A consultation has begun on the decision to conditionally recommend eight digitally enabled therapies which address depression and anxiety disorders, including PTSD and body dysmorphia. Each of the digital technologies includes the support and involvement of an NHS Talking Therapies clinician and all use CBT techniques. The eight therapies are conditionally recommended while further evidence is being generated.
Digital therapies recommended in this latest guidance have the potential to help more than 40,000 people. One in six people report experiencing a common mental health problem such as anxiety and depression in any given week in England, according to NHS Digital and there is high demand for NHS talking therapies with some people currently waiting up to 6 weeks to access help.
These digitally enabled therapies, some of which are already in use, are conditionally recommended for use, although only after a formal assessment with an NHS Talking Therapies therapist, as they may not be the right choice for everyone.
View the NICE draft guidance.
Dr Jake Andrews, Research Fellow at NIHR Mindtech Medtech Cooperative, commented:
NICE recommendation for a therapy is a real hallmark of its quality in terms of how well it works and its safety, as well as showing value for money. The conditional recommendation that these therapies have been given shows that the experts at NICE have reviewed the research evidence and provisionally decided that these tools, if used with a therapist, are likely to be helpful for people living with the conditions they target. It will be important to gather even more evidence about how well these tools work in the general population, to be sure that the research findings to date hold true with wider patient groups. It will be interesting to see if people will continue to use these digital services, as sometimes people can get bored or frustrated with apps and websites and might choose to go back to traditional support from a therapist. As well as patients finding these helpful, clinicians will need to find the tools helpful and not too burdensome to use with their patients, as they do not have a lot of time to spare. If the tools can save clinicians time, then it may be possible to increase the number of people who can access treatment at the same time, although it will be important to consider clinicians' overall workloads.
NICE recommendation for a therapy is a real hallmark of its quality in terms of how well it works and its safety, as well as showing value for money. The conditional recommendation that these therapies have been given shows that the experts at NICE have reviewed the research evidence and provisionally decided that these tools, if used with a therapist, are likely to be helpful for people living with the conditions they target. It will be important to gather even more evidence about how well these tools work in the general population, to be sure that the research findings to date hold true with wider patient groups.
It will be interesting to see if people will continue to use these digital services, as sometimes people can get bored or frustrated with apps and websites and might choose to go back to traditional support from a therapist. As well as patients finding these helpful, clinicians will need to find the tools helpful and not too burdensome to use with their patients, as they do not have a lot of time to spare. If the tools can save clinicians time, then it may be possible to increase the number of people who can access treatment at the same time, although it will be important to consider clinicians' overall workloads.
Early value assessments (EVAs) are a relatively new way for NICE to rapidly assess and identify promising medical technology for rapid deployment into the NHS. The new recommendations come from the 6th and 7th EVAs to have been undertaken. In their first EVA guidance which focused on digital mental health tech for children and young people, NICE recommended LumiNova: Tales of Courage, a studio quality mobile game app for childhood anxiety in children aged 7-12 years, developed by BfB Labs, and evaluated by MindTech’s Dr Jo Lockwood.
Prof Chris Hollis, Director of the NIHR MindTech MedTech Co-operative, said:
“These apps all use CBT techniques and are supported by a trained therapist through text and video. NICE has reviewed the available evidence which shows that supported digital therapies can be as effective as in-person therapy. Some digital therapies – such as virtual reality CBT for social anxiety and agoraphobia may in fact be superior and appear to work faster than traditional in-person therapy.”
“Using apps can be more convenient for people as they remove the need for travel and the content can be accessed anytime, anywhere. For the NHS they can be a more efficient way of delivering therapy to more people and reducing waiting times.”
“NICE has reviewed the therapist-supported apps for these conditions and has found promising evidence for their effectiveness. Following this review – the next step will be to collect ‘real-world’ evidence of effectiveness and value in NHS clinical settings.”
“NICE estimate that 40,000 people with these conditions could benefit from these digital therapies. These apps are not being released direct to the public – rather all people receiving these apps will first have a clinical assessment – which is important as it ensures that the right help is directed early to the people who need it. Furthermore, they will be supported by trained therapists who can ensure that people using the apps are directed to more intensive and/or different help if required.”
To find out more about Lumi Nova, visit the BfB Labs website.