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Transforming PGHD and Digital Nudges into Action

Last month’s Direct Connection explored which features within digital technologies drive engagement, and the value of applying behavioral economic principles to digital nudging. This month we examine how person-generated health data (PGHD) can be used to identify and target individuals for digital nudging and the potential nudging can have on positively impacting health behavior. 

At Evidation, we use PGHD to identify individuals who could benefit from engagement, nudge them towards evidence-supported actions, and measure outcomes and engagement through our various Health Programs on Achievement.

Researchers at Otsuka Pharmaceutical published a study where they examined how passively collected PGHD markers of behavioral change relate to medication adherence in patients with serious mental illness. They used wearable sensor data to compute an activity rhythm score (based on step count patterns) and activity intensity (based on heart rate), and evaluated these scores in combination with a digital system incorporating an ingestible sensor to track medicine ingestion. The study uncovered higher daily levels of activity rhythm and activity intensity correlated with a higher likelihood of medication ingestion on the following day, providing evidence of a potential link between patient activity behavior and medication adherence in this population.

In an Evidation study that examines the relationship between medication adherence and health behaviors among individuals with hypertension, diabetes and dyslipidemia, it was found that adopters of digital trackers tend to be more adherent. This suggests the value of further examining medication adherence programs that incentivize health tracking and insights from connected devices to improve health outcomes. 

Once a patient is targeted through PGHD for additional focus on medication adherence, are digital nudges or other eHealth tools effective in motivating these patients to take positive action? In a recently-published review, researchers evaluated the effectiveness of 29 different eHealth interventions, incorporated in 22 randomized clinical trials, on improving adherence in adults on long-term medication due to a chronic condition. A majority of the interventions analyzed showed a statistically significant effect on medication adherence compared to the control group, with 6 of the 14 evaluable interventions demonstrating a large or medium effect size, and the remaining 8 had a small or negligible effect. The strongest evidence of a positive effect was related to the use of SMS and interactive voice response (IVR) channels, intervention strategies related to teaching skills, facilitating communication or decision making between the patient and health care professional, and coordinating medication adherence care between professionals. 

At Evidation, we also saw the benefits of engaging and motivating individuals to take action through a digital intervention targeting individuals with diabetes to obtain their flu vaccination. By digitally nudging this population, we saw a measurable increase in vaccination rates relative to those who did not engage with the program.

Other Good Reads:

Loss‐Framed Financial Incentives and Personalized Goal‐Setting to Increase Physical Activity Among Ischemic Heart Disease Patients Using Wearable Devices: The ACTIVE REWARD Randomized Trial | Journal of the American Heart Association

Combining Web-Based Gamification and Physical Nudges With an App (MoveMore) to Promote Walking Breaks and Reduce Sedentary Behavior of Office Workers: Field Study | JMIR

The effectiveness of nudges in improving the self-management of patients with chronic diseases: A systematic literature review | Health Policy

Test behavioural nudges to boost COVID immunization | Nature

VA partners with the Digital Medicine Society (DiMe) to advance digital innovation | Digital Medicine Society

What we’ve been up to:

Announcements: We are pleased to announce our collaboration with HealthVerity to provide greater transparency into the patient experience by allowing individuals to connect their wearable and survey data with real-world data from clinical settings. Based on consent per-use, individuals can share electronic medical records, medical and pharmacy claims, and lab data, along with Achievement data, to help researchers better understand, detect, and treat diseases. Read more here.

Research: Machine learning for health must be reproducible to ensure reliable clinical use. In collaboration with MIT, UoT, and Vector Institute of Artificial Intelligence, we evaluated 511 scientific papers across several machine learning subfields and found that machine learning for health compared poorly to other areas regarding reproducibility metrics, such as dataset and code accessibility. Read more here to understand how we can address this problem.

Thought Leadership: This past year, Evidation joined Digital Medicine Society (DiMe) and other influential stakeholders in the Tour of Duty to drive the development and deployment of digital clinical measures to improve clinical research, clinical care, and public health. Digital clinical measurement is central to a more patient-focused future of clinical research and care delivery.  In honor of celebrating the launch of The Playbook: Driving Adoption, DiMe is hosting a webinar to showcase over 100 new resources that deliver valuable information and insights from the Playbook in accessible, bite-sized chunks. It includes new action-oriented resources such as checklists and value frameworks that drive the adoption of digital clinical measures to improve lives. Join our Evidation representatives, Bray Patrick-Lake and Ieuan Clay for the April 30th event by registering here.

Live Panel Discussion: Evidation and HealthVerity are hosting a webinar Wednesday, May 5 at 1 PM ET/ 10 AM PT to discuss how the connection of person-generated health data combined with RWD allows for enhanced insights into the patient journey. Panelists will include Andrew Kress, Co-Founder and CEO, HealthVerity, Mikki Nasch, Co-founder and VP of Business Development, Evidation, and Jimmy Fisher, Director, RWD & Insights Lead, Payer Channel & Access Marketing, Pfizer. Sign up here.

Further reading