Few digital health technologies can address multimorbidity

The rapid proliferation of digital health technologies benefits patients in numerous ways. However, new research shows that using these technologies may be challenging for patients with multiple chronic conditions, as they would have to use several of them concurrently to glean their benefits.

The research, published in JAMA Network Open, aimed to assess the number of digital health technologies a patient with five chronic conditions should be prescribed to receive benefits. The study authors noted that though digital health technologies have proven benefits, most are designed for one condition or problem. Meanwhile, most chronic care patients have multiple chronic conditions.

The researchers conducted a systematic review without meta-analysis, first identifying all digital health technologies that could be prescribed to a hypothetical woman, 79 years old, with type 2 diabetes, hypertension, chronic obstructive pulmonary disease (COPD), osteoporosis and osteoarthritis. They selected the technologies from three FDA databases and the Organisation for the Review of Care and Health Apps (ORCHA) App Library from National Health Service (NHS) Somerset for approved or recommended digital health technologies between Jan. 1, 2019, and Dec. 31, 2022.

They identified 148 unique digital health technologies that could be prescribed to the hypothetical multimorbidity patient. Most of these technologies involved devices (65%), while the rest (35%) were standalone health apps.

Overall, 97% of the technologies were intended for single conditions and problems, and 86% were accessible over the counter. Only five digital health technologies (3.4%) were intended for two or more conditions. 

Most technologies were intended for monitoring, treating and/or managing diabetes (39%), hypertension (17%) and COPD (14%). The tools offered 140 elementary functions, ranging from recording and tracking health metrics to digital therapeutics with interventions.

Researchers determined that the hypothetical patient would need to be prescribed up to 13 apps and seven devices, including a blood pressure monitor, smartwatch and pulse oximeter, to benefit from 28 functions most health professionals considered important.

"The findings of this systematic review suggest that the current state of DHTs [digital health technologies] might generate an important burden for patients with chronic conditions, who often have multiple health problems and conditions," the researchers wrote.

The burden includes patients having to familiarize themselves with different interfaces, create new routines to incorporate the technologies into their lives and potentially deal with contradictory information.

"It is necessary to change the perspective of digital medicine, often focused on products, to recenter it on patients' needs and capacities, pursuing minimally disruptive digital medicine," the researchers concluded.

Several studies have highlighted the variabilities in digital health technology use, further underscoring the need for patient-centered technology development.

For instance, research published earlier this year revealed that older adults' race, sex, age and other demographic factors influence their utilization of digital health technologies. Researchers assessed data from an August 2021 survey, conducted as part of the National Poll on Healthy Aging, that polled adults aged 50 to 80.

Of the 2,110 survey respondents, 81.4% reported using a digital health device. However, female respondents and those aged 50 to 59 were more likely to report digital health technology use than male respondents and those 60 and older. Further, a majority of white adults (70.2%) reported using digital health technologies compared to only 11.4% of Black and 11.9% of Hispanic adults.

Anuja Vaidya has covered the healthcare industry since 2012. She currently covers the virtual healthcare landscape, including telehealth, remote patient monitoring and digital therapeutics.