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Monfort E, Latour P. Fostering patient engagement through the co-design of seizure detection and monitoring technologies: A roadmap for collaboration between research and development. Rev Neurol (Paris) 2024; 180:211-215. [PMID: 38040546 DOI: 10.1016/j.neurol.2023.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 10/02/2023] [Indexed: 12/03/2023]
Abstract
The large number of technological developments suggests that patients with epilepsy can be better supported in the management of their seizures, especially when their condition is drug resistant. Patients and their caregivers, who are generally supportive of seizure detection and monitoring technologies, can provide relevant information to improve their effectiveness. We propose a comprehensive co-design approach to support more efficient development of seizure detection and monitoring technologies. Such an approach should follow the steps of the research and development process, take into account the temporal requirements characteristic of seizure management, focus on the themes of autonomy and self-management, and be guided by disease experts. If co-design practices are to continue to contribute to their development, they must also meet the scientific requirements of validity and reproducibility.
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Affiliation(s)
- E Monfort
- University of Grenoble Alpes, CNRS, TIMC, UFR SHS, 1251, avenue Centrale, CS 40700, 38000 Grenoble cedex 9, France.
| | - P Latour
- Medical Center of La Teppe, 26600 Tain-l'Hermitage, France
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2
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Zhou SM, McLean B, Roberts E, Baines R, Hannon P, Ashby S, Newman C, Sen A, Wilkinson E, Laugharne R, Shankar R. Analysing patient-generated data to understand behaviours and characteristics of women with epilepsy of childbearing years: A prospective cohort study. Seizure 2023; 108:24-32. [PMID: 37060628 DOI: 10.1016/j.seizure.2023.04.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 03/02/2023] [Accepted: 04/06/2023] [Indexed: 04/17/2023] Open
Abstract
BACKGROUND Women with epilepsy (WWE) are vulnerable in pregnancy, with increased risks to mother and baby including teratogenic risks, especially from valproate. The free EpSMon mobile-phone app allows self-monitoring to afford patient-centred feedback on seizure related risks, such as sudden death in epilepsy (SUDEP) to its users. We sought to generate insights into various seizure related risks and its treatments in WWE of childbearing age (16 to 60 years ) using EpSMon. METHODS The study utilizes a prospective real-world cohort of 5.5 years. Patient reported data on demographics, medication taken, diagnoses, seizure types and recognised biological, psychological, and social factors of seizure related harm were extracted. Data was stratified according to frequent and infrequent users and those scoring lower and higher risk scores. Multivariate logistic regression and different statistical tests were conducted. FINDINGS Data from 2158 WWE of childbearing age encompassing 4016 self-assessments were analysed. Overall risk awareness was 25.3% for pregnancy and 54.1% for SUDEP. Frequent users were more aware of pregnancy risks but not of SUDEP. Repeated EpSMon use increased SUDEP awareness but not pregnancy risks. Valproate was used by 11% of WWE, ranging from 6.5% of younger to 31.5% of older women. CONCLUSIONS The awareness to risks to pregnancy, SUDEP and valproate is low. Valproate is being used by a significant minority. It is imperative risk communication continues for WWE based on their individual situation and need. This is unlikely to be delivered by current clinical models. Digital solutions hold promise but require work done to raise implementation and acceptability.
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Affiliation(s)
- Shang-Ming Zhou
- Centre for Health Technology, Faculty of Health, University of Plymouth, Plymouth PL4 8AA, UK
| | - Brendan McLean
- Cornwall Intellectual Disability Equitable Research (CIDER), Peninsula School of Medicine, University of Plymouth, Truro, TR4 9LD, UK; Royal Cornwall Hospital NHS Trust, Truro TR1 3LJ, UK
| | - Elis Roberts
- School of Engineering, Computing and Mathematics, University of Plymouth, Plymouth PL4 8AA, UK
| | - Rebecca Baines
- Cornwall Intellectual Disability Equitable Research (CIDER), Peninsula School of Medicine, University of Plymouth, Truro, TR4 9LD, UK
| | | | | | | | - Arjune Sen
- Nuffield Department of Clinical Neurosciences, University of Oxford, OX39DU, UK
| | | | - Richard Laugharne
- Cornwall Intellectual Disability Equitable Research (CIDER), Peninsula School of Medicine, University of Plymouth, Truro, TR4 9LD, UK; Psychoanalytica St Germans, UK; Cornwall Intellectual Disability Equitable Research (CIDER), Cornwall Partnership NHS Foundation Trust Truro TR4 9LD UK
| | - Rohit Shankar
- Cornwall Intellectual Disability Equitable Research (CIDER), Peninsula School of Medicine, University of Plymouth, Truro, TR4 9LD, UK; Psychoanalytica St Germans, UK; Cornwall Intellectual Disability Equitable Research (CIDER), Cornwall Partnership NHS Foundation Trust Truro TR4 9LD UK.
