Yes, personalized digital interventions actually work

Many physicians intuitively suspect that the key to successful chronic disease management and prevention is to encourage sustained behavior change in their patients. It’s noteworthy when new findings both verify their intuitions and offer new tools to support those changes.

Such are the results of a recent clinical study published in the Journal of Medical Internet Research (JMIR) Diabetes. This retrospective cohort study examined data from 998 people with Type 2 diabetes who used a digital health platform. The goal was to look at the connections between personalization in digital health solutions, sustained behavior alteration, and diabetes outcomes. Interestingly, the research:

1 lends some statistical weight to the idea that supporting sustained behavior change can significantly improve patient outcomes.

2 suggests the need for a hyper-personalized approach to digital health.

Study findings

The study was designed to look at the impact of digital engagement on monthly average blood glucose levels during a patient’s first year managing their diabetes on a digital platform. The 998 people reviewed were categorized into one of two groups:

• engaged users, defined as those who rarely or never used features of the digital health application but who did measure their blood glucose.
• highly engaged users, defined as those who consistently engaged with the application to tag and track their mealtimes, food, exercise, mood, and location along with their blood glucose.

Researchers found that highly engaged users demonstrated statistically significant improvements during the initial period (13%) relative to engaged users (9%). Furthermore, during the initial six-month period, they discovered a 43% drop in monthly average glucose levels in the month following increased digital engagement. Also striking was the fact that intrapersonal differences in digital engagement were associated with the reduction in monthly average glucose levels.

Key takeaways for physicians

So, what insights should providers draw from these findings?

First, the study offers a ray of hope for providers under intense pressure to improve outcomes. We can counsel patients all day long about the importance of healthy habits, but what happens once those patients step outside of the exam room? They may have every intention to adopt healthier behaviors, but the motivation usually wanes quickly once “real life” starts getting in the way. The JMIR study suggests that there is a way to better manage patients beyond the physician visit. Providers who offer access to digital tools that encourage continual self-management should be able to support healthier patient behavior and outcomes.

There’s a caveat, though. It’s not enough just to hand people an app. According to the JMIR research, driving sustained behavior modification requires understanding how people change, what causes those changes, and what helps those changes endure. The digital tools used must be capable of engaging patients dynamically, as each individual’s preferences and attitudes shift.

There are countless instances throughout health care where we try to stratify patients based on demographically derived personas. That’s a great start, but it’s only a start. Truly supporting behavior change demands a deeper, more genuine recognition of each individual’s personal growth.

Ignoring dynamic, intrapersonal change has been a major reason why digital interventions fail to engage patients to the extent necessary to impact outcomes. It makes sense, too. Anyone might be open to trying out a shiny new app. However, they’re not going to continue to engage with it unless it’s easy to use, delivers something that matters to them within the context of their daily lives, and is flexible enough to adapt as their needs change.

The research adds to the growing body of evidence that it is essential to address changes within individuals, not just account for the differences between people.

Omar Manejwala, M.D., is chief medical officer of DarioHealth.