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Thursday July 27 2017

Therapy in the Palm of Your Hands

Even while writing this, I found myself scrolling through one app or another on my phone. It’s truly amazing how the development of technologies, such as the iPhone or the iPad, has made it easier for us to have so much information in the palm of our hands. Even without actively using the Health app already included in my iPhone, I’ve realized now that it tracks how much I walk on a daily basis, along with providing me options to monitor sleep, daily nutrition and fitness.

Such apps, with their utility in daily life, have transformed healthcare, with many being used for conditions ranging from diabetes to inpatient psychiatry, such as smartphone sensors used to monitor behaviour in schizophrenic patients.1,2 Reportedly over 31,000 health and medical apps exist, with many focussed on the prevention and management of chronic diseases, as well as to monitor health behaviours and vitals.2

A new study published in The American Journal of Geriatric Psychiatry has presented preliminary findings that tablets — and, in particular, the built-in apps — can potentially be used as a therapeutic approach to reduce agitation in patients with dementia. This finding, corroborated with that of another study, suggests that technology can be used to improve the quality of life for those dealing with neurodegenerative diseases and the associated side effects of cognitive decline.3

Dementia is a disorder that arises from abnormal brain function and is marked by changes in memory, behaviour, and cognitive functioning.3 Associated with behavioural symptoms such as incoherent speech, agitation, aggression and psychosis, it can lead to increased need for institutionalization, as well as rising healthcare costs.1,3 Current treatments, such as antipsychotics, have had limited benefits with potentially high risk of side effects.1

Previously, non-pharmacologic approaches such as music and art therapy have produced positive outcomes. Most often, however, these approaches have been used under set guidelines for implementation and have been resource-intensive.1 The possibility for apps and other electronic devices to be used as an intervention for patients with dementia presents a more feasible and flexible solution. This is particularly because these technologies can be used to deliver a wide variety of interventions, including music, reading, or video calls with family members, within one small handheld device.

As Ipsit Vahia, who led this pilot study, told Harvard Medical School news, “Our preliminary results are a first step in developing much-needed empirical data for clinicians and caregivers on how to use technology such as tablets as tools to enhance care and also for app developers working to serve the technologic needs of this population.”4 Their study found that tablet use produced positive outcomes in reducing symptoms of agitation, particularly in those with milder forms of dementia.1,4

While the study findings are preliminary and based off of a relatively small sample size, the potential for this to be used as an effective non-pharmacologic intervention in patients — not just with dementia but possibly with other neurodegenerative diseases as well — is enormous.

Admittedly, more research still needs to be conducted to discover any potential side effects from long-term use in such patients, as well as regarding other factors such as the applicability of results to non-inpatient settings. However, this has certainly opened the door for the use of technology as a viable approach to such diseases. Through the use of accessible mobile apps to help reduce agitation, dementia patients can potentially stay in their homes longer as well as have an improved quality of life.

It is estimated that currently around 47.5 million people have dementia worldwide, with 7.7 million new cases annually.5 With the advancement of technology happening at a rapid pace, this presents the opportunity to transform the approach to conditions like dementia and to improve life for those suffering daily due to their cognitive decline.

By Takhliq Amir

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References

  1. Vahia IV, Kamat R, Vang C, Posada C, Ross L, Oreck S, Bhatt A, Depp C, Jeste DV, Sewell DD. Use of Tablet Devices in the Management of Agitation Among Inpatients with Dementia: An Open-Label Study. The American Journal of Geriatric Psychiatry. 2016. Available from: 10.1016/j.jagp.2016.07.011 [Accessed 3rd February 2017].
  2. Payne HE, Lister C, West JH, Bernhardt JM. Behavioral functionality of mobile apps in health interventions: a systematic review of the literature. JMIR mHealth uHealth. 2015;3(1):e20. Available from: http://mhealth.jmir.org/2015/1/e20/?utm_source=TrendMD&utm_medium=cpc&utm_campaign=JMIR_TrendMD_1#Introduction [Accessed 3rd February 2017].
  3. Yamagata C, Coppola JF, Kowtko M, Joyce S. Mobile app development and usability research to help dementia and Alzheimer patients. Systems, Applications and Technology Conference (LISAT), 2013 IEEE Long Island. 2013; pp 1-6. Available from: https://www.researchgate.net/publication/261203141_Mobile_app_development_and_usability_research_to_help_dementia_and_Alzheimer_patients [Accessed 3rd February 2017].
  4. Peterson C. An App A Day. Harvard Medical School. Jan 18 2017. Available from: https://hms.harvard.edu/news/app-day?utm_source=Silverpop&utm_medium=email&utm_term=s2&utm_content=1.30.17.HMS [Accessed 3rd February 2017].
  5. World Health Organization. Dementia. Available from: http://www.who.int/mediacentre/factsheets/fs362/en/ [Accessed 3rd February 2017].

 

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