This has proved to be a great week for digital health credibility.
Firstly Sleepio picked up two honours – one was scoring the highest mark on the first Ranked Health output. The second was getting the American College of Physicians to come out and say that CBT-I should be the treatment of choice for insomnia (above hypnotics).
Meanwhile a study has shown that “A Smart Phone-based ECG Recorder Is Non-inferior to an Ambulatory Event Monitor for Diagnosis of Palpitations”. In layman’s language, the Alivecor/Kardia smartphone peripheral and app are as good as the awkward to wear & cumbersome Holter monitor.
Well done both!
Those who have heard Dr Sophie Bostok, the indefatigable Sleepio Sleep Evangelist, explain (more…)
As Prof Mike Short pointed out recently, 2016 is the tenth anniversary of the start of the Whole System Demonstrator (WSD) programme that in retrospect, because of poor trial design, probably slowed the uptake of digital health in the UK more than any other single action. It seems appropriate therefore to look at how telehealth* has fared over that period, and perhaps even more importantly, is poised for the next ten years.
The mistakes of the WSD are well documented (eg here, here & here) – suffice it to say that it proved beyond all reasonable doubt, at least to this editor, that unlike medicine-based interventions, which seem less sensitive to their care pathway, digital health delivers most of its benefit through enabling a different, patient-centred care delivery, so every digital health intervention needs to be evaluated holistically, and in its own care pathway. Sadly over the ten years, much of the academic work looking at the benefits of telehealth has continued to evaluate the technology in the time-honoured way that medicines have been evaluated, with predictably largely equivocal results.
Those of us who have delivered telehealth projects though have a sense of disconnect as, time and again, a focused implementation – not a pilot – in which the staff delivering the service understand that it will be a permanent change for which they need radically to change the way they deliver care, yields huge returns on investments through savings typically in the 50-90% region. (more…)
A recent randomised control trial gives support to the use of computer-based therapy for treatment of addictions. The results were reported this week at the annual convention of the Association for Psychological Science in San Francisco, following publication in the American Journal of Psychiatry. Although the trial focused specifically on cocaine-dependent individuals, it replicates findings of a RCT carried out in 2008, in which participants had a wider range of substance addictions.
Results of this latest study show that those who received computer-assisted therapy were significantly more likely to attain three or more consecutive weeks of abstinence from cocaine as compared to those not receiving any form of Cognitive Behavioural Therapy (CBT) – 36% compared with 17%. And the effects appear to last; the control group also had better outcomes six months after treatment had ended.
Individuals who receive CBT learn to identify and correct problematic behaviours by applying a range of techniques. Central elements of the therapy include anticipating likely problems, correcting harmful thought patterns, and developing effective coping strategies. The techniques enable people to counteract addiction’s powerful effects on the brain, so they can regain control of their behaviour and lives. (more…)
For those of us suffering from insomnia there’s no denying it can be a real pain! For some it means wakening up a number of times throughout the night, while others are unable to get back to sleep after only a few hours rest. In my case it means drifting off into a peaceful slumber before inevitably waking just minutes later with a jolt, looking like Frankenstein’s monster and wondering if someone just hit me up the face with a bolt of lightning!
The latest NHS approved sleep app is Sleepstation. It’s one of three listed on the NHS Choices Health Apps website, the others are Sleepio and Sleep Diary. (more…)