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3
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Manchanda N, Aggarwal A, Setya S, Talegaonkar S. Digital Intervention For The Management Of Alzheimer's Disease. Curr Alzheimer Res 2023; 19:CAR-EPUB-129308. [PMID: 36744687 DOI: 10.2174/1567205020666230206124155] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 01/08/2023] [Accepted: 01/12/2023] [Indexed: 02/07/2023]
Abstract
Alzheimer's disease (AD) is a progressive, multifactorial, chronic, neurodegenerative disease with high prevalence and limited therapeutic options, making it a global health crisis. Being the most common cause of dementia, AD erodes the cognitive, functional, and social abilities of the individual and causes escalating medical and psychosocial needs. As yet, this disorder has no cure and current treatment options are palliative in nature. There is an urgent need for novel therapy to address this pressing challenge. Digital therapeutics (Dtx) is one such novel therapy that is gaining popularity globally. Dtx provides evidence based therapeutic interventions driven by internet and software, employing tools such as mobile devices, computers, videogames, apps, sensors, virtual reality aiding in the prevention, management, and treatment of ailments like neurological abnormalities and chronic diseases. Dtx acts as a supportive tool for the optimization of patient care, individualized treatment and improved health outcomes. Dtx uses visual, sound and other non-invasive approaches for instance-consistent therapy, reminiscence therapy, computerised cognitive training, semantic and phonological assistance devices, wearables and computer-assisted rehabilitation environment to find applications in Alzheimer's disease for improving memory, cognition, functional abilities and managing motor symptom. A few of the Dtx-based tools employed in AD include "Memory Matters", "AlzSense", "Alzheimer Assistant", "smart robotic dog", "Immersive virtual reality (iVR)" and the most current gamma stimulation. The purpose of this review is to summarize the current trends in digital health in AD and explore the benefits, challenges, and impediments of using Dtx as an adjunctive therapy for the management of AD.
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Affiliation(s)
- Namish Manchanda
- School of Pharmaceutical Sciences, Delhi Pharmaceutical Sciences & Research University, Govt. of NCT of Delhi, New Delhi-110017, India
| | - Akanksha Aggarwal
- Delhi Institute of Pharmaceutical Sciences And Research, Delhi Pharmaceutical Sciences & Research University, Govt. of NCT of Delhi, New Delhi-110017, India
| | - Sonal Setya
- Department of Pharmacy Practice, SGT College of Pharmacy, SGT University, Gurugram, Haryana-122505, India
| | - Sushama Talegaonkar
- School of Pharmaceutical Sciences, Delhi Pharmaceutical Sciences & Research University, Govt. of NCT of Delhi, New Delhi-110017, India
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4
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Banks J, Corrigan D, Grogan R, El-Naggar H, White M, Doran E, Synnott C, Fitzsimons M, Delanty N, Doherty CP. LoVE in a time of CoVID: Clinician and patient experience using telemedicine for chronic epilepsy management. Epilepsy Behav 2021; 115:107675. [PMID: 33342712 PMCID: PMC9760117 DOI: 10.1016/j.yebeh.2020.107675] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 11/25/2020] [Accepted: 11/25/2020] [Indexed: 02/06/2023]
Abstract
