{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T16:14:32Z","timestamp":1787588072896,"version":"build-2736575974"},"reference-count":28,"publisher":"American Medical Association (AMA)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Digital health technologies (DHTs) aiming to monitor, treat, and manage diseases can be prescribed for patients with multimorbidity; yet most DHTs are designed for individual conditions or problems, while approximately half of patients with chronic conditions have multiple chronic conditions.<\/jats:p>\n <\/jats:sec>\n \n Objectives<\/jats:title>\n To identify DHTs approved by the US Food and Drug Administration (FDA) or listed in the Organisation for the Review of Care and Health Apps (ORCHA) library and prescribable for a hypothetical patient with 5 conditions and to model the number of DHTs this patient should be prescribed to receive benefits health professionals considered important.<\/jats:p>\n <\/jats:sec>\n \n Evidence Review<\/jats:title>\n The FDA databases (Premarket Notification 510(k), Premarket Approval, and De Novo) and the ORCHA App Library from National Health Service Somerset were systematically searched for DHTs registered or updated between January 1, 2019, and December 31, 2022, that could be prescribed to a hypothetical woman with 5 chronic conditions (type 2 diabetes, hypertension, chronic obstructive pulmonary disease, osteoporosis, and osteoarthritis). After abstracting each DHT\u2019s elementary functions (ie, simple and delineated features to monitor, treat, and\/or manage conditions), an assessment was undertaken to determine the fewest DHTs this hypothetical patient should be prescribed to receive benefit from digital functions health professionals considered important.<\/jats:p>\n <\/jats:sec>\n \n Findings<\/jats:title>\n A total of 148 DHTs were identified (68 [46%] from FDA databases), of which 96 (65%) involved devices and 52 (35%) were standalone health apps. Only 5 DHTs (3.4%) were intended for 2 or more conditions. DHTs offered 140 elementary functions, ranging from recording, tracking, or visualizing health parameters to providing information to digital therapeutics with just-in-time interventions. The hypothetical patient would need to be prescribed up to 13 apps and 7 devices (a blood pressure monitor, a smartwatch, a pulse oximeter, a connected weight scale, a sensor-attached inhaler to monitor adherence, a lung function monitor, and a blood glucose sensor) to receive benefits from 28 functions at least 3 of 5 health professionals considered important.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n This systematic review found that almost all prescribable DHTs were developed for a single condition or problem. Thus, patients with multiple chronic conditions would have to routinize many DHTs concurrently in daily life to benefit from digital functions health professionals considered important.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2025.7288","type":"journal-article","created":{"date-parts":[[2025,4,25]],"date-time":"2025-04-25T11:30:46Z","timestamp":1745580646000},"page":"e257288","source":"Crossref","is-referenced-by-count":22,"title":["Cumulative Burden of Digital Health Technologies for Patients With Multimorbidity"],"prefix":"10.1001","volume":"8","author":[{"given":"Ngan Thi Thuy","family":"Phi","sequence":"first","affiliation":[{"name":"Universit\u00e9 Paris Cit\u00e9 and Universit\u00e9 Sorbonne Paris Nord, INSERM, INRAE, Center for Research in Epidemiology and Statistics (CRESS), Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor M.","family":"Montori","sequence":"additional","affiliation":[{"name":"Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marleen","family":"Kunneman","sequence":"additional","affiliation":[{"name":"Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, Minnesota"},{"name":"Department of Biomedical Data Sciences, Section of Medical Decision Making, Leiden University Medical Center, Leiden, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Ravaud","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris Cit\u00e9 and Universit\u00e9 Sorbonne Paris Nord, INSERM, INRAE, Center for Research in Epidemiology and Statistics (CRESS), Paris, France"},{"name":"Centre d\u2019epid\u00e9miologie clinique, AP-HP, H\u00f4pital