A new study led by the Technical University of Munich (TUM) has cast doubt on the effectiveness of digital health interventions, such as telemedicine and exercise apps, for patients with type 2 diabetes and coronary heart disease. Despite expectations that these technologies could enhance patient health by promoting lifestyle changes, the study’s findings reveal only marginal improvements.
Led by Prof. Martin Halle, the research shows that while these interventions had some minimal benefits, they fall short of offering substantial health improvements for individuals at high risk of heart attacks and other serious complications. The study highlights the persistent importance of direct medical care and calls into question the growing reliance on digital health tools.
The study, published in Nature Medicine, involved 502 patients (84% male), all of whom had either type 2 diabetes or coronary heart disease. Participants were divided into two groups. One received standard care, including basic dietary guidance and physical activity information, while the other received an individualized, app-supported exercise program and personalized nutrition advice. The study was conducted across eleven sites in Germany.
Over the course of the trial, the intervention group did show a modest improvement in long-term blood glucose levels — a decrease of 0.13 percentage points. However, this was deemed statistically significant yet clinically minor. More intensive participants, who adhered more strictly to the program, saw a greater reduction of nearly 0.3 percentage points. There were also some improvements in body weight, waist circumference, and triglyceride levels, but these were not sustained beyond the initial phase of the study.
The study’s major limitation, according to the researchers, was the low level of participant engagement. Just 41% of those in the intervention group followed the exercise and dietary recommendations sufficiently in the first six months. Many participants struggled with the technology itself, with over two-thirds of the participants, mostly aged around 68, reporting difficulties in using the apps and devices. This low adherence rate led to minimal improvements overall, with a significant portion of participants either not starting the program or failing to meet exercise targets.
Prof. Halle, who specializes in Preventive Sports Medicine and Sports Cardiology, emphasizes that while digital tools are being increasingly integrated into healthcare, particularly in Germany, they should not be seen as a replacement for direct medical care. “This approach was extremely labor-intensive, and the return was low,” he said, noting that older adults, who are particularly vulnerable to the conditions targeted by the study, often face challenges in adapting to new technologies.
Despite the enthusiasm surrounding digital health solutions, the study underscores the need for a more balanced approach to healthcare. “The results clearly show that a comprehensive, holistic approach to care is essential,” Halle concluded. “Apps and digital interventions are not a one-size-fits-all solution, especially in the German healthcare system.”
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