As part of our ongoing interest in patient- and family-centered care in epilepsy, we began, before the onset of the CoVID-19 pandemic, to evaluate the concerns and preferences of those delivering and receiving care via telemedicine. CoVID-19 arrived and acted as an unexpected experiment in nature, catalyzing telemedicine's widespread implementation across many disciplines of medicine. The arrival of CoVID-19 in Ireland gave us the opportunity to record these perceptions pre- and post-CoVID. Data were extracted from the National Epilepsy Electronic Patient Record (EEPR). Power BI Analytics collated data from two epilepsy centers in Dublin. Analysis of data on reasons for using the telephone support line was conducted. A subset of patients and clinicians who attended virtual encounters over both periods were asked for their perception of telemedicine care through a mixed methods survey. Between 23rd December 2019 and 23rd March 2020 (pre-CoVID era), a total of 1180 patients were seen in 1653 clinical encounters. As part of a telemedicine pilot study, 50 of these encounters were scheduled virtual telephone appointments. Twenty eight surveys were completed by clinicians and 18 by patients during that period. From 24th March 2020 to 24th June 2020, 1164 patients were seen in 1693 encounters of which 729 (63%) patients were seen in 748 scheduled virtual encounters. 118 clinician impressions were captured through an online survey and 75 patients or carers completed a telephone survey during the post-CoVID era. There was no backlog of appointments or loss of care continuity forced by the pandemic. Clinicians expressed strong levels of satisfaction, but some doubted the suitability of new patients to the service or candidates for surgery receiving care via telemedicine. Patients reported positive experiences surrounding telephone appointments comparing them favorably to face-to-face encounters. The availability of a shared EEPR demonstrated no loss of care contact for patients with epilepsy. The survey showed that telemedicine is seen as an effective and satisfactory method of delivering chronic outpatient care.
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Affiliation(s)
- Jack Banks
- FutureNeuro SFI Research Centre, The Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin 2, Ireland; Academic Unit of Neurology, School of Medicine, Trinity College Dublin, Dublin 2, Ireland.
| | - Derek Corrigan
- FutureNeuro SFI Research Centre, The Royal College of Surgeons in Ireland, 123 St. Stephen’s Green, Dublin 2, Ireland
| | - Roger Grogan
- Department of Neurology, Beaumont Hospital, Dublin 9, Ireland
| | - Hany El-Naggar
- FutureNeuro SFI Research Centre, The Royal College of Surgeons in Ireland, 123 St. Stephen’s Green, Dublin 2, Ireland,Department of Neurology, Beaumont Hospital, Dublin 9, Ireland
| | - Máire White
- FutureNeuro SFI Research Centre, The Royal College of Surgeons in Ireland, 123 St. Stephen’s Green, Dublin 2, Ireland,Department of Neurology, Beaumont Hospital, Dublin 9, Ireland
| | - Elisabeth Doran
- Department of Neurology, St. James’s Hospital, Dublin 8, Ireland
| | - Cara Synnott
- Department of Neurology, St. James’s Hospital, Dublin 8, Ireland
| | - Mary Fitzsimons
- FutureNeuro SFI Research Centre, The Royal College of Surgeons in Ireland, 123 St. Stephen’s Green, Dublin 2, Ireland
| | - Norman Delanty
- FutureNeuro SFI Research Centre, The Royal College of Surgeons in Ireland, 123 St. Stephen’s Green, Dublin 2, Ireland,Department of Neurology, Beaumont Hospital, Dublin 9, Ireland
| | - Colin P. Doherty
- FutureNeuro SFI Research Centre, The Royal College of Surgeons in Ireland, 123 St. Stephen’s Green, Dublin 2, Ireland,Academic Unit of Neurology, School of Medicine, Trinity College Dublin, Dublin 2, Ireland,Department of Neurology, St. James’s Hospital, Dublin 8, Ireland
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Chen D, Zhu L, Lin X, Hong Z, Li S, Liu L, Zhou D. Epilepsy control during an epidemic: emerging approaches and a new management framework. ACTA EPILEPTOLOGICA 2020. [PMCID: PMC7215138 DOI: 10.1186/s42494-020-00015-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Epidemics are a big threat to world health. The ongoing pandemic of corona virus disease 2019 (COVID-19) has caused a series of challenges to public health. One such challenge is the management of chronic diseases such as epilepsy during an epidemic event. Studies on this topic are rather limited and the related medical practice is full of uncertainty. Here we review recent development of potential approaches for epilepsy control during an epidemic and propose a new three-level management framework to address these challenges.