H\u00f4tel Dieu, Paris, France"},{"name":"Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viet-Thi","family":"Tran","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris Cit\u00e9 and Universit\u00e9 Sorbonne Paris Nord, INSERM, INRAE, Center for Research in Epidemiology and Statistics (CRESS), Paris, France"},{"name":"Centre d\u2019epid\u00e9miologie clinique, AP-HP, H\u00f4pital H\u00f4tel Dieu, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2025,4,25]]},"reference":[{"issue":"22","key":"zoi250273r2","doi-asserted-by":"publisher","first-page":"2076","DOI":"10.1056\/NEJMra2215899","article-title":"Digital technology for diabetes.","volume":"389","author":"Hughes","year":"2023","journal-title":"N Engl J Med"},{"issue":"8","key":"zoi250273r3","doi-asserted-by":"publisher","first-page":"858","DOI":"10.1001\/jamainternmed.2023.2864","article-title":"Assessment of US Food and Drug Administration\u2013approved digital medical devices for just-in-time interventions: a systematic review.","volume":"183","author":"Phi","year":"2023","journal-title":"JAMA Intern Med"},{"issue":"4","key":"zoi250273r4","doi-asserted-by":"publisher","first-page":"346","DOI":"10.1056\/NEJMra2301903","article-title":"Wearable digital health technologies for monitoring in cardiovascular medicine.","volume":"390","author":"Spatz","year":"2024","journal-title":"N Engl J Med"},{"key":"zoi250273r5","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1016\/j.jclinepi.2022.12.006","article-title":"A systematic scoping review of just-in-time, adaptive interventions finds limited automation and incomplete reporting.","volume":"154","author":"Oikonomidi","year":"2023","journal-title":"J Clin Epidemiol"},{"issue":"4","key":"zoi250273r6","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1038\/s41587-019-0045-y","article-title":"Wearable biosensors for healthcare monitoring.","volume":"37","author":"Kim","year":"2019","journal-title":"Nat Biotechnol"},{"issue":"1","key":"zoi250273r7","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1056\/NEJMp1203869","article-title":"Automated hovering in health care\u2013watching over the 5000 hours.","volume":"367","author":"Asch","year":"2012","journal-title":"N Engl J Med"},{"issue":"6","key":"zoi250273r8","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.16634","article-title":"Use of wearable devices in individuals with or at risk for cardiovascular disease in the US, 2019 to 2020.","volume":"6","author":"Dhingra","year":"2023","journal-title":"JAMA Netw Open"},{"issue":"2","key":"zoi250273r9","doi-asserted-by":"publisher","first-page":"110","DOI":"10.2471\/BLT.24.292057","article-title":"A scoping review and expert consensus on digital determinants of health.","volume":"103","author":"van Kessel","year":"2025","journal-title":"Bull World Health Organ"},{"issue":"1","key":"zoi250273r10","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1038\/s41746-024-01049-0","article-title":"Understanding inherent influencing factors to digital health adoption in general practices through a mixed-methods analysis.","volume":"7","author":"Weik","year":"2024","journal-title":"NPJ Digit Med"},{"issue":"1","key":"zoi250273r11","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1093\/ehjdh\/ztab005","article-title":"Barriers and facilitators of the uptake of digital health technology in cardiovascular care: a systematic scoping review.","volume":"2","author":"Whitelaw","year":"2021","journal-title":"Eur Heart J Digit Health"},{"issue":"9836","key":"zoi250273r12","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1016\/S0140-6736(12)60240-2","article-title":"Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study.","volume":"380","author":"Barnett","year":"2012","journal-title":"Lancet"},{"key":"zoi250273r13","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.e6341","article-title":"Adapting clinical guidelines to take account of multimorbidity.","volume":"345","author":"Guthrie","year":"2012","journal-title":"BMJ"},{"key":"zoi250273r14","doi-asserted-by":"publisher","first-page":"2960","DOI":"10.1136\/bmj.p2960","article-title":"Five principles for the development of minimally disruptive digital