Atopic dermatitis (AD), also known as eczema, is an inflammatory skin condition that affects nearly 8% of the population in the USA and 2.4% of the population worldwide. With even mild skin severity, AD can be particularly debilitating because of its widespread impact on all aspects of a patient’s life; from skin comfort, to sleep, to mental wellbeing.
AD is characterized by both chronic symptoms and acute flare-ups, and to date, no known singular cause for the disease has been identified. However, increasing evidence shows that common environmental factors, such as fragrances, food or weather can ‘trigger’ flares, making AD a difficult disease to manage.
Although there are a number of available pharmacologic treatment options for AD, the efficacy and safety profile of these therapeutics are not always favorable, particularly as current treatments of AD are based predominantly on long-term immunosuppressive methods. Additionally, these therapeutics are often focused solely on suppressing skin symptoms, without addressing the additional health repercussions such as stress. As such, there remains an unmet need for safe, sustainable, and holistic treatment pathways for patients with AD.
Digital therapeutics (DTx) are well positioned to meet the challenges of AD treatment and management: by acting as an extension and enhancement to standard AD treatment, DTx solutions can support an AD care plan through remote patient monitoring, counseling and education, and patient self-management.
Current Atopic Dermatitis Treatment Challenges
For patients and healthcare professionals (HCPs), the chronic nature of AD can give rise to several barriers to effective treatment:
- Poor Access
Where primary HCPs aren’t always confident in managing complex AD cases, accessing a dermatology specialist can be challenging. Trends have shown access to a certified dermatologist is largely dependent on geographic location, with the distribution of the profession centered around urban areas and academic universities.
- Limited Time and Resources
In healthcare systems which are busier and more expensive than ever, patients often feel they do not have enough time to discuss all aspects of their treatment with their HCP. In turn, HCPs feel frustrated that consults may only last a few minutes and the scope of what they can offer in that time is limited to organizing the medication prescription.
Many patients are also reluctant to even take up these prescriptions due to a lack of understanding of the potential side effects, not to mention the fear of costs not being covered by their insurer: patients aren’t even beginning treatment when they need it most.
- Insufficient Support for Comorbidities
Atopic Dermatitis affects more than the skin. Research shows that there is a significant association between AD and immune-mediated comorbidities (e.g. inflammatory bowel disease or asthma) and with several mental health comorbidities (e.g. attention-deficit hyperactivity disorder, anxiety, and depression). Treating HCPs are often aware of these associations and the variability between individuals but usually don’t have the time or knowledge to fully support their patients with them.
HCPs need additional support themselves to provide the right information and guidance for their patients in order to alleviate the burden for patients with AD.
- Waning Treatment Adherence
Several factors have been found to contribute to patient commitment to treatment: physicians using a ‘trial and error’ step model resulting in prolonged periods of uncontrolled symptoms before an adequate treatment is found, suboptimal communication with their HCP and multitudes of unaddressed symptoms can all lead patients to wane in their treatment adherence. Patients who have more intermittent care may have poorer outcomes and AD can be hard to get under control again.
Where Do DTx Fill the Gaps?
When AD patients don’t have access to integrated care, symptoms go untreated and quality of life diminishes, so it is critical to find ways of closing the treatment gaps for patients. DTx can play a pivotal role in addressing these gaps in several ways.
DTx Give Access
DTx solutions are well positioned to narrow the treatment gap for rural Americans, who often have limited access to healthcare facilities. Remote monitoring, and continued communication with HCPs offer an opportunity for patients to proactively get ahead of symptoms and convey medication effectiveness or side-effects to physicians in real-time.
By their very nature, DTx solutions have the ability to foster inclusion across age, gender, race, and to close gaps in primary healthcare, allowing HCPs to focus on personalized care.
Looking ahead, it is DTx that will ensure the delivery of health equity through value-based care, while improving health with meaningful outcomes.
DTx Control Comorbidities
The co-occurrence of two or more chronic conditions can increase risk factors and raise the cost of care for patients but a DTx solution can help manage several symptoms at once, taking into account the whole patient picture. By monitoring daily habits and behaviors, DTx can prompt alerts and reminders to keep disease management and treatment on track.
