A program (and not only) that cures. It is the revolution of digital therapies, especially apps for smartphones, but also video games, virtual reality and augmented reality applications. They fall within the digital healtho digital healthcare, but they differ in that their efficacy is studied and demonstrated through the use of randomized clinical trials, typical of the study of traditional drugs. It takes a scientific path to say that an instrument, perhaps valid from a technological and engineering point of view, brings a real advantage on health. Only at that point can it become a heritage of care, on a par with a drug.
Artificial intelligence, so we will reveal the secrets of the heart
in collaboration with the Cardiology Network IRCSS & NExT-H
Effects on blood pressure
Eugenio Santorohead of the medical informatics laboratory of the public health department of the Mario Negri IRCCS Institute (belonging to the IRCCS Cardiology Network), curator of the item Digital Health by Treccani and co-author of the volume Digital therapies, gives the example of a recent Japanese study of hypertensive individuals who were not taking hypertension medications. “Research shows how, with a range of lifestyle modification tips (improve sleep quality; reduce salt and alcohol intake; exercise regularly; improve nutrition and stress management) keep body weight under control) it is possible to reduce blood pressure at the end of the 12-week observation period and to optimize recommendations based on subjective characteristics “. The study compared two groups of people: one undergoing standard lifestyle modification, the other undergoing digital therapy via an interactive application for smartphone. The results obtained show that digital therapies are far superior to lifestyle modification alone. Thanks to these tools I can prevent or manage hypertension in patients who suffer from it. Let’s be clear: the area of hypertension is the one in which the most scientific studies have been conducted. “Further evidence comes from meta-analyzes, that is from synthetic studies that combine the results of different randomized studies trying to give more strength. Here too it has been seen that the effectiveness of digital tools, generally apps, determines an advantage in terms of reduction of blood pressure “adds Santoro. Meta-analyzes and single randomized studies have also shown their usefulness in patient monitoring at home and in remote cardiological rehabilitation “.
Heart, an app to improve prevention
Ideal “target” cardiovascular system
The cardiovascular area is one of the most studied with digital therapies, together with that of the fight against addictions (especially from smoking) and the area of mental health (for anxiety and depression). In particular through the apps. “This is also demonstrated by a study recently conducted by us, a systematic review of the studies that are present on clinicaltrials.gov, the leading international clinical trial registry where everything that is studied internationally is kept track of, including tools of digital health and digital therapies – explains Santoro – We went to see which digital therapies have been most studied and used in the last year or in the last two years through randomized clinical trials. In the 136 studies examined out of 560 identified, it was smartphone apps in 41.9% of cases, web-based interventions in 25.7% and video games in 8.8%, but we also found virtual reality or augmented reality systems. also noted that other technologies such as video games, virtual reality and augmented reality applications are beginning to be present and that these too are acquiring the their importance as therapies thanks to clinical trials that confirm their efficacy. Our Institute is involved in prevention studies, as well as in the treatment of hypertension, and to a lesser extent of heart failure, the major areas in the cardiovascular field where digital therapies have been developed “.
Heart door
Bad habits for heart health, so an app will help us fight them
in collaboration with the Cardiology Network IRCSS & NExT-H
One of these studies (CV-PREVITAL) is the first in Italy to try to scientifically demonstrate, on a very large sample of the population, the effectiveness of a digital system for cardiovascular prevention, i.e. whether it is really possible to improve prevention. with a smartphone app.
Beware of DIY
“Among the apps, those recommended by the doctor must be used because they are scientifically validated and therefore safe – suggests the expert. – If you want to proceed independently, it must be verified that the development of the application has been done in collaboration with scientific societies: this guarantees the reliability of the tool, whether it is a recent or updated app, and finally privacy. If available, it is a good idea to also consult the clinical studies, the scientific evidence supporting the app: usually those who develop it and have conducted a study effective clinician has every interest in communicating it “. How to behave? It is advisable to consult the websites of the main Italian scientific societies: if I suffer from cardiovascular disease I can enter the section reserved for patients, or the app section available almost always on any site and check which tools they have created in collaboration, or directly, and which therefore support and promote “
Heart under control at home, so the hospital will be more and more virtual
in collaboration with the Cardiology Network IRCSS & NExT-H
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The future in Italy
At the moment in our country we are still behind for digital therapies. Abroad, for example in Germany and the United Kingdom, these are widespread because they are approved by regulatory agencies (our Ministry of Health or Medicines Agency) as real therapies and therefore can be prescribed and possibly even reimbursed. In Italy, at a regulatory level, these treatments are included among medical devices, i.e. tools to support a pathology whose purpose is mainly to diagnose or measure diseases. But it must be said that digital therapies have a different purpose, of a curative type: at the moment, due to current legislation, they are not prescribable and reimbursable. “In any case, – concludes Santoro – digital therapies will probably constitute a revolution in the world of prevention and management of diseases, especially chronic ones, because many of these tools are free of side effects and above all focus on the patient who, through the modification of his lifestyle, he can achieve important results “.