Digital Health Age speaks to Professor Mike Trenell, chief scientific officer at Changing Health, a diabetes support programme that combines digital education with behavioural change coaching. The programme was recently used in a study conducted by researchers at Newcastle University. A member of the study used the programme to transition to a healthier lifestyle and even managed to become diabetes and medication free. DHA chats to professor Trenell to find out more about Changing Health and how digital health services like its platform are helping patients throughout the NHS.
- Could you tell me about Changing Health?
Changing Health is the only provider of evidence-based education and behaviour change support tools for people with, or at risk of, type 2 diabetes. It’s a unique combination that improves patient outcomes and makes better use of scarce health resources.
- What makes Changing Health different from other diabetes support programmes?
Changing Health is based on the findings from scientific research and development by some of the country’s leading academics in this field. The education content is derived from the only programme proven to have a clinically meaningful impact on weight and glycaemic control, X-PERT Health. Unlike other health apps, this education is combined with up to 100 minutes of one to one coaching with an accredited behavioural change expert over 12 months. The NIHR found a 12-month intervention leads to a 50% improvement in outcomes – on average, users lose 2kg more than on a three-month programme and crucially, sustain that weight loss over the longer term.
- Digital health technologies are on the rise but do you think people are aware of what is on offer?
Digital healthcare is still a sector in its youth. Innovative companies have a lot of work to do in making healthcare providers aware of the benefits on offer, particularly in a complex commissioning landscape like the NHS. But CCGs are increasingly seeing the value of innovations like Changing Health, which can help patients reduce HbA1c by 0.7% and save almost £3 for every £1 invested.
- Does the NHS need to do more to promote to health technologies for self-managing conditions like diabetes?
Awareness of new NHS services is often quite limited. As patients typically only spend three hours a year with a healthcare professional and fend for themselves for the remaining 8757 hours, support for self-management is vital. Likewise, only a tiny fraction of people attend face to face education courses. Changing Health makes these available to anyone, anytime, anywhere. The potential benefit to people with diabetes and the NHS as a whole is enormous. We would argue that the NHS should do a great deal more to publicise the service. By improving the health of people with diabetes we are reducing the risk of complications which cost the NHS £8bn a year. Given the heavy demands placed on the NHS, you could argue this is very much in its interest.
- What are the biggest benefits people are seeing when they use Changing Health?
On average, users of X-PERT Health, programme Changing Health is based on, see 4.4kg weight loss and a 2.2cm reduction in weight circumference. Combining this programme with lifestyle coaching improves the likelihood of success by 50%. This reduces the risk of complications arising from type 2 diabetes and means fewer unplanned hospital attendances and fewer medications prescribed. That has huge implications for people with type 2 diabetes; one user, who featured on the recent BBC1 documentary How to Stay Young, used Changing Health to reverse her diabetes in just 12 weeks. She’s now entirely medication free. Another reduced his “true body age” by 15 years over the same period, losing 16kg.
- How has the NHS responded to the platform?
We’re seeing very positive results from the CCGs who have adopted the service so far. One diabetes clinical lead told us the service has provided a much higher response rate for diabetes education, with increased on-boarding among all demographics.
- Do you think people are more willing to change their lifestyle when engaging with an app?
We’re not an app; Changing Health users have access to a behavioural change coach who offers personalised support, applying evidence-based techniques scientifically proven to create impact. The service provides highly accessible information and decision support tools, available whenever and wherever is best for the user. Apps alone aren’t enough to change behaviour.
- Does Changing Health use any gamification techniques to motivate users?
There are a number of evidence-based interactive elements to the app to motivate users to meet their goals, which are very effective in facilitating weight loss.
- Do you think the advance of digital technologies in healthcare could divide those without access to services provided by smartphones etc.?
It’s not one or the other; the issue is scale and access. At present, many people with diabetes don’t understand their condition, and digital helps that.
- Any future plans for Changing Health?
Our launch into the NHS this year has been very encouraging. We are building on this to make our service available to NHS patients throughout the country. As well as our services for people with type 2 diabetes and for those at risk of the condition, in early 2018 we’ll be launching an evidenced based digital weight loss service. We have plans to launch in a number of overseas markets.