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Hixson JD, Braverman L. Digital tools for epilepsy: Opportunities and barriers. Epilepsy Res 2020; 162:106233. [DOI: 10.1016/j.eplepsyres.2019.106233] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 09/10/2019] [Accepted: 10/26/2019] [Indexed: 11/27/2022]
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Shegog R, Braverman L, Hixson JD. Digital and technological opportunities in epilepsy: Toward a digital ecosystem for enhanced epilepsy management. Epilepsy Behav 2020; 102:106663. [PMID: 31778878 DOI: 10.1016/j.yebeh.2019.106663] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 10/29/2019] [Accepted: 10/30/2019] [Indexed: 01/01/2023]
Abstract
This commentary details the implications of a growing body of literature supporting several categories of supportive digital tools for the self-management of epilepsy. Although many prior review articles have focused on specific forms of digital epilepsy solutions, we propose the concept of an integrated self-management digital ecosystem. This would include categories of tools including self-management education programs, electronic diaries for self-monitoring, and automated wearables for seizure detection. Within these categories, individual interventions have been studied and made available to patients for years, but the evolution of a digital ecosystem promises the potential to integrate these tools in a manner that can meaningfully benefit patients' health. This commentary presents a discussion of the possible concerns that are preventing more widespread adoption of these digital health resources. Barriers are identified at multiple positions of the healthcare system, including the individual, the organizational, the community, and the policy levels.
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Affiliation(s)
- Ross Shegog
- University of Texas School of Public Health, 7000 Fannin, Suite 2668, Houston, TX 77030, United States of America
| | | | - John D Hixson
- University of California San Francisco and the San Francisco VA Medical Center, 4150 Clement Street, 127E, San Francisco, CA 94121, United States of America.
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Peterson CL, Walker C, Coleman H, Shears G. Reported service needs at diagnosis of epilepsy and implications for quality of life. Epilepsy Behav 2019; 100:106527. [PMID: 31522077 DOI: 10.1016/j.yebeh.2019.106527] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 08/26/2019] [Accepted: 08/27/2019] [Indexed: 11/30/2022]
Abstract
AIM This paper reports on contributing factors to Quality of Life (QoL) in an Australian community sample of people with epilepsy (PWE). METHOD Three hundred and ninety-three respondents or 29.6% of people on the Australian Epilepsy Research Register participated in Wave 4 of a longitudinal survey. A quantitative analysis was undertaken and a qualitative investigation examined open-ended responses by 44 PWE on the support services that they received following diagnosis of epilepsy. RESULTS Total Quality of Life in Epilepsy-31 Items (QOLIE-31) score for the community-based sample was 55.99 (SD 19.85) [Range 6.34-96.20]. Age, paid employment, seizure frequency, number of antiepileptic drugs (AEDs), and perceived prosperity had significant impacts on QoL. In addition, use of support services showed that availability of a first seizure clinic, accurate information on support services and peer support were associated with the highest QoL. A qualitative investigation revealed that on first diagnosis, a lack of information was the main theme. Furthermore, PWE reported a lack of understanding of available supports by a range of health professionals, schools, and in the general community. DISCUSSION Psychosocial factors were important in explaining QoL, and the positive effects of first seizure clinics, accurate information on support services, and of peer support have been confirmed in the literature. The lack of knowledge of support services on being diagnosed with epilepsy is a problem evident in the community and pathways are required to support people dealing with their epilepsy. CONCLUSION More emphasis is needed in providing availability of supports to enhance the future wellbeing and QoL of people when epilepsy is diagnosed.
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Affiliation(s)
- Chris L Peterson
- School of Humanities and Social Sciences, La Trobe University, Bundoora, Australia; Epilepsy Foundation, Surrey Hills, Victoria, Australia.
| | - Christine Walker
- Chronic Illness Alliance, Moonee Ponds, Australia; Epilepsy Foundation, Surrey Hills, Victoria, Australia.
| | - Honor Coleman
- School of Psychological Sciences, The University of Melbourne, Parkville, Australia; Department of Neuroscience, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia; Epilepsy Foundation, Surrey Hills, Victoria, Australia.
| | - Graeme Shears
- Epilepsy Foundation, Surrey Hills, Victoria, Australia.
