Digital health, digital pills, digital therapeutics… With the ‘digital’ suffix being increasingly used in the digital health industry, the meaning behind some terms might not be so evident at a glance. For instance, one might think that ‘digital therapeutics’ and ‘digital pills’ are interchangeable terms; but they are in fact totally different digital health tools.

While we last year, we have yet to talk about digital therapeutics. And this is exactly what we have set out to do with this article; as the latter might very well be a viable option in your future treatment.

What is digital therapeutics?

The , a non-profit engaged in the evidence-driven advancement of digital therapeutics, even considers the term as a “new category of medicine”. The organisation digital therapeutics (DTx) “deliver medical interventions directly to patients using evidence-based, clinically evaluated software to treat, manage, and prevent a broad spectrum of diseases and disorders.”

Source: https://www.htworld.co.uk/

Particularly important in this definition is that digital therapeutics are evidence-based, clinically evaluated software. This demarcates them from , which are themselves physical, ingestible medications (i.e. hardware) with embedded electronic circuits.

However, while DTx are software-based, they are subject to the same regulatory oversight that traditional medicines undergo. This ensures that the product is safe to use, effective as well as has clinical impact. They can also be prescribed independently or in concert with other medications or treatments in order to optimise patient outcomes.

The edge of such clinically proven software is manifold. Since DTx are accessible via devices like a smartphone or tablet, they can expand access to care in underserved areas. Moreover, such a mode of care delivery, which can easily be adopted at home, forgoes any stigma tied to traditional therapies. But as with traditional medicines, the end goal of DTx is for the treatment, management or prevention of medical conditions.

Finding digital therapeutics

Digital therapeutics are not at a conceptual stage but are well within the production and delivery stages. In fact, DTx targeting chronic medical and mental conditions have been developed . The Digital Therapeutics Alliance even has . This list can prove to be particularly important as it helps differentiate DTx that physicians can actually prescribe from unregulated apps that overpopulate online app stores.

To help separate the wheat from the chaff, the Digital Therapeutics Alliance has put forth for DTx. The organisation says that all products claiming to be digital therapeutic must adhere to these foundational principles:

Source: https://dtxalliance.org/

One such DTx product is , a prescription-only software that assists type 2 diabetics to manage their condition. It recommends patients personalised insulin doses as well as acts as a coach in managing their diabetes. A showed that a precursor to the software helped improve glucose control as compared with standard care.

Another example of DTx is . The app supports cancer patients by allowing them to report potential symptoms that they might encounter; subsequently, it shares self-care instructions with them. Through Kaiku Health, patients can also message their care team. Studies such forms of digital monitoring lead to good patient adherence and satisfaction, as well as save time by reducing in-person visits or even phone consultations.

Contemplating digital concerns

Of course, given how DTx are wholly digital options, they carry with them . These technologies will increasingly manipulate sensitive data and will become prey to malicious third parties. As such, their design and clinical applications must factor in these issues and reinforce cybersecurity measures.

Source: https://hbr.org/

Another potential issue that in regards to DTx is that of “app burnout”; or the lack of adherence to prescribed DTx. While their short-term use in managing chronic conditions, adherence regarding their longer-term use has yet to be explored.

Such pertinent issues relating to DTx have to be appropriately addressed as they become viable alternatives for patients.

Will you be prescribed digital therapeutics?

These definitions, examples and relevant concerns give a clearer picture of what digital therapeutics are. Essentially, they represent a paradigm shift in how we think of medical care delivery. While we still think that initiated but not driven by advanced technologies, DTx will have an enormous impact on how we deliver care and practice medicine.

Sure they might not currently be as widespread options as traditional therapies; but researchers already to play in mental health management. And we can also expect this role to extend in other medical fields as well. As such digital-based tools and programs gain more backing from clinical tests, they will be seen as viable alternatives for practitioners, who can turn their use into common practice. 

Just like physicians have been prescribing lifestyle changes for appropriate ailments for centuries, they will similarly prescribe smartphone apps and digital health technologies. And this shift towards DTx will not be because they look exciting, but because they have been proven to be working for patients.

Written by Dr. Bertalan Meskó & Dr. Pranavsingh Dhunnoo

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