Sidekick takes this one step further with its multi-chronic platform, designed from the outset to support patients with comorbidities. Patient-centric by design, the platform provides an integrated experience that gives patients the tools to manage multiple conditions in one space. It can monitor and support the patient’s entire journey, giving patients the option to choose the tools, educational support, and insights that are most meaningful and useful to them and their specific conditions.
DTx Educate Patients
Education is an ideal adjunct to conventional therapy as patients should be equipped with the knowledge on how to manage their side effects, how to avoid risk of infection, how to control symptoms at night, as well as figuring out environmental triggers unique to them. This empowerment is critical to integrated care and patient engagement.
A DTx skin solution like Sidekick’s can provide a private and educational space for patients to learn the skills for self-management and understanding of individual exacerbating factors through tailored educational content and the community feed. The educational support of DTx takes the burden off the provider and puts it directly into the hands of the patient, giving them up-to-date information on AD as well as contributing to access of care.
DTx Create Continuity of Care
Since atopic dermatitis is a chronic condition, continued communication and follow up by the dermatologist or HCP is critical. The lack of scheduled check-in visits is a main pain point of patients looking for comprehensive care.
Once a treatment plan is prescribed, checking in with the patient to see if the medication is being administered successfully and if any changes need to be made helps break down barriers to care. While HCPs understand the benefit of timely follow-up visits, staffing issues, a lack of resources, and office workflow protocol can make follow-up visits challenging.
As a reliable tool and extension to the prescribed AD treatment plan, a DTx solution can act as a continuation of care outside the traditional brick and mortar healthcare facility.
With remote monitoring of symptoms and physiological data tracking, HCPs have on-demand access to treatment progress and medication adherence, allowing back and forth communication with the opportunity to pivot the treatment plan as needed. This positive feedback loop builds trust between the patient and physician too.
DTx are Cutting Edge
In a world where most patients will have access to a smartphone, DTx make the best use of that ready-to-use tool. With bespoke software based on the latest research into behavioral economics and self-determination theory, DTx like Sidekick’s can offer powerful, insightful, and motivational support to patients that would benefit from increased self-advocacy in their treatment journey as well as more consistent ongoing care.
By complementing pharmacologic treatment, DTx can help patients develop renewed trust in the medications they take, as well as in the physician that prescribes them. Working collaboratively, DTx can offer a new therapeutic edge to a current medication, perhaps particularly useful in patients whose motivation for ongoing treatment may have slipped over time.
DTx can also be used in a package with newer medications coming to market, ensuring they are used in the most effective way from day one and giving the best chance at improving patient outcomes.
As an additional benefit, the real-world data captured through remote monitoring elevates the clinical significance of DTx solutions allowing pharma companies to evaluate patient outcomes, capture reported side effects, and monitor medication adherence. Real-world data from DTx are also critical to assessing medication effectiveness, and have already shown to provide key insights for future innovations and medical breakthroughs.
Shaping a Holistic Solution for Atopic Dermatitis
Atopic dermatitis is challenging to treat and manage for both patients and HCPs. A successful AD treatment plan requires holistic care to address the whole person and their comorbidities, not just symptom management. DTx solutions not only address these treatment challenges through built-in education, remote monitoring, and continuous communication with both the HCP and a licensed dermatologist, they can also provide real-world data and evidence to support medication effectiveness and treatment plan success.
DTx solutions can also be used anywhere, resulting in accessible care to all patients no matter where they live.
Treatment optimization and personalized care allow HCPs to tailor the treatment plan to each patient depending on their needs, allowing for positive patient engagement and real-time support to minimize symptoms and improve quality of life.
DTx work synergistically with traditional pharmacotherapeutics to provide a ‘package’ of support for the patient; leading to more accurate monitoring of symptoms over time, optimized treatment adherence, empowerment to modify behaviors to make lasting healthy lifestyle changes and a restored sense of control for the patient and physician.
Together, DTx and pharma can shape the future of healthcare to become a more inclusive and personalized experience that treats the whole person and not just a set of symptoms. As partners, they can improve clinical outcomes for people living with atopic dermatitis beyond what can be achieved with traditional therapeutics alone, at benefit to all players in the healthcare system.
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