Advancing digital therapeutics and AI

Benefits to patients and health systems

written by Sian Jarvis, CB, FRCGP(H) , CMO

Looking ahead to our plans for 2024, with new investment in place, we at Liva want to reflect on the progress we’re making to help people achieve better health and wellbeing through our digital-first behaviour change programmes.??

The coaching team at Liva have now supported nearly 60 thousand patients and participants who are living with obesity, prediabetes and type 2 diabetes, to lose weight and prevent, manage and reverse their condition.?

Our coaches know well how lonely and challenging this journey can be for people but they also know with the right personalised support the difference they can make is life-changing.

Jo is one of Liva’s patients on the NHS Type 2 Diabetes Path to Remission programme coached by Fumi Fukada. Jo was proud to share her story when she was only half way through the programme and had already lost significant weight – 20 kilos – and achieved a reduction in blood sugar levels putting her on course to a diabetes-free life.??

Dennis is another patient who had tried so many different ways to control his weight and manage his condition until he was referred to Liva’s digital-first coaching programme. The combination of digital engagement and one-to-one personalised support, like having a pocket life coach, was a real game-changer for him.? After just 18 weeks he had lost 6 stone (38kg) and achieved the results he needed to get his diabetes under control and start the journey to remission.?

Impact at scale through digital-first innovation

Developments in digital health tools, technology and AI are pushing the boundaries of medical science, health and healthcare reform.??

We are witnessing how digital therapeutics are advancing better outcomes especially for people living with cardiometabolic conditions. Obesity and Type 2 Diabetes are on the rise worldwide, placing enormous pressure on health systems. With early diagnosis and proactive care these conditions can be reversed; the World Health Organisation estimates 80% of chronic disease can be prevented.

Results from Liva’s random controlled trial in Denmark demonstrated how this is possible. The study found 47% of patients with prediabetes reversed their condition and 37% of people living with diabetes entered the non-diabetic range, setting them on course for remission.**

We continue to build on this work and are achieving even better outcomes for NHS patients. Liva is the digital provider for three NHS programmes: The Healthier You NHS Diabetes Prevention Programme, Digital Weight Management and Type 2 Diabetes Path to Remission Programmes.? In October last year we were excited to report early results from this last programme, showing patients losing significant weight and 70% of the patients after six months achieving HbA1C blood sugar levels within the non-diabetic range, setting them on course to put their diabetes into remission.??

Jo is one of a 100 new referrals Liva is receiving each month and she talks about the difference it has made to her life. Click the image below to hear her story.

Artificial Intelligence fast-tracking personalisation

Liva’s data and analytics team has been harnessing the power of machine learning and AI to accelerate the design of personalised coaching programmes. Our coaches need to process vast amounts of information and data from their patients during a life-change programme: number of steps taken, activity levels, weight-loss, changes to diet, drops in tracking frequency, questions on a range of subjects.? This year we launched a new insight module powered by AI that automatically highlights and processes this information, enabling our coaches to precisely personalise each behaviour change plan and frees them up to offer more one-to-one support to their patients.?????

This year, we will step up our use of AI and machine learning providing our coaches with automated transcribed summaries of patient activities, auto-generated journals of past activity, and assistance in generating the right personalised health content, behavioural nudges and notifications for patients to enhance their change journey.??

Our hybrid approach combining digital engagement with one-to-one coaching delivers consistently high engagement and retention rates across all our programmes.? AI and digital engagement is enabling us to maximise the impact of our professional coaching team, offering patients more actionable insights and timely motivational feedback.? Liva has a deep understanding of how to motivate people to achieve sustainable behaviour change, combining pioneering digital solutions with clinical coaching expertise.??

With further developments and applications of AI we aim to scale the impact of our programmes to advance better health outcomes and tackle inequalities in 2024.?

Making the case for change through research and evidence

The safety and efficacy of our digital therapeutic programmes are well-supported by extensive evidence from randomised controlled trials (RCTs) and other clinical studies. Together with partners we have collaborated in 6 randomised controlled trials and 13 real world evidence clinical trials.??

Off the back of this, in October last year we were delighted to be selected by the National Institute for Health and Care Excellence as one of the leading digital therapeutics platforms to offer hybrid weight-loss programmes in partnership with the NHS to help tackle the obesity crisis. ?The results from one of our studies into medicated weight-loss were analysed by NICE as part of their assessment.? In this study patients lost 4.5kg in six months supported by Liva’s lifestyle change coaching platform in contrast to those patients using conventional methods who reported weight-loss of only 1.5kg.??

In the same study, the Defeat Obesity Project conducted in Denmark, there were other noteworthy outcomes.? Just five months into the project participants recorded an impressive 32% reduction in sick days at work, substantial weight loss averaging 12.7%,? improved sleep quality, and a surge of 16% in people self-rating their health as ‘very good’.?

Participants also recorded a remarkable 6.5% improvement in mental health.? These findings offer an insight into the potential benefits of scaling digital-first lifestyle change programmes across a range of cardiometabolic conditions including obesity.? Improved mental health, reduced work absence, lower rates of hypertension and heart disease as well as overall better health and wellbeing could be achieved if targeted lifestyle change programmes were rolled out at scale across the population.?

We are eagerly anticipating the final report of the Defeat Obesity Project report which will be available in February 2024.

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Our research delivering new insights for 2024

We’re also expecting the first results from another project funded by the European Union’s Horizon 2020 research and innovation programme that is setting out to revolutionise maternal and child health.? Liva is collaborating in a unique randomised controlled trial, testing an innovative maternal health intervention for lifestyle behaviour change during pregnancy and the first year after birth.??

The new study Bump2Baby and Me Project , reaches across four countries and targets pregnant women at high risk of gestational diabetes (GDM) and follows them until their baby’s first birthday. The coaching support and healthcare delivery will be comprehensive and offered remotely in order to reach more women wherever they live.?

Perhaps one of our biggest, most exciting collaborations to date has come to fruition and will deliver new insights through 2024 and beyond.? This is named the Lighthouse Consortium on Obesity Management (LightCOM) and is a three year clinical trial bringing together researchers from the UK and Denmark to develop and test new obesity management programmes.? The goal is to improve health and quality of life through solutions can contribute to lasting changes, including long-term weight loss.? The Novo Nordisk Foundation is backing the project with a grant of DKK 180m (￡24.2 m).??

The programmes will be tested across the healthcare system in both Denmark and the UK and will make use of dietary strategies as well as our innovative digital and health technology solutions to support lasting lifestyle change.?

This year Liva has advanced and expanded its operation in order to deliver impact at scale thanks to the commitment of our dedicated team of digital health professionals and expert clinical coaches.? We are proud to have collaborated with the biggest health systems, life-science companies and academic institutions and established our reputation as a trusted digital-first health partner.? We would like to thank our partners and our teams for their hard work and look forward to what we can achieve together in 2024 for better health and wellbeing.

References

* https://www.who.int/data/gho/data/themes/noncommunicable-diseases

** A Loss in a Primary Care-Anchored eHealth Lifestyle Coaching Program in Denmark: Randomized Controlled Trial”; JMIR Diabetes May-2022; DOI:10.2196/39741