Digital Therapeutics for IBD
From biometric wearables to fitness and diet apps, digital devices are becoming an integral part of healthcare. Tech-based therapeutics are creating a space for patients to observe and monitor their symptoms, allowing them to take responsibility and ownership of conditions such as inflammatory bowel disease (IBD). But what does the science and experts say about the safety and efficacy of digital therapeutics for IBD management?
According to Forbes, since 2011, more people worldwide own cell phones than toothbrushes.
Digital Therapeutics for IBD Management
Inflammatory bowel disease (IBD) is one of the many chronic diseases that can be improved from digital health advances. This multifactorial disease is best managed with a combination of medications, diet therapy, lifestyle changes, and surgery with the ultimate goal of reducing inflammation.
Digital therapeutics also offer benefits to healthcare practitioners, insurers, and pharmaceuticals by developing new ways to collect data. They gather in-depth knowledge of unknown patient complaints, challenges and symptoms leading to more refined, specific, and beneficial treatment protocols.
Digital Therapeutics for Pharma
Digital therapy and pharmaceutical company partnerships add value to patients while increasing profits. Many leading pharmaceutical companies are looking beyond the pill to drastically improve their offerings.
Partnerships between digital health and pharma companies are a recipe for financial success. According to a panel discussion at the DTx East conference in Boston, and cited in MedCityNews, this collaboration could be a $1 billion dollar opportunity.
MediSafe CEO, Omri Shor shared a company-based case study promoting this “match made in heaven”. The results of the study showed that customized digital programs for chronic disease, such as diabetes and cardiovascular disease, improved medical adherence by between 8-20 percent.
Digital Therapeutics for Hospitals
According to IDEO, the digital therapeutics global market is currently estimated at $1.8 billion but is predicted to reach $7.1 billion by 2025. Much of the growth is expected to come from pharma investment but also from digital therapeutics that improve hospital patient chronic disease management and improved wellbeing.
These programs offer benefits to hospitals and doctors. They can be prescribed by a physician who is concerned about the patients’ disease but not able to influence behavior on a day to day basis. Healthcare can be reshaped by the improved management of disease treatment.
MedTech Views explains that digital therapeutics are predicting and transforming measurable outcomes for the future of healthcare. Data can be collected, analyzed, applied and tested while exploring the best therapies for patients with the best outcomes possible. This provides opportunities for healthcare organizations to enhance overall care experience, improve the health of large populations, and reduce global health care costs.
What the Science Says
Although limited, some high quality research has suggested significant benefits of digital therapeutics, including more effective psychotherapy, complimenting medical care, and improving quality of life.
Cognitive Behavioral Therapy (CBT) is a type of psychotherapy that has been effective in helping IBD symptoms. Research has suggested that when it’s given over the phone or online, it’s more effective in relieving the symptoms than current standard CBT care.
In August 2019, The Journal of Medical Internet Research conducted a review of research that examined the impact of digital health apps in the clinical care treatment plan for inflammatory bowel disease.
-A total of 68 articles were reviewed including 11 digital health apps and 4 commercial apps.
-Most apps had an educational component with the majority focusing on patient-reported outcomes related to disease activity. A few focused on treatment management.
–Significant benefits were seen in trials relating to education, quality of life, quality of care, treatment adherence, and medication management. No studies reported a negative impact on any of these factors.
-Mixed results were seen in terms of effect on office visits and follow-up.
It was concluded that digital health can fit into, compliment, and improve standard clinical care of patients with IBD. It’s suggested to continue validation and improvement both from a clinical and patient side for more accurate quality of care from these types of apps.
According to the Experts
Physicians and medical professionals are the experts so their opinions should be considered the highest when it comes to patient care. The Journal of Medical Internet Research provided physicians with web-based surveys to gather information on how they view digital health as a part of the clinical care of IBD. There were a wide variety of positive and negative perspectives.
-A total of 100 practicing physicians across the United States completed a web-based, self-report survey to examine their opinions.
-Physicians had consistent agreement of the benefit of administrative benefits such as: scheduling doctor appointments, locating clinics, providing medication information.
-Conversely, many physicians believed that chatbots cannot: effectively care for all of the patients’ needs, display human emotion, and provide detailed diagnosis and treatment because of not knowing all personal factors associated with the patient.
In summary, physicians believe that chatbots may have a beneficial role to play in health care to support, motivate, and coach patients while streamlining organizational tasks, but cannot replace the human approach of health experts.
NoriHealth’s Health Lead and Registered Dietitian, shares her first hand experience and attitude towards working with patients via a digital space:
“I had a lot of skepticism about digital healthcare since I thought patients got a lot more by meeting me in person. Accountability, human empathy, and trust for instance.
But after working as a web-based mental health coach at Ginger.io, I came to realize that patients actually opened up MORE, giving me specific details about what was going on for them. Which in turn helped me help them.
It also took away any preconceived judgments of what the counseling experience would be like. From both my and their end.”
Patient Perspective
Patients experience many frustrations when it comes to IBD treatment. According to Crohn’s & Colitis UK, one third of people living with Crohn’s or Colitis don’t have the support of a specialist IBD nurse. There’s a lack of multidisciplinary care with psycho-social support, delay in being diagnosed, and inability to effectively communicate with health care providers.
NoriHealth’s mission is to help solve some of these shocking facts. Nori’s own CEO, Roeland Pater, shared his personal experience from the patients’ perspective and what motivated him to create Nori:
“I’m part of a majority that needs more support and additional care. Hospital check ups twice a year are important to rest assured about inflammation levels and such, but it does not help with many other factors that exist when living with a chronic condition.”
Roeland has interacted with many others just like him. Suffering from the condition with limited resources…
“Almost every patient I talk to deals with uncertainty, fear, anxiety even. And also has to face practical challenges every day with diet, hydration and work/life balance. Hospitals cannot provide support on this due to the already huge workload, and I understand that. But that does not mean that we accept it. We need to be able to get chronic disease patients extended care, and that’s exactly what we are doing with Nori Health as well.”
Check out more on Roeland’s story on HuffPost.
Final Thoughts
There’s no denying it, technology is here to stay. Digital therapeutics can be an excellent addition to standard health care. They help put the patient in charge of their treatment, fill the gaps between clinic visits, and can help increase accountability and habit change.
This is exactly what NoriHealth aims to do. Nori never replaces the recommendations of physicians by acting as a supporting agent in IBD disease management. The Nori program encourages patients to get in touch with how they feel and manage the lifestyle conditions that are within their control.
This article has been written by Lisa Booth, registered dietitian and nutritionist, and co-founder of Nori Health. Content is based on her professional knowledge, and our collection of 100+ scientific research study papers.