Integrating Prescription Digital Therapeutics Into Practice


Nidal Moukaddam, MD, PhD, Baylor College of Medicine, comments on where she sees prescription digital therapeutics being most useful when managing behavior-driven conditions.

Megan Coder, PharmD, MBA: Dr Moukaddam, regarding behavior-driven conditions, where do you see prescription digital therapeutics being most beneficial?

Nidal Moukaddam, MD, PhD: That’s a good question. Again, go back to the clinician perspective. The ideal digital therapeutic is something that is based on solid scientific and diagnostic ground, that is helpful for the patient when they are outside of the clinician’s office. A clinician, doctor, nurse practitioner, or anyone treating a patient always wishes that they could be with the patient when things happen, so they can detect what’s going on.

Caregivers cannot rely on what people tell them all the time, given that mood will affect your recollection and the presence of bias when you’re anxious or paranoid. Digital therapeutics fit very well as an extension of your clinician, which is your greater context. Regarding details, if you want to think about how we can apply this, you think of it as either teaching a skill or perpetuating a skill or behavior, which is where digital therapeutics would fit best.

You can see the applicability in terms of preventing self-harm, preventing cutting or self-injurious behavior. Moreover, you can see it in the realm of addiction. It’s very big. For example, the reSET app, using cognitive behavior principles can reinforce many of the things that we tell our patients and teach our patients. To pick the right digital therapeutic, you must know what you’re going for. However, those objectives can be hard to measure in psychiatry and mental health, so you need context. The first level of context is what am I prescribing this for, or what am I recommending this for? The second level of context is what do I expect this to achieve? If I’m expecting it to teach a new skill, you’ll need have to a starting point in the clinical encounter, which an app cannot do by itself.

Megan Coder, PharmD, MBA: That’s an excellent overview of how those processes work and how they’re integrated into that perspective. Thank you.

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