Apr 18, 2020

Protecting those most vulnerable to serious illness due to COVID-19

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We are in the midst of a pandemic that affects almost every aspect of our daily lives and livelihoods. While good data is still emerging, we know that COVID-19 disproportionately harms older individuals with underlying health conditions like diabetes, heart disease and obesity. More than ever, we need solutions that can improve health, monitor risks, and escalate care quickly when needed. We need to be able to deliver these solutions remotely to exceptionally large numbers of people in a cost-effective way without placing additional burden on the healthcare system, doctors or nurses. Protecting these most vulnerable individuals will be critical to any effective public-health approach and economic recovery effort, especially following immediate crisis response and until effective therapies and vaccines become available.

Protecting the Most Vulnerable Using Digital Therapeutics - A Potential Solution

Recently, we tested a digital therapeutic (software designed for the treatment, prevention, or mitigation of disease) among individuals from 32 states now known to be at higher risk of severe illness due to COVID-19 - older adults with underlying health conditions. All study participants had poorly controlled diabetes (HbA1c 8.7%); they averaged 55 years of age, were taking an average of 2.2 antidiabetic medications, and were obese (BMI 34.7). Significantly, they were first diagnosed with diabetes nearly 11 years prior, on average, yet still were poorly controlled despite a diagnosis and treatment with medications.

Using the digital therapeutic developed by Better, 60% of study participants lowered HbA1c by 1% or more, a degree of reduction associated with a 21% decrease in diabetes related mortality and a 40% reduction in microvascular complications, or became well controlled (HbA1c <7.0%) in an average of 71 days. We hypothesize that longer duration of use may result in even greater improvements in glycemic control.

Validated digital therapeutics may play an important role in protecting the most vulnerable. They can be rapidly deployed into large populations as mobile apps to improve health, remotely monitor disease biometrics and self-reported symptoms, and escalate care as needed for triage and medical direction. This may be an effective way to protect high-risk patients and keep them out of hospitals, emergency rooms and primary care clinics, alleviating burden on the system and associated costs.

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