Today in France, more than 99% of the population aged 15 or over is equipped with a telephone, fixed or mobile (source: Insee). Today, the smartphone has many features and has the ability to interact with real-time feedback via its many sensors. In addition, smartphone applications could have many advantages, offering new complementarities to care, among others, to underserved populations in terms of health mapping.
Digital therapy or “DTx”
Since very recently, a new emerging class of therapies has tended to complement the so-called “traditional” drug approaches: digital therapies or DTx. By definition, these digital therapies provide evidence-based therapeutic interventions that are driven by high-quality software programs to prevent, support or treat syndromes or disease (in addition to standard care).
This recognition as a means of treatment by the health authorities, in the same way as a classic drug, allows these new methods of care to be integrated into the medical system and to be reimbursed by insurance companies and social security.
The contribution of digital therapy in the treatment of addiction
The treatment of a patient suffering from an addiction disorder is based on consultations with a health professional at more or less constant intervals. However, the interactions between the patient and the healthcare professional remain intermittent, which compromises the ability to provide real-time responses to the patient’s lifestyle (physical activity, sleep), social interactions and cravings, which are known to be predictive factors of relapse.
In addition, during this time interval, the patient may encounter difficulties in remaining abstinent and reconsuming his substance when different events occur (stressful situation, social pressure, availability of the substance, demotivation, low morale…).
Cognitive-behavioral therapies are part of other types of therapies inserted in digital applications, which allow to provide the patient with a learning adapted to his psychological profile in order to replace the inappropriate behavior with a more appropriate one. The term “digital” comes into play here because the therapy is directly available on the user’s connected device, allowing him/her to have access to exercises that are proposed as a complement to his/her usual medical care.
The medical need is very real: thus, the use of digital technology as a digital companion is essential to reinforce motivation and therefore abstinence in this process of stopping addiction.
State of the art of digital therapy in addictology
In the United States, the opioid crisis has encouraged the emergence of new therapeutic and digital solutions. To address this major public health problem, the American company Pear Therapeutics has launched the first digital treatment for opioid addiction using cognitive-behavioral approaches and a financial reward system to motivate patients to stop using.
Subsequently, other U.S. companies have focused on developing digital treatments to combat substance addictions. Quit Genius offers a complete 100% virtual assistance program via audios and interactive exercises, as well as Click Therapeutics, which has set up a follow-up program for tobacco that provides access to a personalized messaging service and personalizes treatments through artificial intelligence.
At the same time, the emerging market of digital therapies is very dynamic and has seen many players develop and bring innovative solutions to Europe: the German company GAIA offers Vorvida ®, a digital therapy for alcohol addiction, and the Swedish company Alex Therapeutics® has set up QuitSmoking®, an AI-based support program for nicotine addiction.
A digital therapy soon available in France to stop tobacco addiction !
For several months, the young French company KLAVA Innovation has been developing a digital therapy medical device for people suffering from tobacco addiction. In combination with artificial intelligence, the software application delivers personalized guidance and support for each patient/user. The two objectives of this approach are to help the patient on a daily basis and to provide medical and nursing teams with additional keys to their clinical practice.
Within the framework of a feasibility study, one of KLAVA’s objectives is to reach a first proof of concept (POC) in the addictology department of the AP-HP Paul Brousse.
Real-world evidence for a prescription digital therapeutic to treat opioid use disorder, Yuri A Maricich & co, Curr Med Res Opin. 2021 Feb
Long-Term Effectiveness of a Clinician-Assisted Digital Cognitive Behavioral Therapy Intervention for Smoking Cessation: Secondary Outcomes From a Randomized Controlled Trial, Jamie Webb & co, Nicotine Tob Res. 2022 Oct
The Effectiveness of an Internet Intervention Aimed at Reducing Alcohol Consumption in Adults, Jördis M Zill and co, Dtsch Arztebl Int. 2019 Feb
Clinical Trial of an Innovative Digital Therapeutic for Smoking Cessation With Biochemical Verification, clinicaltrials.gov, 2022
Authors:
Alexia ADDA
Dr Ivan GASMAN (Psychiatrist)
English 
French