Today in France, over 99% of the population aged 15 or more have a telephone, fixed or mobile (source: Insee). Today, the smartphone has numerous functions and has the ability to interact with feedback in real time through its many sensors. In addition, smartphone applications could offer a number of advantages, including new complementarities to treat, among other things, people who are underserved when it comes to health mapping.
Digital therapies or "DTx"
Since very recently, a new class of emerging therapies has been tending to complement the so-called “traditional” drug approaches: the digital therapies or DTx. By definition, these digital therapies provide evidence-based therapeutic interventions that are driven by high-quality software to prevent, support or treat syndromes or diseases (in addition to standard care).
Recognition as a treatment method by the health authorities, in the same way as a conventional drug, means that these new methods of care can be integrated into the medical system and be reimbursed by insurance companies and social security.
The contribution of digital therapy in the treatment of addiction
Care for a patient suffering from an addiction disorder is based on consultations with a healthcare professional at more or less regular intervals. However, interactions between patient and healthcare professional remain intermittent, which compromises the ability to provide real-time responses to the patient's lifestyle (physical activity, sleep), social interactions and health desires, all of which are known to be factors predictive of relapse.
Furthermore, during this time, the patient may encounter difficulties to remain abstinent and to reconsume their substance when various events occur (stressful situation, social pressure, availability of the substance, lack of motivation, low morale...).
Cognitive and behavioral therapies are just some of the therapies integrated into digital applications, which provide the patient with training adapted to his or her psychological profile in order to replace inappropriate behaviour with a more appropriate one. The term “digital” comes into play here, as the therapy is directly available on the user's connected device, enabling them to have access to proposed exercises in addition to its usual medical care.
The medical need is very real: for example, the use of digital technology as a digital companion is essential to boost motivation and then abstinence in this cessation addiction process.
State of the art of digital therapy in addictology
In United States, the opioid crisis has fostered the emergence of new therapeutic and digital solutions. In response to this major public health problem, the American company Pear Therapeutics has launched the fisrt digital treatment of opioid addiction using cognitive-behavioral approaches and a system of financial reward to motivate patients to stop using drugs.
Subsequently, other U.S. companies focused on developing digital treatments to combat substance dependence. Quit Genius offers a comprehensive 100% virtual assistance program with audio and interactive exercises, as well as Click Therapeutics, which has set up a tobacco monitoring program which provides access to a personalized messaging service and personalizes treatments with artificial intellignece.
At the same time, the emerging market for digital therapies is very dynamic and has seen many players develop and provide innovative solutions in Europe: German company GAIA offers Vorvida ®, a digital therapy for alcohol addiction, and the Swedish company Alex Therapeutics® , which has set up QuitSmoking®, an AI-based nicotine dependence support program.
A digital therapy soon available in France to stop tobacco addiction!
For several months now, the young French company KLAVA Innovation has been developing a digital therapy medical device for people suffering from smocking. Combined with artificial intelligence, the software application offers personalized support and guidance for each patient/user. The two objectives of this approach are to help patients in their day-to-day lives, and to provide medical and care teams with additional keys to their clinical practice.
In the context of a feasibility study, one of KLAVA's objectives is to achieve a first proof of concept (POC) in the AP-HP Paul Brousse addictology department.
Real-world evidence of a digital prescription therapy to treat opioid use disorder, Yuri A Maricich & co, Curr Med Res Opin. 2021 Feb
Long-term efficacy of a clinician-assisted digital cognitive behavioral therapy intervention for smoking cessation: secondary results of a randomized controlled trial, Jamie Webb & co, Nicotine Tob Res. 2022 Oct
The effectiveness of an Internet-based intervention to reduce alcohol consumption in adults, Jördis M Zill and co, Dtsch Arztebl Int. 2019 Feb
Clinical trial of innovative digital smoking cessation therapy with biochemical verification, clinicaltrials.gov 2022
Autors:
Alexia ADDA
Dr Ivan GASMAN (Psychiatrist)
English 
French