Prof. Hoirun Nisa, SKM., M.Kes., Ph.D.

Professor of Epidemiologi, Faculty of Health Sciences, UIN Syarif Hidayatullah Jakarta

Chronic diseases such as obesity, diabetes, hypertension, and heart disease are now increasingly worrying global health problems. The increasing prevalence of these diseases not only burdens the health system but also reduces the quality of life of millions of people. Meanwhile, the development of digital technologies such as health apps (mHealth), text messaging, wearable devices, and telemedicine has opened up new opportunities to support the public in managing chronic disease risk factors.

The question is, to what extent is digital technology truly effective in controlling the risk of these chronic diseases?

A systematic review of 548 articles published between 2016 and 2021 identified 13 relevant randomized controlled trials (RCTs), and the answer is not a simple yes or no. The use of digital technologies utilizes various modalities, including mHealth (apps), text messaging, and a combination of modalities, with a strategic focus on education, self-management, and social support. Evidence shows that the use of digital technology consistently helps reduce weight and body mass index. This is certainly good news, considering that obesity is a gateway to many chronic diseases. However, the results are still unclear and inconsistent for other indicators such as blood pressure, blood sugar, or cholesterol.

Why Is Weight More Easily Managed?

Weight loss seems easier to achieve using digital technology because of its immediate nature: apps can track calories, provide activity reminders, or provide instant social support. Meanwhile, blood pressure or blood sugar levels are influenced by more complex factors, including genetics, stress, sleep patterns, and medication adherence. Therefore, education or motivational messages using digital technology alone are not enough.

The Role of Digital Technology in Chronic Disease Management

The integration of digital technology in chronic disease management focuses on three main pillars: proactive monitoring, personalized intervention, and increased access to services.

1. Remote Monitoring and Wearable Devices

Wearable devices and medical sensors have revolutionized the way health data is collected. Patients can now continuously monitor important health risk parameters such as glucose levels (through Continuous Glucose Monitoring (CGM), blood pressure, heart rate, sleep patterns, and physical activity levels. This real-time data is sent to healthcare providers, enabling early detection of anomalies or concerning trends. This shifts care from reactive to proactive.

2. Telemedicine and Virtual Consultations

Telemedicine, or remote healthcare, eliminates geographical and time barriers, ensuring timely intervention. Patients can have video consultations with doctors, receive electronic prescriptions, and receive guidance without leaving home, which is crucial for improving adherence to scheduled appointments.

3. Digital Health (mHealth) Apps and Behavioral Interventions

Mobile (mHealth) apps offer highly personalized daily tools. These apps can track food intake, provide medication reminders, and provide customized exercise plans. This personalized service is powered by artificial intelligence (AI). These apps help patients maintain difficult lifestyle changes through personalized feedback and encouragement.

Key Strategies for Digital Healthcare

The success of digital technology in chronic disease management is determined by a structured, patient-centered, and data-driven implementation strategy:

1. Behavior Change Intervention

This strategy focuses on changing patient behavior. Technology is used to provide personalized education and information (e.g., disease-specific dietary guidance), facilitate self-advocacy (through tracking and goal-setting features), and create social reinforcement (digital community forums) for ongoing motivation.

2. Remote Monitoring

This strategy ensures proactive monitoring through continuous data collection from wearable devices. Data is processed for early detection and automated alerts to patients or physicians, enabling rapid intervention before conditions worsen.

3. Improved Access and Efficiency of Services

This strategy aims to facilitate access to services. Through telemedicine and virtual consultations, distance barriers are eliminated. The use of an integrated electronic medical record system improves care coordination and ensures all providers have a complete picture of the patient's health.

4. Advanced Data Analytics and Personalization

This strategy involves the use of artificial intelligence (AI) to analyze patient health Big Data. AI not only supports predicting the risk of future complications but also enables the tailoring of personalized treatment recommendations specific to each individual, such as medication dosages or lifestyle programs.

Challenges and the Future

While the potential of digital technology is enormous, its implementation still faces challenges such as disparities in access, adherence, concerns about data security and privacy, integration with healthcare services, and limited scientific evidence. However, developments in AI and machine learning will transform digital technology from mere monitoring tools into personal health assistants integral to chronic disease management.

Conclusion

Digital technology offers a critical bridge to more effective and patient-centered chronic disease management. By enabling continuous monitoring, personalized interventions, and increased access through integrated strategies, this technology not only controls risk but also empowers individuals to take active control of their own health, promising a future where chronic disease can be better managed and complications can be avoided.

However, challenges of access, adherence, data security, system integration, and scientific evidence must be overcome to fully realize its benefits.

With clear regulations, patient education, and further research, digital health could become a vital partner in reducing the burden of chronic disease in the future.

References:

Nisa H, Barsbay F. (2022). Digital Health Interventions to Improve Cardiometabolic Risk Profile among Adults with Obesity and Chronic Diseases. Nurse Media Journal of Nursing (NMJN) 12 (1), 133-150.

World Health Organization. (2022). Global report on assistive technology. Geneva: World Health Organization and the United Nations Children's Fund (UNICEF).