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Nurses are set to be given the green light to recommend health apps and devices to their patients who are at risk of developing chronic illnesses.
New draft guidance from the National Institute for Health and Care Excellence (NICE) states health professionals can “consider” digital and mobile interventions to help change damaging behaviours.
“We need to systematically build the real-world evidence for these interventions”
Tools such as apps and wearable devices may help people achieve health goals, according to the NICE guidelines, which will go to consultation before implementation.
Examples given include helping people get physically active, manage their weight, quit smoking, reduce alcohol intake or reduce unsafe sexual behaviour.
However, NICE stressed that the effectiveness of such interventions remains unknown and recommends their use only in addition to regular health services and “not as a replacement”.
The body also acknowledged that such advice may not be suitable for particular vulnerable groups because it may lead to limited interaction with health professionals.
“As an example, these interventions could be used by abusers to prevent people who are trafficked and young people who are vulnerable to sexual exploitation from having a face to face consultation that would expose the person to the authorities,” said the guidelines.
Health professionals should also make patients aware of potential “unintended consequences” such as disordered eating or excessive exercise.
Interventions should come from a reliable source where possible such as the Couch to 5k, Change4Life Food Scanner or Smoke Free apps backed by Public Health England, added NICE.
Patients should be advised to check their personal data settings, read the terms and conditions and be aware of advertising and extra costs.
The document said: “The committee were not confident that digital and mobile health interventions would be effective on their own for most people because of the poor evidence.
“But they agreed it would be better than nothing for people who want a more discreet tool to help change their behaviour or who cannot make it to face-to-face consultations.”
In terms of how the changes would affect practice, NICE said health professionals may need extra time during the initial appointment to introduce the technology to patients.
However, after this, health resources should be “freed up” because patients will be using the interventions in their own time, leading to cost savings.
Welcoming the guidance, Matthew Walker, director of strategy and digital lead at the National Association of Primary Care, said improving access to digital interventions for patients was “hugely important” and brought healthcare in line with the way the public was accessing other services.
However, Mr Walker warned that investment was needed in training to support health professionals to make the ambitions a reality.
He told Nursing Times: “There’s going to be a large proportion of the clinical workforce who may not be up to speed on some of these applications and so they need to be supported to do that.
“They have had their training and their career in what you might call conventional prescribing and medicines and what have you, and then this is a new thing coming along.”
“Digital interventions for behaviour change could help people make important improvements to their lifestyle”
He also highlighted the need to build the evidence-base behind these interventions to give health professionals confidence in prescribing them.
“It’s one of the challenges that we at NAPC are hoping to try and challenge really which is we need to systematically build the real-world evidence for these interventions,” said Mr Walker.
“Because otherwise practitioners are going to look at it and say: ‘well we have always done it this way and we are confident that it has worked okay enough…what’s the evidence for doing this now?’”
If these issues could be overcome and sufficient safeguards put in place for patient confidentiality, Mr Walker said the new approach offered a “huge opportunity to provide more proactive care”.
“What we have found through our work is that there’s a huge need to deliver ‘light touch’ interventions in terms of things like lifestyle change and proactive health,” said Mr Walker.
“There’s a huge need out there because that’s where a lot of cost and a lot of difficulties for patients is happening because it’s not delivering for them at the moment.”
A consultation on the draft NICE recommendations will run until 6 March 2020 and can be completed here.
Paul Chrisp, director of NICE’s centre for guidelines, said: “Digital interventions for behaviour change could help people make important improvements to their lifestyle, which may reduce their risk of developing serious chronic conditions such as diabetes and cardiovascular disease.
“Clinicians may choose to consider these interventions as an option to work alongside traditional health care services towards a change in behaviour.”