medicine.","volume":"383","author":"Lenfant","year":"2023","journal-title":"BMJ"},{"issue":"71","key":"zoi250273r15","doi-asserted-by":"publisher","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews.","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"issue":"6","key":"zoi250273r16","doi-asserted-by":"publisher","first-page":"716","DOI":"10.1001\/jama.294.6.716","article-title":"Clinical practice guidelines and quality of care for older patients with multiple comorbid diseases: implications for pay for performance.","volume":"294","author":"Boyd","year":"2005","journal-title":"JAMA"},{"issue":"3","key":"zoi250273r24","doi-asserted-by":"publisher","first-page":"e195","DOI":"10.1016\/S2589-7500(20)30292-2","article-title":"Approval of artificial intelligence and machine learning-based medical devices in the USA and Europe (2015-20): a comparative analysis.","volume":"3","author":"Muehlematter","year":"2021","journal-title":"Lancet Digit Health"},{"issue":"1","key":"zoi250273r25","doi-asserted-by":"publisher","first-page":"118","DOI":"10.1038\/s41746-020-00324-0","article-title":"The state of artificial intelligence-based FDA-approved medical devices and algorithms: an online database.","volume":"3","author":"Benjamens","year":"2020","journal-title":"NPJ Digit Med"},{"issue":"1","key":"zoi250273r26","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1038\/s41746-020-00370-8","article-title":"Characteristics and challenges of the clinical pipeline of digital therapeutics.","volume":"3","author":"Patel","year":"2020","journal-title":"NPJ Digit Med"},{"issue":"1","key":"zoi250273r27","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1038\/s41746-018-0021-9","article-title":"Prescribable mHealth apps identified from an overview of systematic reviews.","volume":"1","author":"Byambasuren","year":"2018","journal-title":"NPJ Digit Med"},{"key":"zoi250273r28","doi-asserted-by":"publisher","first-page":"b2803","DOI":"10.1136\/bmj.b2803","article-title":"We need minimally disruptive medicine.","volume":"339","author":"May","year":"2009","journal-title":"BMJ"},{"key":"zoi250273r1","unstructured":"US Food & Drug Administration. What is digital health? Accessed May 30, 2024. https:\/\/www.fda.gov\/medical-devices\/digital-health-center-excellence\/what-digital-health#benefits"},{"key":"zoi250273r17","unstructured":"US Food & Drug Administration. 510(k) Premarket notifications. Accessed March 27, 2023. https:\/\/www.accessdata.fda.gov\/scripts\/cdrh\/cfdocs\/cfPMN\/pmn.cfm"},{"key":"zoi250273r18","unstructured":"US Food & Drug Administration. Device Classification Under Section 513(f)(2)(De Novo). Accessed March 27, 2023. https:\/\/www.accessdata.fda.gov\/scripts\/cdrh\/cfdocs\/cfPMN\/denovo.cfm"},{"key":"zoi250273r19","unstructured":"US Food & Drug Administration. Premarket approval (PMA). Accessed March 27, 2023. https:\/\/www.accessdata.fda.gov\/scripts\/cdrh\/cfdocs\/cfPMA\/pma.cfm"},{"key":"zoi250273r20","unstructured":"The Organisation for the Review of Care and Health Apps. Somerset Apps Library. Accessed March 24, 2023. https:\/\/nhssomerset.nhs.uk\/news\/success_stories\/somerset-apps-library\/"},{"key":"zoi250273r21","unstructured":"The Organisation for the Review of Care and Health Apps; American College of Physicians. App Library 2023. Accessed March 24, 2023. https:\/\/acplibrary.orchahealth.com\/en-US"},{"key":"zoi250273r22","unstructured":"Internaltional Medical Device Regulators Forum SaMD Working Group. Software as a Medical Device (SaMD): key definitions. Accessed March 27, 2023. https:\/\/www.imdrf.org\/docs\/imdrf\/final\/technical\/imdrf-tech-131209-samd-key-definitions-140901.pdf"},{"key":"zoi250273r23","unstructured":"The Organisation for the Review of Care and Health Apps. Market Facts and Figures. Accessed June 4, 2024. https:\/\/orchahealth.com\/market-facts-and-figures\/"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2833286\/phi_2025_oi_250273_1744992051.46282.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,25]],"date-time":"2025-04-25T11:30:49Z","timestamp":1745580649000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2833286"}},"subtitle":["A Systematic Review"],"short-title":[],"issued":{"date-parts":[[2025,4,25]]},"references-count":28,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,4,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2025.7288","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,25]]}}}