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Technology-enabled seizure detection and reporting: The epilepsy network project. Epilepsy Res 2019; 153:85-87. [DOI: 10.1016/j.eplepsyres.2019.02.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 02/22/2019] [Accepted: 02/25/2019] [Indexed: 11/20/2022]
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10
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Owens S, Sirven JI, Shafer PO, Fishman J, Wild I, Findley M, Derry R, Walters J, Kopplin V, Kakacek J. Innovative approaches reaching underserved and rural communities to improve epilepsy care: A review of the methodology of the Connectors Project. Epilepsy Behav 2019; 90:273-283. [PMID: 30391149 DOI: 10.1016/j.yebeh.2018.09.029] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 09/22/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE The Connectors Project, a collaboration between the Epilepsy Foundation and UCB Pharma, was a multiyear project designed to improve epilepsy care in underserved communities. A core objective of the Connectors Project was to pilot new and innovative approaches to epilepsy awareness and education in rural and underserved areas, including standardized curricula for healthcare providers and patients. METHODS A series of consensus conferences explored opportunities and barriers to epilepsy care throughout the United States including access to local Epilepsy Foundations, neurologists, and epilepsy centers. Data from QuintilesIMS™ were examined for access to newer antiepileptic drugs (AEDs)-a proxy for quality of epilepsy care-in different regions. State factors (e.g., local epilepsy foundation office, access to newer vs. older AEDs, and geographic density and diversity) were used in selecting four states as examples of rural and underserved areas to pilot the awareness and educational programs. For each state, a work team assessed challenges and opportunities, tailored educational curricula, and developed strategies for effective delivery of the educational programs. Interventions were held between June 2016 and June 2017. Interventions consisted of outreach and awareness programs, in-person health education to healthcare providers and patients/families, and digital health education. RESULTS Michigan, Nevada, Oklahoma, and West Virginia were identified as pilot states representing geographically diverse areas, ranging from a state with a large high-density population center with several epilepsy centers and a local Epilepsy Foundation office (Michigan) to a state with predominately rural areas and a few small urban cores, two epilepsy centers, and no in-state Epilepsy Foundation office (West Virginia). State work teams tailored interventions and examined options for type, intent, ease of use, and impact. All states implemented outreach and awareness initiatives and in-person health education for patients and healthcare providers; use of digital health education was variable. Measurement of the interventions was agreed to be performed by the use of patient and physician surveys and reevaluation of data from QuintilesIMS for access to newer AEDs. CONCLUSION Local Epilepsy Foundation offices successfully connected healthcare providers in rural and underserved areas to epilepsy education designed to enhance quality care in epilepsy. Educational opportunities for people with epilepsy and their families addressed critical gaps in accessing quality epilepsy care and self-management. Tailored and innovative educational approaches can be used to increase awareness levels and to overcome geographic challenges in reaching underserved populations. Relationship building and repeated, consistent engagement with healthcare providers and patients can assist in improving communication and self-management skills among patients with epilepsy.
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Affiliation(s)
- Steven Owens
- Epilepsy Foundation, 8301 Professional Place-East, Suite 200, Landover, MD 20785, USA.
| | - Joseph I Sirven
- Department of Neurology, Mayo Clinic, 5777 East Mayo Boulevard, Phoenix, AZ 85054, USA.
| | - Patricia O Shafer
- Epilepsy Foundation, 8301 Professional Place-East, Suite 200, Landover, MD 20785, USA; Department of Neurology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215, USA.
| | - Jesse Fishman
- UCB Pharma, 1950 Lake Park Drive SE, Smyrna, GA 30080, USA.
| | - Imane Wild
- UCB Pharma, 1950 Lake Park Drive SE, Smyrna, GA 30080, USA.
| | - Mark Findley
- Epilepsy Foundation of Greater Cincinnati, 895 Central Avenue, Suite 550, Cincinnati, OH 45202, USA.
| | - Russell Derry
- Epilepsy Foundation of Michigan, 25200 Telegraph Road, Suite 110, Southfield, MI 48033, USA.
| | - Jenniafer Walters
- Epilepsy Foundation of Oklahoma, 11212 North May Avenue Suite 108, Oklahoma City, OK 73120, USA.
| | - Vicki Kopplin
- Epilepsy Foundation of Minnesota, 8301 Professional Place East, Suite 200, St. Paul, MN 20785, USA.
| | - Jody Kakacek
- Epilepsy Foundation, 8301 Professional Place-East, Suite 200, Landover, MD 20785, USA.
