The LIVA blog stream
Published 21th May
Maintaining the GP-patient relationship to drive effective treatment
New research from the University of Leicester has revealed that the number of patients in England who were able to get an appointment with their family doctor fell by 27.5% between 2012 and 2017.
The researchers stated that, due to the decline in regular contact between patients and GPs, relationship continuity is at risk of being damaged with consequences for people’s health. The literature suggests that when people see the same GP, they are more likely to take their prescribed medication, go to the GP to prevent poor health and are therefore more likely to have any illness diagnosed earlier.
Worryingly, it’s likely the situation could get worse. Figures revealed this week that over 1,000 family doctors have left the profession. This is despite a government drive to recruit 5,000 extra doctors by 2020.
Based on our research and patient experience, it’s alarming to think that the number of GPs are falling and that there has been a sharp decline in the GP-patient bond over the last six years. In our view, the GP-patient relationship is a key driver of efficient treatment.
This is particularly true for the treatment of chronic diseases such as Type 2 diabetes and heart disease, which require patients to make lifestyle changes. From previous medical studies, it has been proven that the most important driver in long-term lifestyle changes is a strong and personal relationship based on trust. Be that with a GP, health professional or even friend or family member.
It’s important that the healthcare system recognises this and takes action to encourage patients to have someone to form a strong relationship with, whether that is with a GP or a personal health coach. Digital health tools can help with this too. Apps, for example, can allow healthcare professionals to keep in touch with certain patients that require ongoing support to treat an illness. In addition, video and text consultations can take place on an ongoing basis to maintain the relationship and ensure the patient stays on track. Ultimately, this relationship is the most powerful tool to helping patients manage and prevent many chronic diseases. Therefore, if meeting the same GP is impractical, and numbers of GPs is strained, innovative digital health tools could well provide the solution to maintain effective relationships.
Published 7th May
More education is needed to help GPs use eHealth
The NHS and other health services are steadily using wearables, fitness apps and home monitoring devices to help patients with lifestyle changes. Health professionals are increasingly aware of the need for individuals to make changes such as improving diet and increasing exercise to tackle the growing problem of health-related diseases such as Type 2 diabetes, obesity and heart disease.
How do GPs use eHealth?
The NHS is trialling digital health interventions, such as Liva, to tackle Type 2 diabetes and has launched online GP consultations. In other countries like Denmark, where Liva Healthcare was founded, GPs use digital health records and electronic health consultations on a daily basis. But how do GPs find using eHealth? And what do they need from health authorities in order to support their patients; healthy lifestyle behaviour?
To get to the bottom of this, our co-founder and medical director, Dr Carl Brandt, recently conducted a study to explore GPs’ perspectives on eHealth devices. GPs from Denmark were interviewed on how they used eHealth and mobile health (mHealth) devices to help patients with lifestyle diseases and to understand how they thought eHealth could be used in the future.
The study found that all GPs communicated on a daily basis with patients about disease and medicine via their electronic health record and the internet. However, this communication was often only one-way (i.e. from the GP to the patient). GPs also said they are familiar with behavioural change techniques and are ready to use them in eHealth but only if they are used to optimise processes and not hinder other treatments.
The future of eHealth
When looking to the future use of eHealth in patient lifestyle coaching, the study revealed that more education is needed for GPs in order to help them recognise patients’ abilities and preference to use eHealth when wanting to make changes to their lifestyle. The study identified that eHealth has the potential to become an important tool for GPs in future work to improve the health of their patients. However, education is needed and more research is needed to understand how GPs can become active in developing behavioural change eHealth solutions that will create the future framework for collaboration among general practice, local authorities and patients.
Published 23th April
Preventing Type 2 diabetes: Andrew’s story
“I’m 50 and I wish I’d had this when I was 40…I don’t want to be a diabetic, end of story. I want to enjoy life.” – Andrew, a patient using the Liva Healthcare app to prevent Type 2 diabetes.
Diabetes Prevention Week
This last week was Diabetes Prevention Week which aimed to raise awareness of the causes of Type 2 diabetes and the complications associated with it.
The awareness week comes as we are now five months into the pilot of the digital stream of the NHS Healthier You: Diabetes Prevention Programme. Patients at risk of developing Type 2 diabetes based in Humber, Cost and Vale and North East London are still being referred to Liva Healthcare. And many are already reaping the benefits.
Progress is being made
The best part about the work we do at Liva Healthcare has been seeing the progress patients have made. So far, we have recruited over 200 patients in North East London to be part of the programme and over 80 in Humber, Coast & Vale. We are really pleased with how the pilot is going, with some patients losing up to a stone in their first two months on the programme.
But don’t just take our word for it! Watch this Channel 5 video all about how digital interventions, including Liva, are tackling Type 2 diabetes: https://bit.ly/2K486DQ
Published 9th April, Kristoffer From, founder of Liva Healthcare
Tackling the root cause of Type 2 diabetes: obesity
Obesity is responsible for about one in ten deaths in Britain and costs the NHS £5.1 billion a year. It vastly increases the risk of developing type 2 diabetes, which is the leading cause of blindness in people of working age and leads to more than 100 amputations a week. Type 2 diabetes has been called a global health epidemic.
