Opportunities and challenges of lifestyle intervention-based digital therapeutics in LDL-C management: a scoping review

基于生活方式干预的数字疗法在低密度脂蛋白胆固醇(LDL-C)管理中的机遇与挑战:一项范围界定综述

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Abstract

BACKGROUND: In recent decades, the prevalence of dyslipidemia, especially high low-density lipoprotein cholesterol (LDL-C), has risen sharply in China. Although lifestyle interventions are important, traditional face-to-face approaches have limitations. Digital Therapeutics (DTx) can provide an effective solution by delivering remote medical interventions to patients via software and hardware, thereby optimizing existing clinical treatment methods with enhanced convenience and accessibility. OBJECTIVES: This study aims to explore the current evidence on the effect of lifestyle intervention-based Digital Therapeutics (LI-DTx) on high LDL-C, and to analyze their advantages and disadvantages. ELIGIBILITY CRITERIA: This scoping review examines clinical studies assessing the effects of DTx on LDL-C levels. Papers were included in the final analysis if there was evidence that DTx had effects on lowering LDL-C levels. SOURCES OF EVIDENCE: Papers that were published between January 2014 and December 2023 were included in the PubMed database. CHARTING METHODS: Data extracted from the publications included country, year, study type, study population, sample size, study duration, intervention, and changes in LDL-C level. RESULTS: A total of 23 target literature were identified. Twenty-one studies confirmed that LI-DTx could optimize the LDL-C level through remote lifestyle interventions such as diet, exercise, medication, and health education, of which 14 studies reported a significant reduction in LDL-C level (p < 0.05). In the future, the development and design of DTx will need to improve intelligence, personalization, applicability, real-time performance, and data security; integrate with traditional healthcare systems; facilitate multidisciplinary collaboration in dyslipidemia management; and enhance long-term patient engagement with DTx platforms. CONCLUSION: LI-DTx may offer a more effective and sustainable solution for LDL-C management, although several challenges remain. Further randomized controlled clinical trials are needed to provide scientific support for its efficacy and safety.

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