Readers Write: Obesity and Beyond: How Digital Therapeutics Are Shaping the Future of Managing Chronic Diseases

Obesity and Beyond: How Digital Therapeutics Are Shaping the Future of Managing Chronic Diseases
By Joseph Rubinsztain, MD

Joseph Rubinsztain, MD is CEO and founder of ChronWell of Sunrise, FL.

As the COVID-19 pandemic took a collective toll on patients’ mental and physical health in the United States, our obesity problem only intensified. Even before the pandemic, 42% of Americans were obese, while two in five recently surveyed reported to gaining an average of 29 pounds since the pandemic began.

Despite the risks of serious disease associated with high blood sugar, hypertension, high cholesterol, and excess abdominal body fat, the pandemic’s disruption to daily routine seemed to spark trends of unhealthy eating and inactivity. What’s more, studies show that having a BMI over 30—which defines obesity—increases the risk of being admitted to hospital with COVID-19 by 113%, of being admitted to intensive care by 74%, and of dying by 48%.

Obesity, as it turns out, is the greatest risk factor contributing to the burden of chronic diseases in the US. It is closely linked with metabolic syndrome, a cluster of conditions that increase risk of heart disease, stroke, and diabetes. What’s worse, research suggests that nonalcoholic fatty liver disease (NAFLD), a “hidden” condition that’s strongly associated with obesity, is on the rise. It causes accumulation of liver fat and ultimately inflammation and scarring if left undetected and untreated.

While the burden of chronic diseases in the US has never been heavier, providers are struggling to provide the continuous support patients require to make much-needed lifestyle changes to improve their health. Physicians can suggest interventions like increased exercise and a healthy diet, but patients across the board struggle to maintain lifestyle changes because treatment plans fail to integrate into their lives in any meaningful way. Providers simply don’t have the staff or bandwidth to repeatedly nudge, support, educate, integrate, and encourage new and sustainable habits in such a high percentage of their patients.

There is, however, a solution that can automate and simplify the process with evidence-based outcomes: digital therapeutics (DTx). These technologies deliver interventions driven by high quality software programs to prevent, manage, or treat a range of medical disorders and diseases. Used independently or complementing medications, devices, or other therapies to optimize patient care and health outcomes, DTx is leveraged directly by patients, or, perhaps most optimally, in concert with physician guidance as part of a prescribed care plan.

Using remote monitoring technology and mobile access points, DTx continuously connects patients and their care teams through methods such as text communication / alerts, on-demand education, exercise coaching, diet reminders and advice, digital assistance, general care coordination, and procurement of medical supplies, to name a few. By streamlining these functions and guiding behavioral change, DTx deliver a personalized care plan to fit specific patient needs in between physician visits, encouraging compliance to treatment plans and overcoming hurdles through reliable partnership and continuous motivation.

Quality algorithms process patient information about clinical presentation, medical history, blood biomarkers, diagnostic imaging exams, laboratory tests, and social determinants of health (SDOH), for example, to generate optimal personalized interventions. Built on specific metrics and outreach methods, these evidence-based interventions create tailored goals and guided treatments that drive higher compliance and better outcomes. Through automation and intelligent integration, physicians are alerted to specific concerns and patient needs with minimal friction so the care team can intervene when needed. DTx becomes a digital extender for managing chronic care cases more efficiently and continuously, enhancing the patient-physician relationship.

As we witnessed the increased use of digital health tools over the past 18 months, acceleration of DTx has become prominent, with notable innovation on the certification, reimbursement, and regulation fronts in the US. Digital therapeutics will help build the roadmap to agile, personalized treatment of chronic conditions, presenting opportunities to provide better, smarter care.