Covid-19 has greatly accelerated the research and development of digital health tools for treating acute diseases and/or managing chronic diseases in patients’ homes.The two categories that have experienced rapid growth are Digital therapy, Prescriptions alone or together with medications, and virtual care solutions such as remote patient monitoring tools.
Providers, payers, and investors are excited about these technologies, because by combining the personal mobility technologies that patients already know and frequently use, both can be delivered in the comfort of patients’ homes. However, the main question is, especially for solutions that have been used for longer than one or two months, is: Will the patient continue to use them? Digital medical technology may “wow” providers, payers, and drugmakers, but what about patients and their home caregivers?
There are multiple use cases for these technologies. For example, Mild Cognitive Impairment (MCI) caused by Alzheimer’s disease is a particularly challenging chronic disease that requires providers and caregivers to manage it, and there is no effective clinical pathway for drugs. Therefore, digital health companies are developing new technological solutions that can be used at home to stimulate brain activity to slow the progression of the disease.
Of course, patient participation and non-compliance pose a challenge to doctors Face more than a century Traditional medical treatment is also a challenge for digital health technology developers. This is why digital tools must use technologies such as gamification to create personalized experiences for patients so that they can interact with them and provide active data to complement passive data collection and continuous monitoring.AS McKinsey describeBringing such a healthcare ecosystem to life requires a strong “participation layer” to “provide consumers with a personalized and integrated experience, improve provider productivity, attract formal and informal caregivers, and improve Results and affordability.”
By promoting participation and providing an engaging experience, patients will continue to use digital tools as prescribed and experience improved health outcomes, whether through virtual care and remote patient monitoring or prescribing digital treatments.
Ideal use cases for neurodegenerative diseases
Approximately 12% to 18% of people 60 years of age or older suffer from MCI, which is manifested by early memory loss or loss of other cognitive abilities (such as language or visual/spatial perception) in people who are still able to live independently. Alzheimer’s Disease AssociationAlthough MCI itself is a challenging disease, it is also an early indicator of potential Alzheimer’s disease or other types of dementia. It is also worrying that the prevalence of MCI in the United States is rising. According to a study, from 1996 to 2014, female cognitive impairment increased from 18.7% to 21.2%, and male cognitive impairment increased from 17.6% to 21.0%. Epidemiological analysis Released in 2020. Similarly, the incidence of dementia increased by 1.7% in women and 2% in men.
MCI can be disturbing and burdensome for both individuals with this disease and caregivers in the home.A three-year MCI nursing staff study found 21.1% and 29.5% Reports the clinically significant burden of the study, especially if they have other social determinants of health and health challenges.To make matters worse, compared with non-nursing staff, nursing staff More likely to be absent Work or performance is worse, less physical activity, visits to the emergency room, depression, insomnia, anxiety, and pain are more common.
In recent decades, thanks to new drugs and other treatments, healthcare has made tremendous progress in managing the most onerous diseases we face, including heart disease, respiratory diseases, and many types of cancer. However, MCI, Alzheimer’s disease and dementia continue to challenge suppliers and pharmaceutical companies.
Literature review published in 2018 American Family Doctor Summarize “There is no drug… that can prevent or delay cognitive decline, cognitive impairment, or dementia.” These results were echoed in another 2018 learn inside Canadian Medical Association Magazine (CMAJ) reviewed eight randomized clinical trials and three accompanying reports on cognitive enhancers, and determined evidence that these drugs “do not improve cognition or function in patients with mild cognitive impairment and are associated with greater risk of gastrointestinal harm .”
Digital tools show promise
However, more and more evidence shows how digital tools can slow the progression of the disease. Meta-analysis of research Elderly people who use computerized cognitive training show small to moderate positive effects on overall cognitive function, memory, working memory, and executive function. Importantly, an earlier study of patients with memory-related MCI found that playing certain games on a tablet for more than 4 weeks not only improves memory, but the researchers also came to the conclusion of gamification.”Maximum participation Cognitive training by increasing motivation. “
But the challenge is that not all cognitive behavioral therapies are equally effective for every patient, so it is necessary to provide individuals with very specific personalized and dynamic care paths. With the support of a virtual care team specializing in neurodegenerative diseases, the use of artificial intelligence, machine learning and new biomarkers can support and accelerate the best personalized treatment. The use of gamification technology and cognitive tasks on smartphones or tablets can promote participation, while enabling patients’ clinicians to remotely monitor their cognitive functions and use personalized cognitive rehabilitation technologies to intervene as needed.
The algorithm can then automatically adjust or titrate mobile device-based treatment activities based on emerging digital biomarkers related to cognitive function, emotion, and behavior, thereby personalizing each patient’s treatment. For example, the number and types of tasks and games provided can be adjusted according to the speed of the patient’s finger movement, the time to complete the game or task, and the facial expressions recognized through the device’s camera.
MCI’s digital tools can also be combined with methods such as reminiscence therapy, which uses images of the patient’s past to evoke positive memories and emotions, which have been shown to improve cognitive function. Patients’ home caregivers can also access an app where they can monitor patient compliance and even contribute to reminiscence therapy by uploading family photos and videos.
Although patients and clinicians need to be the main focus of developing and prescribing these digital therapies, the patient’s family (usually the caregiver in the home) is an important consideration. In order to protect the physical and mental health of nursing staff and maximize their participation, the technology needs to be as intuitive for them as for patients. Digital health tools should also provide educational content and self-care technology to help caregivers manage family members with neurodegenerative diseases.
Although the era of using digital health tools to manage MCI and possibly prevent greater cognitive decline has just begun, it is a promising new treatment direction for very complex diseases. However, the more development and research on these solutions, it is clear that the most effective technology will be the system that individuals with MCI and their caregivers like to use for a long time. Only through participation can providers and digital health innovators expect to slow down cognitive decline and bring better results.
Photo: SIphotography, Getty Images
