OBJECTIVES: While, digital therapeutics (DTx) are assessed for their efficacy and satisfaction, it is imperative that their utilization is also evaluated. This targeted literature review aims to evaluate the utilization of DTx across different therapeutic areas.

METHODS: PubMed was searched for original articles published from 2015 to 2022, in English using a combination of keywords, focused on DTx and user perceptions on acceptance, and utilization. Two investigators independently reviewed title/abstracts followed by full texts of studies using a predetermined study selection criterion. Data were extracted by themes and included DTx characteristics, therapeutic area, utilization evaluation metrics and sentiments. Utilization was defined as patient perceived ease of use, and usefulness, elicited using standardized frameworks or tailored mixed methods metrics.

RESULTS: The search criteria yielded 326 publications, and 47 publications were included after title/abstract and full text screening. Among them, 15 studies evaluated patients’ utilization of DTx. Most DTx were in the areas of psychiatry, addiction, infectious diseases, and endocrinology. Different types of DTx were evaluated including Cognitive Behavioral Therapy (iCBT) (5/15), digital pills (4/15) and wearables (2/15). Eight studies used utilization-specific frameworks (e.g. System Usability Scale) while others used mixed methods to elicit feedback about perceived utilization.

Overall, the evidence reported was positive (9/15) or mixed (5/15). Mixed/negative feedback received was around difficulty to use due to disability, poor interface design and connectivity issues. CBT users reported challenges with ease of use, learning and sustainability to use DTx for disease management. Digital pills reported negative sentiments on design, and technological issues. DTx for addiction, rheumatology, and psychiatry showed positive to mixed utilization, with negative results mostly in sleep medicine.

CONCLUSIONS: Most studies reported positive utilization, however a large section of the studies had small samples, unstandardized evaluation and no comparators which indicate a need to develop standardized utilization assessment protocols and evaluation metrics.