Whilst we often associate Type 2 diabetes with older people, new research has revealed a concerning relationship between Type 2 diabetes and childhood obesity. Research from King’s College London has revealed that childhood obesity can increase the risk of Type 2 diabetes four-fold by the age of 25 compared to children with a normal BMI.
The need to change lifestyles
This latest research demonstrates further the need to prevent obesity from early life. The lead author of the King’s College London research, Ali Abbasi highlighted how “more than half of adults and one out of three children leaving primary school are now overweight or obese”. The Government needs to invest more in engaging the public in diabetes prevention efforts. This includes following a healthy diet and exercise regime.
Some cities are leading the way
Whilst in many places childhood obesity rates are rising, one place where they are falling is Amsterdam. The city has set up a healthy-weight programme which has overseen a 12% drop in overweight and obese children. The programme costs under £5.3m a year and relies on working with existing professionals such as teachers, doctors nurses and social workers to enforce a consistent, healthy lifestyle message. Children are taught how to eat healthily, are not allowed sugary snacks or fizzy drinks in school and are encouraged to be active. What’s more, fitness classes are offered to those that need more help. The city has also started initiatives such as banning fast food adverts on the subway. We believe this is a fantastic step forward and other cities should follow suit.
So what’s happening in the UK?
The good news is that private companies, and the NHS, have started to innovate in order to tackle Type 2 diabetes. Digital health tools, such as Liva Healthcare, have been developed to facilitate healthcare professionals to see more patients at once and track their progress more regularly. Losing weight isn’t easy but digital tools have the potential to support sustainable, lasting changes to someone’s lifestyle and prevent the onset of chronic diseases, such as Type 2 Diabetes. Creating a healthier lifestyle is quite a radical thing to do and commit to. Key to succeeding is having a supportive network. Technology exists to facilitate this and connect individuals facing similar health concerns. Thereby providing an instant, digital support network.
This isn’t about replacing healthcare professionals with algorithms, it’s about facilitating them. However, these initiatives are largely for adults. Other policies are needed to help tackle childhood obesity in the UK, to prevent later diagnoses of Type 2 diabetes, such as the programme seen in Amsterdam.
Please get in touch if you’d like any further information on how our platform works: email@example.com
Published 26th March
New research shows trusted relationships are essential in driving patient weight loss with digital health tools
Digital health tools are on the rise, indicating that apps run on algorithms may be able to step into the shoes of healthcare professionals. However, new research recently published in the BMJ Open suggests that digital health tools still need a human touch.
The human touch
The research, led by Dr Carl Brandt at the University of Southern Denmark, looked to understand the key facilitators and barriers to achieving long-term weight loss. Qualitative interviews took place with patients who had previously taken part in a weight loss intervention study which used e-health tool Liva Healthcare.
The interviews revealed that whilst digital health tools are effective in helping patients lose weight, it is only when this is paired with a trustworthy relationship between the patient and a healthcare professional. Patients reported this relationship was essential for achieving long-term successful weight loss.
Facilitators and barriers to weight loss
Other facilitators for sustainable weight-loss were found to be daily goal setting, having strong social support, connecting to others going through a similar struggle to lose weight through online support forums and using e-health tools.
Barriers to weight loss were found to be having a lack of confidence, being addicted to high-calorie food and a lack of social support.
What does this all mean?
The research has strong implications for treating chronic lifestyle diseases, many of which are caused or aggravated by preventable lifestyle choices, such as an unhealthy diet, physical inactivity and tobacco use. Research has already shown that e-health tools have a positive relationship with driving weight loss in patients, however this latest research shows this can be even more effective if combined with a strong personal relationship and social support. Liva Healthcare does just that – we provide patients with an app but it is not just an algorithm at work. The patient has access, through the app, to a personal health coach ensuring that the individual has strong support and a personalised approach to their weight loss programme.
Digital health tools should therefore look to support healthcare professionals, not replace them. Ultimately, successful, sustainable weight loss depends on the ability of healthcare professionals to provide strong, positive support on a regular basis with their patients.
Diabetes is on the rise: the importance of digital health technologies in transforming lives – Kristoffer From shares his thoughts
Published 12th March, Kristoffer From, founder of Liva Healthcare
A growing health problem
Diabetes UK revealed last week that diabetes diagnoses have more than doubled in 20 years. Currently 3.7 million people over the age of 17 are known to be living with the disease, compared to 1.8 million over 16-year-olds in 1998. Although the research didn’t break down the prevalence of Type 1 versus Type 2 diabetes, Diabetes UK said both had risen, with Type 2 increasing more.
Making healthier choices
Type 2 diabetes is often brought on by unhealthy and sedentary lifestyles. To reverse the rising numbers, the root cause needs to be tackled. Greater efforts need to be placed on educating the public about making healthier choices when it comes to their lifestyle, including having a balanced diet and incorporating exercise on a weekly basis. The importance of this can’t be ignored.
