As discussed in the previous chapter, there is reason to believe that using Lifeness improves the efficiency and quality of care for patients struggling with overweight and obesity. Health care workers and patients are more likely to interact through Lifeness, increasing patients' motivation, a crucial factor for self-management in obesity. This chapter focuses on how Lifeness can contribute to improve chronic disease management of overweight and obesity. We have divided the potential societal effects into 1) The burden of disease 2) Health care costs and 3) Production loss. The aim is to provide a discussion of potential societal effects that can be expected from Lifeness, as a supporting tool in the chronic disease management of overweight and obesity. In some parts of the discussion, findings from a pilot study performed by Lifeness will be presented.
As described in chapter 1, there is a large burden of disease associated with overweight and obesity. That means that even small positive changes can have a great positive societal impact. Chapter two describes how standard of care and mHealth interventions might improve both physical and mental health. In order to determine whether an intervention provides health gain, i.e., reduces the burden of disease, it is normal to measure both disease specific outcomes and generic health outcomes. In this case, disease specific outcomes can be change in weight, HbA1c-level[1] and other comorbidities directly related to the disease. Generic measurements, on the other hand, aim to capture the change in general health which makes it easier to compare heterogeneous disease areas and thus help decision-makers in the allocation of resource use. Both types of outcome measurements are important when assessing the burden of disease.
Patients suffering from obesity at a rehabilitation institution in Norway, have had the chance of testing Lifeness in a preliminary pilot study. The following figures illustrate some of the trends from a survey performed after using Lifeness as a supporting tool in the rehabilitation programme. The figures must be considered carefully as the sample sizes were small. However, the results indicate expected trends and the potential impact on the burden of disease, by using Lifeness as a supporting tool in prevention and treatment of obesity.
Figure 3-1 shows that 58 percent of the respondents lost weight during the period of using Lifeness. 25 percent maintained their weight loss.
Figure 0‑1 Change in weight after using Lifeness for at least 12 months. N = 24. Source: Survey from a pilot study performed by Lifeness.
If we compare this to the goals of each individual,[2] all individuals that had a goal of maintaining their weight, actually lost weight. Approximately 60 percent of those with a goal of losing weight, achieved their goal during this period. These are promising results which can impact the burden of the disease positively.
Change in weight is a specific outcome measurement, important to measure. However, in the long term it is crucial to stay motivated to either keep losing weight or maintain a suitable weight. Motivation can be captured in more generic outcome measurements.
Figure 2 Has the use of Lifeness changed your motivation in the right way? N = 24 Source: Survey from a pilot study performed by Lifeness
It seems like there is a tendency towards being more motivated to achieve their goals when using Lifeness. Approximately 80 percent of the respondents were more motivated after using Lifeness compared to baseline. When adjusting for how long every respondent had used Lifeness,[3] we found a positive association between increased use of Lifeness and motivation. Long-term motivation is one of the greatest challenges’ chronic disease management faces.[4] We found no significant difference between working status, age, or educational level with regards to how motivated the respondents were.
The aim of Lifeness is to be a supporting tool together with other interventions in both prevention and treatment. Consequently, it is important to find out whether interventions improve health by adding Lifeness.
Figure 0‑2 How has the use of Lifeness affected your rehabilitation program? N = 24. Source: Survey from a pilot study performed by Lifeness
The survey showed that 71 percent of the respondents experienced an overall improved rehabilitation program when using Lifeness. Similar to motivation, there was a tendency towards being more satisfied the longer a respondent had used Lifeness. All of the respondents that had used Lifeness for over a year, answered that they had improved their overall rehabilitation program due to Lifeness.
The positive association between long-term use of Lifeness, increased motivation and improved overall rehabilitation program are promising results with regards to the challenges of long-term follow-up. If Lifeness contributes to reducing the occurrence of relapses, helping people to maintain a sustainable lifestyle, this could lead to a reduction in the burden of disease and generate great societal impact.
There is little evidence on the effect on health workers direct resource by using Lifeness. However, the increased flexibility in the patient communication, allows health care workers to organise their time more efficiently.