What is the difference between digital therapeutics and fitness apps?

The Digital Therapeutics Alliance (DTA) is a non-profit organization, engaged in the evidence-driven advancement of digital therapeutics (DTx). Jessica Shull, the DTA’s European lead, told The Sidebar why it is important to make a clear distinction between DTx and general fitness applications, and why trust is paramount to success.

Digital health is coming of age as regulators begin to approve digital therapeutic solutions that prevent, manage or treat medical disorders or disease, sometimes complementing traditional drug therapies.

But getting the message about this new class of products over to doctors and patients is a challenge, as their approach to treating disease is so different from established conventional medicines.

With this in mind, trade association the DTA has released a code of ethics and a series of guidance documents to help build trust with patients and doctors.

“The new guidance is important as the developing industry seeks to build relationships with patients and differentiate itself from lifestyle and wellness apps. In contrast, DTx products are medical interventions driven by high quality, evidence-based software programs,” Shull said.

Image: Provided by Jessica Shull


The DTA has produced a DTx Code of Ethics outlining ethical standards governing issues such as safety, privacy, and marketing guidelines. The Code reads rather like a doctor’s Hippocratic Oath, asking companies to ensure products do no harm and that they are backed with suitable evidence and patient information. Companies signing up to the Code must ensure data is secure and protected, and that they have the organizational and human resources to sustain products through their life cycle.

Shull told The Sidebar that signing up to the Code builds trust with doctors and the general public, and allows stakeholders to differentiate between health apps and digital therapeutics backed with clinical evidence.

“The ease of making apps has meant that anyone can create and make them available to the public, but there is no way to tell in the iTunes store, for instance, which ones have clinical evidence behind them and which don’t,” Shull explained.

“DTx are based on evidence, often on several clinical trials, having undergone years of development, refining, testing, Randomized Controlled Trials (RCTs), and always with healthcare professionals and end users (patients) involved in the design. They have a direct effect on the user’s disease or condition, so there must be careful studies done to prove their safety, accuracy, and efficacy.”

Sidekick was founded by clinical doctors with extensive research experience and the company understands the importance of quality clinical research. Sidekick’s results have been proven in clinical studies, including RCTs, in the target population, to lower long-term blood glucose, improve weight control, medication adherence and psychological health.

DTA executive director Megan Coder expanded on Shull’s comments in a recent press release.

“DTx products provide a monumental opportunity to improve how healthcare is delivered by increasing therapeutic options for unmet medical needs and expanding patient access and engagement. Given the importance of these therapies, DTA members appreciate the responsibility of protecting patients and end users every step of the way,” Coder said.

“In many ways, digital therapeutics are an extension of a clinician in a patient’s everyday life as they receive active treatment outside of a clinic. This is why these documents are so important,” she added.

The new guidelines build on previous work by the DTA, which in 2018 produced an industry report that offered a DTx definition, outlined industry principles, and provided information on different DTx product types.

The DTA has also collaborated with other organizations to outline digital products available to patients and clinicians. This categorization demonstrates how products making higher-risk medical claims must undergo greater levels of clinical evidence and regulatory oversight.

This demonstrates that not all digital products are the same and shows those products that are delivering medical interventions and making medical claims, are taking a serious approach to ensuring patient safety, protection and care.