Berlin/Hamburg, December 14th, 2021 – HelloBetter Diabetes and Depression, the first online therapy course for the treatment of depressive symptoms in people with type 1 and 2 diabetes, is now eligible for prescription and reimbursement. Physicians and psychotherapists can thus prescribe the Digital Health Application (“DiGA”) on prescription.
Prof. Dr. David Ebert, Professor of Psychology and Digital Mental Health Care at the Technical University of Munich and Founder and Chief Scientific Officer at HelloBetter, explains:
“About 25 percent of all people with diabetes suffer from depressive symptoms, and in many cases depressive symptoms and diabetes are closely interrelated. In Germany alone, this affects about two million people. Although there are specialised psycho-diabetological therapy concepts that are specifically tailored to those affected with diabetes and depression, their availability is very limited. HelloBetter Diabetes and Depression addresses precisely this issue and offers those who suffer from this comorbidity timely and highly effective care. The online therapy course thus closes a gap in care in diabetology and can help to substantially improve the care of this patient group.” One advantage of the new therapy option: the effects are very large and it does not cause the side effects common with Psychopharmaceuticals.
How HelloBetter Diabetes and Depression works
Patients are treated through a twelve-week digital therapy course based on the methods of cognitive behavioral therapy. It consists of a web application structured into six course units and a final refresher unit. In it, patients learn about their disorder, strengthen their problem-solving skills, and learn new behaviors as well as long-term strategies to prevent relapses. Participants receive personalised written feedback from HelloBetter’s trained psychologists after each session. In addition, users can use a companion mobile app as a digital diary, symptom and mood tracker, activity planner and reminder. In this way, HelloBetter can also be used by physicians or psychotherapists as part of the treatment to provide targeted support.
The legal basis for this new therapy option becoming eligible for universal reimbursement in the German healthcare system is the Digital Care Act (DVG) passed by the German Bundestag on 7 November, 2019. It aims to improve the healthcare system by means of digital innovation. Officially tested digital health applications can now be prescribed on prescription. The Federal Institute for Drugs and Medical Devices (BfArM) reviews the manufacturers’ applications and maintains a list of products that can be prescribed.
The basic prerequisite for listing in the directory is a medical device certification. In addition, the medical benefit of the DiGA must be scientifically proven and strict data protection and security standards must be met. In order for a product to be permanently included in the DiGA directory, the manufacturer must present conclusive evidence already at the time of inclusion which – after thorough examination by the authorities – has been recognised as scientifically valid. In the case of HelloBetter Diabetes and Depression, this clinical study was conducted by researchers from the universities of Lüneburg, Freiburg, Marburg and Amsterdam.
Easy and quick access to specialised care
According to an analysis by the German Federal Chamber of Psychotherapists (BPtK) using data of more than 300,000 insured, around 40 percent of patients typically waited in between three to nine months for outpatient psychotherapy treatment in 2019. According to the BPtK president, the Corona pandemic has further exacerbated the situation. HelloBetter Diabetes and Depression can help to address this massive unmet need, by offering immediate access to low-threshold, digital psychotherapeutic care. The online course is tailored to the specific challenges of the approximately two million people in Germany suffering from both depressive symptoms and diabetes. For them, mechanisms that are normally used to regulate patients’ psychological state – such as exercise – are often difficult to use or can only be used to a limited extent. It provides support for diabetologists, who are often confronted with patients that feel stuck in a kind of vicious circle: Depression is significantly associated with nonadherence to diabetes treatment recommendations including missed medical appointments, diet, exercise, medication use, glucose monitoring, and foot care. Poor adherence to self-care may increase blood glucose, which in turn may contribute to depressive symptoms and consequently contribute to decreased adherence to self-care behaviors and negatively impacts the management of diabetes. With HelloBetter Diabetes and Depression, patients can independently achieve a long-lasting improvement in their depressive symptoms.
HelloBetter supports patients, but also prescribers
Patients are treated through a twelve-week digital therapy course based on the methods of cognitive behavioral therapy. It consists of a web application structured into six course units and a final refresher unit. In it, patients learn about their disorder, strengthen their problem-solving skills, and learn new behaviors as well as long-term strategies to prevent relapses. Participants receive individualised, written feedback from HelloBetter’s trained psychologists after each session. In addition, users can use a companion mobile app as a digital diary, symptom and mood tracker, activity planner and reminder. In this way, HelloBetter can also be used by physicians or psychotherapists as part of the treatment to provide targeted support.
HelloBetter’s strong scientific evidence base
A team of scientists and psychotherapists developed and evaluated the interactive therapy program over more than four years of research. The study that proved the effectiveness of the course was led by Dr. Stephanie Nobis, Prof. Dr. David Ebert, Prof. Dr. Dirk Lehr and Prof. Dr. Matthias Berking. The results were published in high-ranking international scientific journals.¹
The RCT demonstrated that 62 percent of participants showed a substantial improvement in depressive symptoms. These were measured using the General Depression Scale (GDS). Compared to an active control group that had access to an online psychoeducational program, depressive symptoms were significantly (p = .001) lower after use. Overall this is classified as a large effect size (Cohen’s d = 0.94). Depressive symptoms remained significantly lower in follow-on measurements 6 and 12 months after patients had completed the course. The size of the effects found was thus even higher than the mean effects found in a recent meta-analysis² for pharmacotherapeutic (SMD = 0.57) treatments for depression in people with diabetes. In addition, positive effects on other measures of mental health (worry, diabetes-related emotional stress, quality of life, behavioral activation, problem-solving ability) could also be demonstrated. Participant satisfaction was also extremely high: 92 percent said that they would recommend the programme to a friend.
For the scientific evidence and their user-centered therapy approach, HelloBetter’s medical products have already been awarded multiple acclaimed awards and came out on top of two major tests of digital health applications conducted by Stiftung Warentest.
¹ https://care.diabetesjournals.org/content/38/5/776 und https://onlinelibrary.wiley.com/doi/abs/10.1111/dme.13173
HelloBetter is among the world’s leading providers of digital therapy courses. The company was founded in 2015 by psychologists Prof. Dr. David Ebert, Dr. Hanne Horvath and Dr. Elena Heber. David Ebert, Professor of Psychology & Digital Mental Health Care from TU Munich, is an internationally recognised expert and global pioneer of digital interventions for mental health conditions. HelloBetter prevention and treatment courses cover eight major mental health issues ranging from depression, anxiety or insomnia to vaginismus and chronic pain. More than 30 randomised-controlled studies on the effectiveness and cost-effectiveness of their therapy courses have been published in peer reviewed journals. No other provider globally has a comparable body of clinical evidence for the effectiveness of its solution. The company is based in Berlin and Hamburg and employs more than 70 people. Further information is available at www.hellobetter.de
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