The upcoming levy on sugary drinks in the UK in April is a welcomed initiative, helping reduce the amount of fizzy drinks consumed. Similar interventions in Mexico and Hungary have shown positive results with 12% and 40% reduction respectively in the first year of implementation. But more needs to be done to drive lifestyle changes in the UK in order to reduce the prevalence of Type 2 diabetes.
A helping hand
In order to help people make lasting changes to their lifestyle and prevent Type 2 diabetes prevalence rising even further, we need to look at how to drive behaviour change to encourage healthier lifestyles. At Liva we believe the best approach is to use digital interventions to extend the work that health professionals do. For example, by using technology, healthcare professionals can be continuously connected with patients to help set and monitor lifestyle goals. Technology can therefore both facilitate and extend the work of healthcare professionals by giving them the tools to communicate with patients remotely and monitor far more patients at once. Giving a helping hand to people in need of a lifestyle change can help stop the progression of the disease, or even roll it back completely.
You can drive behaviour change and patient engagement digitally
Published 26th February, Kristoffer From, founder of Liva Healthcare
In 2009, Phillippa Lally, health psychology researcher at University College London published a study in the European Journal of Social Psychology to figure out just how long it actually takes to form a habit. The study examined the habits of 96 people over a 12-week period. The data was analysed, and on average it took 66 days (over two months) before a person’s new behaviour became automatic.
Making lifestyle changes is a radical thing to do
Creating a new habit is therefore difficult. Having support from others around you and self-motivation is key. When making healthy lifestyle changes, it is common for people to hit a brick wall, and we find this usually happens between three to six months on. Breaking through that plateau is difficult. That’s why sometimes individuals in need of a lifestyle change to support their health needs somebody to help take them to the next level.
Digital platforms can drive patient engagement
In order to drive long-term behavioural changes in their patients, healthcare professionals can significantly benefit from using an online platform to stay in touch with their patients.
For example, Liva is a digital healthcare app whereby a patient, who has or is at risk of a chronic lifestyle disease such as Type 2 diabetes, is given a professional health coach.
Patients have an initial face-to-face meeting with their coach, to discuss their current lifestyle and long-term objectives. After this meeting, the relationship moves online with the patient and coach having regular contact to ensure the patient is remaining on-track with their individual goals.
We have found the most important feature of the digital intervention is the relationship between the coach and the patient. This is the key that will improve and potentially even reverse the patient’s medical condition. In our experience, it is only with this relationship that patients truly benefit from what digital platforms have to offer such as health tracking tools.
Relationships are key for digital interventions
Healthcare professionals should never be replaced with algorithms. It’s very important that digital health industry doesn’t get too digital. At Liva, we see that patients don’t want to communicate with an automated messaging system when they are trying to change some fundamental things in their life.
When using Liva, the coach’s relationship with the patient drives change. Liva’s digital health platform facilitates it. In our view, digital health interventions are paramount to reducing costs and scaling up services to treat more patients suffering from chronic lifestyle diseases. However, the human touch must remain to ensure that the interventions are truly effective.
Using digital interventions to improve heart health
Published 12th February, Kristoffer From, founder of Liva Healthcare
This National Heart Month Kristoffer From explains the role that digital health can play in managing chronic heart disease
February is National Heart Month in the UK. For this, the British Heart Foundation promotes making small changes towards a healthier lifestyle. Around seven million people live with cardiovascular disease in the UK. However, despite the high prevalence of cardiovascular diseases in the UK, the good news is that 80% of premature heart disease, stroke and diabetes can be prevented. So how can we do this?
Digital health solutions
During the digital transformation age, health technology has taken off. Over the last few years, digital tools have been developed to assist patients in dealing with conditions such as heart disease.
One treatment for cardiovascular diseases is for patients to undergo lifestyle changes. These changes include regular exercise and stopping smoking. Often it is small changes to daily routines that can make a big difference to a person’s health and, in the long term, save a life. Digital innovations are helping patients make these changes and stay on track. Through digital health interventions, such as apps, health professionals can monitor their patients remotely and create a personalised intervention to help them change their lifestyle and improve their heart health. Health professionals can for example monitor their patients exercise and smoking levels, food and water intake and sleeping patterns.
At Liva, our digital health platform does just this and has proved effective in tackling lifestyle diseases. We have had promising results on the use of digital interventions to help with weight loss – one form of treatment for those with, or at risk of, chronic heart disease. For example, we monitored the progress of 136 patients using our app. Over the period, 82% of the patients lost weight, losing an average of 6.3kg, demonstrating signs of a successful lifestyle intervention. Encouragingly these patients appear to be losing more weight, and faster, than previous studies with digital health interventions have shown.
Given the large-scale problem of heart disease, and the cost to our national health service, digital interventions, such as Liva, are a valuable tool for the health service in order to cut costs and scale up treatment with more patients attended to remotely. If you would like more information on the Liva platform and how this could help your business, a colleague, or yourself, please get in touch firstname.lastname@example.org