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Report: Digital diabetes management tools are falling short

by Marissa Plescia
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Digital diabetes management tools fail to provide meaningful clinical benefits, increase healthcare spending and pose new challenges report The Peterson Health Technology Institute (PHTI) shows.

This is PHTI’s first report. launch Appointed as independent evaluator of digital health solutions in July. The analysis evaluated her eight digital tools that support people with type 2 diabetes: DarioHealth, Glooko, Omada, Perry Health, Teladoc’s Livongo, Verily’s Onduo, Vida, and Virta. These solutions use her three approaches:

  • Remote patient monitoring (Glooko)
  • Behavior and lifestyle modification (DarioHealth, Omada, Perry Health, Livongo, Onduo, Vida)
  • Nutritional Ketosis (Virta)

PHTI investigated both clinical effectiveness and financial impact for the company. The researchers reviewed more than 1,100 of his papers, including 120 from the companies they evaluated. The analysis found that remote patient monitoring and behavioral and lifestyle modification solutions achieved only modest reductions in hemoglobin A1c compared to patients receiving usual care (although “clinically meaningful”). It turns out that this is not the case. These tools also did not improve other health factors such as weight loss, BMI, blood pressure, or cholesterol.

“One of the things that was most impressive about this evaluation was the consistency of the results,” PHTI Executive Director Caroline Pearson said in an interview. “Researchers often see data that is very messy. All of this data is arranged in very narrow spheres of influence, where digital solutions offer small benefits compared to usual care. “However, the benefits are not large or durable enough to actually change people’s health outcomes or clinical care.”

Additionally, these solutions led to a net increase in spending. A patient using a remote patient monitoring solution can expect to see an increase in annual spending of $723 to $2,002, depending on the type of coverage. For those using behavior and lifestyle modification tools, annual spending is expected to increase by $484 to $574.

However, Virta’s solution, which leverages nutritional ketosis, has yielded more promising results. It produced clinically meaningful reductions in hemoglobin A1c and was able to achieve remission in some patients. Although there is an initial increase in net expenses, this may result in long-term savings.

Mr Pearson said PHTI aims to provide better evidence about the digital health industry and enable companies with good evidence to be adopted by the market.

“Right now, we’re actually seeing that there’s not a close link between evidence of performance and market adoption,” she said. “It means that good technologies with good evidence will not be adopted, and technologies that do not provide that value will be widely adopted. Our hope is that By continuing to do so, we can drive better innovation and better investment.”

Omada, one of the companies assessed, pushed back, pointing out that the PHTI report only considered two metrics: Cost and HbA1c reduction.

The reality is that diabetes self-management education and support (DSMES) is a complex treatment approach, and A1c reduction may not be the goal for everyone participating in these virtual care programs. ” Dr. Carolyn Jasik, Omada Health’s chief medical officer, said in an email. “As a DSMES certified provider, further analysis will take into account other measures such as weight, lifestyle modifications, patient education, program participation, and care retention to better understand the true value of virtual care. We look forward to providing you with a program for diabetes, prediabetes, weight management, and hypertension. ”

She says a recently published peer-reviewed study by Omada found that people with type 2 diabetes and elevated A1c had an average lower A1c of 1.8 points and weight loss of 7.3 pounds after one year. added.

PHTI offered several recommendations for buyers, innovators, and providers. It recommended that buyers require data analysis and transparency, and align payments with clinical outcomes. On the other hand, healthcare providers need to understand the effectiveness of a solution before recommending it to their patients. Innovators must ensure they create adequate evidence to support the adoption of their solutions.

In the future, PHTI plans to analyze solutions for virtual physical therapy, blood pressure monitoring, and mental health.

Photo: Gustavo Frazao, Getty Images

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