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Chronic disease treatment requires quite some discipline and it is not always easy for kids to follow the regimen rigorously. Poor chronic disease management leads to various health risks and it is known that one of the important factors related to poor medication adherence is associated with mental health problems. It needs to be noted that treatment adherence is one of the most critical issues in pediatric care setting. But technology helps us in forming a source of knowledge while improving patient's mood and experience. For that reason, digitally delivered therapeutics (app therapy) have gained a lot of interest lately.
Digitally delivered therapeutics create an opportunity to put the patients in the center of their health. While it all started from physical activity trackers already 10 years ago when Fitbit released their first device that gained mainstream interest, the market is now full of both hardware and software solutions for disease prevention and management. For example Oura ring is for sleep tracking, allowing you to take action based on your sleep activity, a common underlying factor of healthy life. More recently, further progress has been made towards digitally delivered therapeutics - the focus is shifting from health monitoring towards offering additional support based on the data. Such solutions are available for both kids and adults.
Health applications range from wellbeing and mindfulness to weight management and physical activity apps. Most are for health monitoring while commonly offering some gamified content to engage the users and reward healthy lifestyle. It has been estimated that every day 5 million people download an health app. These numbers have increased significantly over the past years, however the safety of those health apps is still a concern because there is no proper regulation of health and wellbeing apps. While the safety and validation are still a concern, these solutions add value to healthy individuals and could be potentially used in prevention of various diseases. For example people are able to learn more about healthy lifestyle and diet, how it should look like and evaluate their own behavior. Knowledge is the first step in behavior change.
At the same time, app therapy or digitally delivered therapeutics require further certification. Apps that are suitable for clinical context need to be evaluated scientifically and commonly need to be approved by the FDA or registered as a medical device. However, the underlying content could be similar to health apps, by delivering knowledge and then adding additional support, but the validation of the content needs to be extensive and thorough. Chronic illnesses are very burdening and if you add uncertainty to the equation then it will do more harm than good. Patients need to be able to trust the information that is available in the application, otherwise it becomes an additional burden. If the information is trustworthy, then app therapy allows patients to take charge of their health - they are able to use their digital health solutions without the supervision of their doctor in their safe home environment. Their treatment becomes part of their life and does not involve thinking about it during medical visits. Not everyone is strong-willed enough to follow the prescribed regimen between appointments and this is where digital health solutions become most beneficial. At the same time, doctors are able to get better insight into their patients' condition through remote monitoring while patients become more aware of their health and wellbeing.
Many people are still very sceptical about m-health solutions. It has been difficult to implement m-health solutions in a clinical setting over the recent years as doctors have been rather traditional in their views on medical care. However, we have definitely seen a shift in their mindset. Patient-centered care involves a lot of new tools that the care team needs to use in order to provide comprehensive care. In pediatric care setting, these digital tools need to be fun and cool because kids lack the intent that adults have. Their care needs to be delivered in a delicate and attractive way for them to actually get additional benefits out of that.
Are we going to see a situation where cardiologists are taking pulse measurements from a health tracker into consideration? Or will psychologists base their diagnosis on the results of a daily mood measurement from an app for people with depression? What do you think?