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Afra P, Bruggers CS, Sweney M, Fagatele L, Alavi F, Greenwald M, Huntsman M, Nguyen K, Jones JK, Shantz D, Bulaj G. Mobile Software as a Medical Device (SaMD) for the Treatment of Epilepsy: Development of Digital Therapeutics Comprising Behavioral and Music-Based Interventions for Neurological Disorders. Front Hum Neurosci 2018; 12:171. [PMID: 29780310 PMCID: PMC5946004 DOI: 10.3389/fnhum.2018.00171] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 04/12/2018] [Indexed: 12/29/2022] Open
Abstract
Digital health technologies for people with epilepsy (PWE) include internet-based resources and mobile apps for seizure management. Since non-pharmacological interventions, such as listening to specific Mozart's compositions, cognitive therapy, psychosocial and educational interventions were shown to reduce epileptic seizures, these modalities can be integrated into mobile software and delivered by mobile medical apps as digital therapeutics. Herein, we describe: (1) a survey study among PWE about preferences to use mobile software for seizure control, (2) a rationale for developing digital therapies for epilepsy, (3) creation of proof-of-concept mobile software intended for use as an adjunct digital therapeutic to reduce seizures, and (4) broader applications of digital therapeutics for the treatment of epilepsy and other chronic disorders. A questionnaire was used to survey PWE with respect to preferred features in a mobile app for seizure control. Results from the survey suggested that over 90% of responders would be interested in using a mobile app to manage their seizures, while 75% were interested in listening to specific music that can reduce seizures. To define digital therapeutic for the treatment of epilepsy, we designed and created a proof-of-concept mobile software providing digital content intended to reduce seizures. The rationale for all components of such digital therapeutic is described. The resulting web-based app delivered a combination of epilepsy self-care, behavioral interventions, medication reminders and the antiseizure music, such as the Mozart's sonata K.448. To improve long-term patient engagement, integration of mobile medical app with music and multimedia streaming via smartphones, tablets and computers is also discussed. This work aims toward development and regulatory clearance of software as medical device (SaMD) for seizure control, yielding the adjunct digital therapeutic for epilepsy, and subsequently a drug-device combination product together with specific antiseizure medications. Mobile medical apps, music, therapeutic video games and their combinations with prescription medications present new opportunities to integrate pharmacological and non-pharmacological interventions for PWE, as well as those living with other chronic disorders, including depression and pain.
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Affiliation(s)
- Pegah Afra
- Department of Neurology, University of Utah, Salt Lake City, UT, United States.,Department of Neurology, Weill Cornell Medicine, Cornell University, New York, NY, United States
| | - Carol S Bruggers
- Department of Pediatrics, University of Utah, Salt Lake City, UT, United States
| | - Matthew Sweney
- Department of Neurology, University of Utah, Salt Lake City, UT, United States.,Department of Pediatrics, University of Utah, Salt Lake City, UT, United States
| | - Lilly Fagatele
- Department of Neurology, University of Utah, Salt Lake City, UT, United States
| | - Fareeha Alavi
- Department of Neurology, University of Utah, Salt Lake City, UT, United States
| | - Michael Greenwald
- Department of Medicinal Chemistry, College of Pharmacy, University of Utah, Salt Lake City, UT, United States
| | - Merodean Huntsman
- Department of Medicinal Chemistry, College of Pharmacy, University of Utah, Salt Lake City, UT, United States
| | - Khanhly Nguyen
- Department of Medicinal Chemistry, College of Pharmacy, University of Utah, Salt Lake City, UT, United States
| | - Jeremiah K Jones
- Software Development Center, University of Utah, Salt Lake City, UT, United States
| | | | - Grzegorz Bulaj
- Department of Medicinal Chemistry, College of Pharmacy, University of Utah, Salt Lake City, UT, United States
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