A NEW online health service, currently available only in Cork, is expected to roll out further afield.
The digital therapeutic service RediCare — the founding company’s based in Ballincollig, Co Cork — helps prevent, manage, and treat chronic health conditions, such as obesity, high blood pressure, high cholesterol, and pre- and type 2 diabetes.
Dr Niall Colwell, a cardiologist in South Tipperary general hospital, in Clonmel, is medical adviser to RediCare.
Digital therapeutics involves software being applied to medicine to deliver a treatment, with a clinically proven result.
“Living with chronic conditions can be a daily struggle, but RediCare can help people transform to a much healthier way of living,” Dr Colwell says.
60% of people in Ireland have at least one chronic health condition, so LloydsPharmacy has teamed up with RediCare ControlDTx to give their customers access to the new online service.
“The public has an insatiable appetite for health information, but they want it correct,” says Laura Dowling, aka social media’s ‘Fabulous Pharmacist’ and supervising pharmacy manager at LloydsPharmacy, Stillorgan, Co Dublin.
The RediCare programme gives participants the tools and support to develop lifelong habits that will benefit their health — the service includes unlimited, one-to-one health consultations, recipe range, dietary advice, shopping lists, and an online support forum.
With an emphasis on wraparound support from health coaches and pharmacist, Ms Dowling explains: “Someone can come into the pharmacy and we’ll help them sign up online if they’re older and not that techie. It takes a couple of minutes and they’re good to go,” she says.
The pharmacist will be on hand if the participant needs more support to get confident with the programme, if they have a question, or simply want to voice any concerns about their condition.
RediCare gives patients health literacy, says Dowling. “There are videos that explain their chronic illness in layman’s terms, making it very easy for the regular person to understand exactly what’s going on in their body when they’re told they have high blood pressure, high cholesterol, or diabetes,” Dowling says.
She frequently sees people who are shocked and uncertain after having just been diagnosed with these conditions. “Doctors are busy and under pressure, so patients are told their ‘blood pressure’s high, stop eating white bread, and take this medication’. They don’t know what to do. Taking medication [only] is quite a passive act,” she says, adding that the digital therapeutic service enables patients to take control of their health.
“They’re playing an active role in their own health-management,” Dowling says.
Once signed up, the patient inputs their details — e.g. their medical diagnosis, whether they have multiple chronic conditions — and the programme is tailored to their circumstances and profile.
“It will, for example, tailor a diet plan for them to best manage their illness, using a whole-foods approach,” says Dowling.
Dr Colwell says there’s a need for some form of IT-driven diet and lifestyle intervention that patients with chronic illnesses can embrace. “Many of the risk factors for cardiovascular (CV) disease — which includes heart attack and stroke and which kill one-third of Irish adults — are preventable,” he says.
When Dr Colwell was 18 his dad died of a heart attack, aged just 56. “It had a reasonable impact on my view of the world,” he says.
With heart disease often called a ‘silent killer’, Dr Colwell says: “You could be walking about with high blood pressure and high cholesterol and early diabetes and not know. There’s a condition called impaired glucose intolerance, which is intermediate between normal glucose control and having diabetes. About 7% of the population has diabetes, but a further 7% has impaired glucose intolerance.”
Half of adults develop high blood pressure by age 55, while 70% of middle-aged Irish adults are overweight or obese and high cholesterol is also common, and Dr Colwell says each of these components contributes to CV disease.
“The risk factors are multiplicative in effect — if you have high blood pressure, high cholesterol, a bit of diabetes, and you’re obese, you’re at very high risk. If you’re smoking 20 a day, that triples the risk. A lot of people are walking around blissfully unaware,” Dr Colwell says.
Elaborating on the value of a digital therapeutic service, he says a GP — noticing that a patient’s overweight or obese and that their blood pressure’s up — would refer them to a dietician.
“They end up on a big waiting list. They don’t get the ready attention they need. Whereas, the computer doesn’t get tired, sick or go on holidays. It’s there 24/7. A digital therapeutic service [like RediCare] isn’t about replacing anything — it’s about helping patients get their risk factors down,” Dr Colwell says.
Changes in nutrition and lifestyle can have a significant impact on chronic conditions and RediCare can help treat type 2 diabetes, lower blood pressure, improve cholesterol ratios, lower weight, and thereby reduce heart disease risk.
Participants on the programme can expect results within their first eight to 12 weeks of starting RediCare.
Results from studies of previous users have shown improvements including a 6kg weight loss, a 6.8cm reduction in waist-size, or a reduction in systolic blood pressure of 8.3%.
Since around 2015, cohort studies of RediCAre have been presented to bodies including the Irish Cardiac Society, the European Society of Cardiology, the European Federation of Internal Medicine, and EuroPrevent, and Dr Colwell says they all showed that one-third of patients with type 2 diabetes could reduce, or come off, their medication.
And patients’ HbA1c (marker denoting average blood-sugar level over past four months) was reduced by 1%.
“This equates similarly to drug therapy; this non-pill approach was shown to be as potent as being on a pill for diabetes,” says Colwell.
Citing RediCare’s advantages over regular support websites for various chronic conditions, Dowling says the latter often have a static quality.
“They’re not [always] interactive; the diet plans aren’t tailored to the individual patient’s health circumstances. With RediCare, every week new recipes and new health information is added. If the WHO suggests something is good for something, there will be a video about it.”
With so many fad diets, Dowling says RediCare aims to sustainably improve diet. “You’re not going to be hungry on it, or be counting calories.”
A healthy message
At LloydsPharmacy Youghal, store manager, Charlotte Mills, says nobody has signed up yet for RediCare, but that there’s a lot of interest. “We’re at the point of getting the message out. This is about educating people, about using food as medicine.” Aside from those with chronic conditions, Mills foresees that even fit and healthy people will use the programme. “They’ll do it for general health, because they feel they could be doing something a little different and want to make sure they’re doing things right,” Mills says.
Dr Colwell confirms that some Cork-based GPs are already prescribing RediCare for their patients.
“All the major medical organisations recommend lifestyle therapy. It’s about treasuring our health, so that we don’t run into preventable complications,” he says.