outcome Measure) who started or completed DTx courses in the period from January 2021 – March 2022 (n = 9388). For each week in the investigated time period, we looked at the cumulative PROM score and cumulative number of DTx courses started or completed. As the GAD PROM is positively weighted, a higher score indicates a more positive result. We saw a strong correlation between high cumulative GAD PROM scores and the number of DTx courses started or completed. This indicates that an increased engagement with DTx courses leads to a higher GAD PROM score, and therefore a reduction in GAD within the My IBD Care user base.”
This supports the findings of our earlier study, undertaken as part of Techforce 19, which showed significant improvements in disease control and generalised anxiety after two weeks of using our My IBD Care app.
Chronic diseases and their burden on public health and the individual
People with chronic diseases in the UK have greater healthcare needs than the rest of the population. They require more appointments, extensive and often specialised treatment and ongoing follow up care. This is further exacerbated by the fact that many of these people live with multiple such conditions. These comorbidities increase the quantity and complexity of care required. Yet often these conditions and their symptoms are treated on an individual basis by teams that do not necessarily cross paths. This makes it difficult to provide the type of holistic care that is often necessary to target and address broader areas of health and wellbeing.
There is also often a lack of support for the patient’s emotional health when living with a chronic disease. It can be difficult to find resources that are accessible and/or affordable when they are most needed. These elements, like mental health, diet and sleep, are the cornerstones of wellbeing. Through addressing these, often overall symptoms are positively impacted. Additionally, as patients with chronic diseases tend to see their doctor at set appointments, it can be difficult for a doctor to have an accurate view of how they are really doing, especially in between appointments.
This is, however being improved by the implementation of processes such as patient-initiated follow up (PIFU).
Enter self-management: The benefits of self-management in chronic disease
DTx can play a very crucial role in the self-management of chronic diseases as it provides external, evidence-based support that is tailored to specifically help an individual with their condition and support them in living a happier, healthier life with more confidence. Self-management for those living with chronic diseases may look different depending on the individual and their personal needs. Aside from medication, there are a few different ways to self-manage one’s chronic condition. Firstly, identifying one’s triggers that cause a flare and actively doing one’s best to avoid these triggers is a self-management strategy. Additionally, identifying what improves one’s physical/mental health and incorporating it as a vital part of one’s self-management routine is also important. DTx can help to meet all of these needs.
DTx is particularly effective in managing chronic disease
Involving DTx in the management of a chronic condition provides a sense of empowerment for patients as they are able to gain a sense of control over the aspects of their health that they can improve through practical suggestions and practices. DTx can be used to manage conditions like IBD and rheumatoid arthritis by providing helpful, specialised and practical support to individuals living with a chronic disease.
For example, for people living with inflammatory bowel disease (IBD) or inflammatory arthritis, our My IBD Care and My Arthritis apps both offer expert-led courses that are specific to the conditions themselves. They are evidence-based and the information and support that is provided through these courses help individuals self-manage different parts of their wellbeing, such as their sleep, so that their health as a whole can improve, and they can have constant access to support in between their clinical appointments and in addition to medication.
DTx provides patients with another tool to use alongside their medication and clinical care, that will help them manage their symptoms and overall wellbeing.
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Evaluation of the My Arthritis App Digital Therapeutic
My IBD Care Service Evaluation at King’s College Hospital & The Royal London
