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The majority of nearly 300 physicians snap-polled by FirstWord have observed an increased prevalence in mental health issues in the last two months as the COVID-19 crisis deepened. Subsequently, many have turned to digital therapeutics in their practice to manage both existing patients and new ones who are seeking help to cope during the pandemic.
In April, the US FDA issued an emergency policy that authorises digital therapeutics designed to treat psychiatric symptoms and disorders - specifically those that have not yet received regulatory approval - to be distributed temporarily during the COVID-19 pandemic in order to ensure continued care of patients while reducing face-to-face doctor-patient interaction and curbing potential spread of the virus. Since then, a number of companies have launched their products into the market, including Akili Interactive Lab with its Endeavor digital programme for attention-deficit hyperactive disorder and Pear Therapeutics with its schizophrenia digital therapeutic.
Happify Health, which specialises in digital therapies for depression and anxiety, has launched a new portal to enable its health plan members to connect faster to mental health resources. Citing the World Health Organization, the company said people affected by emergency situations, such as the global COVID-19 pandemic, experience immediate psychological distress, hopelessness, and sleep issues, and that 22% of people are expected to develop depression, anxiety, post-traumatic stress disorder, bipolar disorder or schizophrenia.
Our snap-poll aimed to assess the level of change in doctors’ prescribing trends around mental health digital therapeutics and what challenges might remain for the continued uptake of these products in mainstream medicine. Some 296 psychiatrists and general practitioners from the US and EU5 countries (Germany, France, UK, Spain and Italy) responded. Below are the results of our poll. Hover your cursor over the charts to get specific data points.
Prior to COVID-19, digital therapeutics featured very little in the practices of the vast majority of respondents. This class of products appear to be less popular among US physicians compared to EU physicians. Just over half - 52% - of US respondents said they did not use digital therapeutics to manage any of their patients at the start of the year, and a significant 40% said they were prescribing these products to less than 50% of their patient base.
A slightly smaller proportion of EU5 respondents said they either did not prescribe digital therapeutics (43%) or prescribed them to fewer than half of their patients (34%). While the percentages were still small, there were about four times more EU5 respondents who said they used digital therapeutics on half their patients (12% EU5 versus 3% US) or on more than half their patients (9% EU5 versus 2% US).
Over two-thirds of respondents from the US and EU5 have observed an increased prevalence in mental health issues in the last two months, as the COVID-19 worsened globally.
More US physicians (38%) than EU5 physicians (21%) said they are seeing this rise from existing mental health patients reporting worsening symptoms and also from new patients seeking help.
There are some discrepancies in responses between the EU5 countries, with Germany appearing to be least impacted by mental health issues arising from the COVID-19 pandemic. Some 52% of German respondents said they have not seen any increased prevalence in mental health symptoms at all. From those Germany physicians who have seen a significant change, 29% said these were mainly from existing patients reporting worsening symptoms, while 8% said these came from new cases.
When physicians were asked to rate how significant an increase - if at all - in the volume of digital therapeutic prescriptions/recommendations they have made to patients in response to the COVID-19 pandemic, only a minority of respondents said there had been no increase at all (27% US, 19% EU5).
Reflecting the higher level of resistance among US physicians towards digital therapeutics, as observed in their responses to question 1, less than half (47%) US respondents said there has been a moderate to significant increase in the uptake of these products in their practice. In contrast, a bigger proportion (56%) of EU5 respondents assigned the same significance ratings of 3 and above.
In terms of the benefits physicians believe digital therapeutics can bring to their practice, both US and EU physicians agree that the biggest is that these technologies offer a good complement to conventional pharmacotherapy. Interestingly, a much smaller proportion of physicians overall picked digital therapeutics being an alternative to conventional medicine as a benefit.
A slightly bigger proportion of physicians in the US compared to the EU appreciated the remote patient monitoring and interaction capabilities enabled by digital therapeutics.
Reimbursement is the key concern for US physicians when it comes to obstacles standing in the way of digital therapeutics’ wider adoption. In contrast, reimbursement is the least of EU5 physicians’ concerns, which is perhaps not surprising considering most European health care systems are publicly funded. Instead, EU5 respondents see bigger challenges in the other issues mentioned, such as getting enough clinical evidence and regulatory approval to back the uptake of the technology among clinicians, and also accessibility and lack of patient motivation (which could be interrelated factors).
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