Terve Päivä is a digital lifestyle guidance treatment pathway and service platform developed in collaboration with healthcare professionals. It provides professionals with a means to guide clients both in a preventive manner and as in support of pharmacotherapy. For clients, the service provides a structured pathway towards a healthier lifestyle, including a better diet, increased exercise, and stress management. The service works through a browser-based user interface and is available on a variety of devices, including computers, tablets, and smartphones. [1]
The objective of the Terve Päivä service is to promote health and well-being through various lifestyle changes. The service offers three complete six-month pathways, the contents of which are based on current care recommendations:
- General lifestyle guidance
According to information received from the company, 90% of the users of the service will continue until the end of the six-month service period. [1]
Research evidence relating to the product under evaluation
The product has undergone a peer review study to evaluate the effectiveness of the Terve Päivä service’s six-month digital health intervention in early-stage diabetics as well as type 2 diabetics. The digital service pathway used in the assessment aims to support a comprehensive change in the client’s lifestyle. The service pathway included diverse lifestyle topics such as eating habits, physical activity, as well as monitoring of the client’s progress and support from a nurse or a doctor. [2]
The data from the study was collected using an online questionnaire. Data were collected on the weight, height, and waist circumference of the participants before and after intervention. Anthropometric data were collected from 23 subjects with prediabetes and 33 subjects with type 2 diabetes. More than half of the respondents were men with type 2 diabetes with an average age of 60 years. The participants averaged a body weight of 92 kg, a body mass index (BMI) of 32 kg/m2 and a waist circumference of 109 cm. [2]
In addition to the anthropometric data, the study also collected health data, such as data on physical activity, eating habits, and experience of the state of health. 52 people provided health data for the study. The majority of respondents were women, 26 with prediabetes and 26 with type 2 diabetes. Their average age was 61 years. [2]
Pre- and post-operative changes during the intervention period as well as differences in responses between prediabetic patients and type 2 diabetics were evaluated using non-parametric analyses.
During the intervention period, participants lost an average of 3.0 kg of weight (-6.0 – -1.0 kg p < 0.001), their BMI decreased by 0.90 kg/m in2 (-2.02 – 0.10, p < 0.001), and waist circumference decreased by 4.0 cm (p < 0.001). Their observed state of health (p < 0.001), dietary habits (p < 0.001), and physical activity habits (p < 0.001) were estimated to have improved accordingly. Changes during the intervention period did not differ between prediabetics and type 2 diabetics. [2]
The study concluded that the beneficial effects of the 6-month digital intervention on health-related behavioural changes in prediabetics and type 2 diabetics could be demonstrated. Regular professional guidance combined with the digital pathway will improve the effectiveness of the intervention.
There were no randomly selected participants or control groups in the study. However, the sample, based on registry data, is representative of those groups of diabetics who were advised to participate in the intervention as part of the normal course of clinical treatment. [2]
Literature reviews
A systematic literature review, completed in 2020, investigated the clinical impacts of digital tools in health coaching, education, and behavioural promotion in patients with prediabetes or type 2 diabetes. The purpose of the systematic review was to provide input to support decision-making for those health care organisations considering adopting such digital tools. [3]
In the systematic review, 20 of the 21 studies included in the review demonstrated statistically significant improvements in at least one measure of diabetes management, such as long-term glucose (hbA1c), fasting blood sugar (fP-Glucose), and body mass Index (BMI). Weight loss at one year ranged from -3.04% to -8.98%, which corresponds to results achieved through traditional coaching in the course of preventive diabetes treatment. Four studies reported weight loss within these percentages. In addition, studies comparing online coaching with personal or telephone coaching showed statistically superior or equivalent results for the online training group. There were five such studies (N = 5). [3]
The conclusion of this review was that digital health coaching provides a promising strategy for the long-term management and prevention of type 2 diabetes, and its benefits are comparable to in-person or telephone coaching. [3]
A study completed in 2019 assessed the effects of a digital intervention tool on diabetic patients in eight municipalities in Denmark between 2016 and 2018. Each of the eight municipalities offered a digital intervention platform through its own organisation with the help of local health care professionals such as nutritional therapists, nurses, physiotherapists, and occupational therapists. In the study, changes in body weight were assessed at 6, 9 and 12 months. [4]
The population consisted of 103 diabetic patients, 57 of whom were women (55.3%). All participants’ BMI at baseline was > 30 kg/m2. Patient data was collected from the intervention database based on data registered by patients and their respective professionals and the data met the following criteria:
- The subjects had registered as users of the platform due to diabetes.
- The digital intervention platform was in use at some point during the time period the material was collected (7 June 2016 through 2 May 2018).
- There were at least 90 days and no more than 365 days between registration of the first and last weight measurement.
- No unrealistically fast weight changes were recorded during the data collection (> 0.5 kg/day).
The majority of patients in the study, 88/103 (85.4%) lost weight, while 15/103 (14.6%) maintained or increased their weight. The results demonstrated an average weight loss of 4.8 kg (4.3%) from the original body weight over a period of approximately 7 months (P < .05). Female patients lost 4.22% of their original body mass, while men lost 4.41% of their weight.
The study also found that the time spent on the intervention was a significant factor in weight loss. The change in body weight in patients who had recorded their body weight for 9 months was a weight loss of (5.56%) and the mean weight loss in patients who had recorded their body weight for 12 months was (6.27%). [4]
Recommendations and previous assessments
The National Institute for Health and Care Excellence (NICE) has issued its recommendations on the use of digital weight management technologies in the UK health care sector. These recommendations focus on assessing the clinical effectiveness of weight management technologies.
Digital weight management technologies are an integral part of the recommendations, offering an alternative to traditional face-to-face weight management services. Preliminary evidence suggests that the weight loss achieved through the technologies is comparable to traditional services over a two-year period. [5]
The recommendations also noted that diverse weight management programmes incorporating dietary habits, physical activity, and behavioural change techniques can help adults lose weight and maintain weight management for at least 12-18 months. This provides some evidence of how diverse technologies can effectively complement the health care weight management strategy. [6]
