Brent I. Fox, Pharm.D., Ph.D and Joshua C. Hollingsworth, Pharm.D., Ph.D.

We made it. 2020 has finally come to a close, and 2021 has now begun. Although we are still not out of the woods yet in terms of the pandemic, we do have effective vaccines that are now being widely distributed and administered, likely by many of you reading this column. This is a major milestone for managing the virus and the impact it has on us. And we have to say that personally, it just feels good to leave 2020 in the dust and to start anew. And now that we are well into the new year and resolutions are (hopefully still) underway, we would like to take a moment to reflect on the previous year, to look forward to this year, and to consider ways you may use mobile apps and tools to support your own health and wellness, as well as the health and wellness of your patients.

What health and fitness apps are you using or do you plan to use for your personal health and wellness? Click here to let us know.

Health and fitness apps, particularly those with video workouts, performed strongly in 2020. Although personal health and wellness have always been important, 2020 and the COVID-19 pandemic may have made both mental and physical wellness more important than ever. Health behaviors are of course key here. This includes medication adherence, which we have written about in our ComputerTalk columns before, but it also includes behaviors in the domains of movement and exercise, diet, stress management, sleep, and social connection. We are all aware that guidelines for chronic disease states such as hypertension, diabetes, or hypercholesterolemia universally recommend a healthy lifestyle in conjunction with pharmacotherapy, if warranted. Unfortunately, and as you also well know, the pandemic made many behaviors within these domains difficult. Gyms closed. Social distancing requirements prevented social gatherings. Collectively, these circumstances negatively impacted stress and sleep for many, making it more difficult to stick to a healthy eating pattern. That said, all is not lost. Many persevered through the pandemic by finding new health behaviors and routines that were both feasible and sustainable during the new normal.

A big part of the solution for many have been health and fitness apps. Such apps can provide training and serve as tools for tracking, thereby making target health behaviors easier to do. According to a report by Apptopia, six of 10 of the top health and fitness apps “offer video workouts or video-guided exercises.” These include Fitbit, Muscle Booster, BetterMe, Fitness Coach, Samsung Health, and Home Workout. Looking at the four remaining apps, Calm and Headspace focus on meditation, MyFitnessPal allows users to track their diet and exercise, and Flo is a women’s health tracker.

Top Mobile Health App Picks

Apple’s and Google’s top app picks for 2020 are also reflective of the year’s challenges. Wakeout! — Apple’s pick for top iPhone app of the year — follows the trend seen with the top health and fitness apps. It provides videos for short active breaks and movements that can be integrated into your day in order to combat sedentarism. The app also includes a productivity timer and several wind down bedtime routines. Apple named Zoom its iPad app of the year. As you know, probably too well at this point, Zoom is video conferencing software, and it has been used during the pandemic by friends, families, and groups to connect; by healthcare providers to see their patients (which we wrote about as well); by educators for remote learning; and by fitness coaches, dieticians, and chefs to deliver and receive things like workout and cooking classes. Endel, Apple’s pick for the Apple Watch app of the year, creates personalized soundscapes to help you relax, focus, or get to sleep. Similarly, Google’s top app pick, Loóna, creates soundscapes — guided sessions that combine activity-based relaxation, storytelling, and sounds — that are meant to help create the right mood for sleep. These apps may be beneficial to you and your patients who want to exercise more, manage stress, connect virtually with others, participate in remote learning, eat healthier, or get better sleep in the new year.

We also saw a few more FDA (Food and Drug Administration)-cleared prescription-only mobile medical apps (i.e., Rx apps) in 2020. We wrote about Rx apps previously. In March, the FDA cleared Somryst, an Rx app produced by Pear Therapeutics that provides cognitive behavioral therapy (CBT) along with personalized, algorithm-generated sleep restriction recommendations for adults with insomnia. Although CBT is recommended as first-line therapy for insomnia (CBTI), the majority of patients with insomnia do not receive the therapy, largely due to a shortage of CBTI-certified clinicians. Somryst aims to help close this gap in treatment. In November of 2020, the FDA cleared NightWare, an Rx app for adults who suffer from nightmare disorder or have nightmares related to post-traumatic stress disorder (PTSD). Pulling heart rate and movement data from an Apple Watch, NightWare uses a proprietary algorithm to create a unique sleep profile for patients that is then used to determine when the patient is likely having a nightmare. When a nightmare is detected, the app vibrates the Apple Watch to gently wake the patient. Be on the lookout for prescriptions for these and other Rx apps for your patients. We expect to see more innovation and utilization in this space this year.

Of course a big focus in 2021 will be safe and effective vaccination against COVID-19. With two FDA-approved vaccines now available, millions of doses have already been administered, and many millions more are needed. As we ramp up vaccination across the nation, the CDC (Centers for Disease Control and Prevention) has developed a mobile tool — Vaccine Safety Assessment for Essential Workers (v-safe) — in order to keep a close eye on adverse events in real time. V-safe is a voluntary system that uses text messaging and web surveys to provide short (less than five minutes) personalized health check-ins post-vaccination. These check-ins occur daily for the first week and then weekly for five weeks after vaccination, and at three, six, and 12 months after the final vaccine dose. If an individual reports a clinically significant adverse event, then a telephone follow-up is conducted to gather more information, and the event is reported via the Vaccine Adverse Event Reporting System (VAERS), the U.S. early warning and safety monitoring system for vaccines. V-safe also reminds users when it is time to get their second COVID-19 vaccine dose, if needed. As healthcare providers, we can encourage patients to sign up for and use the v-safe tool. More v-safe users means more data, which will allow us to better assess the safety of the vaccines at the population level.

So there you have it. The majority of the top health and fitness apps of 2020 included instructional videos as a primary feature. Some of Google and Apple’s top app picks for the year focused on helping us be less sedentary (Wakeout!); set the mood when we need to relax, focus, or get some sleep (Endel and Loóna); and connect virtually with others (Zoom) no matter the purpose. A few new Rx apps made it to market, and we expect to see more growth in this space in 2021. And the CDC developed and disseminated v-safe to better monitor the safety of the COVID-19 vaccines in real time. What health and fitness apps are you using or do you plan to use for your personal health and wellness? What apps do you recommend to your patients? Do you have any patients who have been prescribed an Rx app? If you are administering COVID-19 vaccines, are you encouraging your patients to use v-safe? Let us know. We welcome your comments. CT

Joshua C. Hollingsworth, Pharm.D, Ph.D., is an assistant professor, Pharmacology and Biomedical Sciences, Edward Via College of Osteopathic Medicine, Auburn Campus, and Brent I. Fox, Pharm.D., Ph.D., is an associate professor in the Department of Health Outcomes Research and Policy, Harrison School of Pharmacy, Auburn University.
The authors can be reached at jhollingsworth@auburn.vcom.edu and
at foxbren@auburn.edu.

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