The Communication Challenges in Digital Therapeutics - Vivek Hattangadi

The Indian Council of Medical Research–India Diabetes (ICMR-INDIAB) study, a cross-sectional population-based survey, assessed a representative sample of individuals aged 20 years and older drawn from urban and rural areas of 31 states, union territories, and the National Capital Territory of India.

 This new study published in “The Lancet Diabetes and Endocrinology” estimates that 101 million people in India - 11.4% of the country's population - are living with diabetes. A survey commissioned by the health ministry also found that 136 million people - or 15.3% of the people - could be living with pre-diabetes.

This means an increase in the prediabetes populace by over 40%. And without doubt, this is a matter of great concern. Although I do not have the statistics for other countries, probably, this risk is equally deep in other countries too.

This blog is an expression of my concern for the health of the people of India and how this progression from prediabetes to diabetes can be delayed.

One option is Digital Therapeutics (DTx)

What are the challenges for the adoption of DTx and how can these be communicated is the crux of my blog.

The Communication Challenges in Digital Therapeutics

Is the common man in India aware of Digital Therapeutics?

I called up a few friends who were well placed in their professions like; a Director and Vice President of an international bank, a retired professor of English, a teacher of Physics in one of the most reputed schools of Mumbai, a M. Tech from IIT-Mumbai and so on. Shockingly, they had not even heard the term digital therapeutics.

Spreading awareness of digital therapeutics and using it to delay the progression of prediabetics to diabetics is an enormous task. And this is where companies in digital therapeutics can collaborate with the pharmacist or endocrinologist societies to help these prediabetics and help India.

Digital therapeutics is a broad and organized system integrating dietary changes, exercise routines, continuous monitoring and even personalization. Since diabetes is long-term, doctors can safely endorse digital therapeutics as they can help in better medication adherence and superior sugar control. Continuous glucose monitors via apps on smartphones can provide prediabetics with nudges and alerts.

Overcoming the communication challenges

You have a two-fold challenge: Creating awareness of digital therapeutics amongst the general public and also addressing the benefits of digital therapeutics amongst the 136 million prediabetic populace.

Undoubtedly, digital therapeutics is preparing for take-off in our country. By 2030, possibly it will be very popular as more and more are becoming digitally intelligent. Understanding the hurdles and the stumbling blocks to the adoption of digital therapeutics is the key to understanding how the hurdles can be overcome.

Social media can be harnessed for creating awareness of digital therapeutics. Social media has a promising future in healthcare, especially in patient engagement and empowerment. Realization is dawning gradually that social media can provide a platform for patients to gather information, explore options, and share their experiences. 

Social media provide online platforms for interactions to occur around various health topics relating to patient education. Social media include various technological approaches such as blogs, micro-blogging (e.g. Twitter), social networking (e.g. Facebook and LinkedIn), video-sharing sites (e.g. YouTube), Then you have web-based programs and virtual coaching and Smartphone apps. These apps however must be very simple to understand and use. You can communicate two very vital patient-centred messages.

1. How using DTx, can enhance patients’ adherence to therapy. High adherence to treatment translates into a better delay in the progression of prediabetes. Non-adherence on the other hand, not only affects both individual patients and the healthcare system, it may even result in to an earlier onset of diabetes.
2. You can also communicate how digital therapeutics can play a complementary role in prediabetes management by supporting people with psychological support, and education.

Using your imagination, you can think to have more means to spread awareness both of digital therapeutics and the risks and perils of prediabetes.

What can you communicate to doctors?

To popularise, digital therapeutics, the first thing is that doctors must be made aware that digital therapeutics is not a threat to their practice or their patients.

The use of digital therapeutics is inevitable in the future. And this is what doctors need to communicate to the prediabetic population. But will the doctors feel comfortable telling their patients about the use of DTx? Is it an existential threat to them? Such questions may certainly cross the minds of a few conservative doctors with a fixed mindset.

Like AI, DTx can be seen as both a threat and an opportunity for doctors, depending on how they approach and adapt to this emerging field.

DTx can automate many aspects of healthcare, potentially reducing the need for direct doctor involvement in some routine tasks like ordering and interpreting laboratory and diagnostic test results or prescribing medications.

DTx also presents an opportunity for doctors to enhance the care of the prediabetes populace. DTx can serve as a tool that augments the doctor’s ability to monitor Hb1Ac levels and manage them effectively. They can leverage these digital solutions to access real-time data, track progress, and receive alerts or recommendations based on advanced algorithms and machine learning. By incorporating DTx into their practice, doctors can delay the progression of diabetes and provide more personalized care in this process.

If the doctors have this attitude, they will be too happy to communicate the benefits of DTx to patients. This is because digital therapeutics also presents an opportunity for doctors to enhance patient care.

Doctors with high levels of integrity towards patients will certainly share such information with them.

Doctors should also realize that patients, especially younger patients are getting more and more digitally intelligent. By 2030, I see an environment if any doctor does not use DTx apps, the digitally intelligent patient may potentially even look down at such a doctor as a quack.

Doctors therefore should look at digital therapeutics as something which can enhance their image and reputation and increase their practice. Patients will also see them as one who is at the forefront of healthcare advancements and can deliver more effective, personalized treatments.

What can you communicate to the pre-diabetes populace?

Doctors and DTx companies can then tell the patients that DTx apps can augment their ability to monitor and treat patients effectively. doctors can communicate to their patients how these DTx apps can help him/her access real-time patient data, track treatment progress, and how they can receive alerts or recommendations.

Doctors can tell the patients upfront how these DTx apps can delay the progression of diabetes and even provide individualized and personalized care.

Patients need to be told how many people like them struggle with adhering to prescribed medications and implementing the behavioural and lifestyle changes that are needed to manage and stabilize their prediabetes conditions. Prediabetes seldom needs medication but necessitates regular monitoring of Hb1Ac levels and lifestyle changes. Hence, doctors need better end-to-end solutions that proactively and comprehensively monitor the health of the prediabetic.

Doctors can tell the prediabetic that DTx can also offer self-guided interventions, personalized treatment plans, and remote monitoring capabilities, enabling the prediabetic populace to manage their conditions more independently. This could potentially reduce the number of visits to doctors for minor issues, freeing up a doctor's time for more complex cases.

DTx can encourage behavioural changes to improve adherence to suggested therapies including non-pharmacological therapies, diet, and lifestyles.

Conclusion: Successful integration of DTx needs patient engagement and adoption. Effective communication strategies can include creating awareness of DTx amongst doctors and the prediabetic populace, clear instructions, and ongoing support. This may involve providing information through omnichannel communication and even personalized messaging. These can promote acceptance and encourage them to incorporate DTx into their prediabetes management plans.

Reference

V. Mohan, Shashank Joshi, Rupinder Singh Dhaliwal et al. (June 07 2023) Metabolic non-communicable disease health report of India: the ICMR-INDIAB national cross-sectional study (ICMR-INDIAB-17). Lancet Diabetes Endocrinol. 2022. Available at https://doi.org/10.1016/S2213-8587(23)00119-5 Accessed on 9 June 2023