The Osher Lifelong Learning Institute at the University of Utah offers a rich and evolving array of courses, lectures, and special activities for people who are 50 years of age and older. On 12/13/17 I was fortunate to be attending an Osher LLI Lunch and Learn. The keynote speaker was Dr. Greg Bulaj of the Medicinal Chemistry Department at the University of Utah. I was especially interested in his talk and had reserved a space well in advance as I expected the lecture to be pertinent to Therapeutic Harp work.
It was titled: Digital Medicine and Music for Epilepsy, Pain, Depression, and Cancer: How Mobile Apps and the Internet Deliver Non-pharmacological Therapies for Chronic Disorders.
Dr. Bulaj has been conducting research combining drug therapies with music and digital apps to improve the outcome for patients. As he began his lecture he informed us that one of the biggest healthcare challenges today is the fact that patients do not take their prescribed medications either at all, or sporadically, or incorrectly. According to research in the area of Medication Non-adherence, 50% of people with chronic diseases to not take their medications as prescribed. This can result in increased mortality and morbidity rates, reduced quality of life and shortened lifespans. The reasons for non-adherence vary including medications being too expensive, regimens too difficult to follow, patient denial of disease and need for treatment, discontinuing medication due to patients feeling well, and unpleasant medication side effects.
In the case of epilepsy, if meds are taken incorrectly seizure activity increases.
Mobile Medical Apps
Medical Mobile Apps are considered medical devices and require FDA approval and clearance. Examples include:
Epicadence: mobile software for the treatment of epileptic seizures (under development)
Blue Star: prescription digital intervention to treat Diabetes Type II. In clinical trials it was shown to be just as effective as medication. It is an FDA cleared mobile medical app and delivers behavioral self-management content.
Pear Therapeutics: mobile app to treat substance abuse (FDA cleared prescription digital therapeutic)
MusicGlove used to treat stroke and traumatic brain injury, and Cerebral Palsy.
Project EVO videogame by Akili Interactive treats ADHD and Autism.
NeuroRacer videogame to treat and monitor cognitive decline.
Pain RelieVR: Virtual Reality device and software to manage pain.
ReMission: videogame for pediatric cancer patients.
Intellicare: A suite of apps for the mobile phone to treat depression and anxiety from the molecular level to the behavioral level. ‘A novel suite of 13 speedy mini-apps called IntelliCare significantly reduced depression and anxiety in study participants, who used the apps on their smartphones up to four times a day. The reductions of 50 percent in anxiety and depression are comparable to results expected in clinical practice using psychotherapy or with antidepressant medication.” https://www.sciencedaily.com/releases/2017/01/170105123102.htm
Patient Empowerment Exercise Video game, called PE Game, for pediatric oncology patients. Similar to Wii.
Combination therapy for cancer patients includes cancer drugs and the PE Game. Builds strength and improves positive attitude which can improve the immune system. The mobile game is loaded on a tablet and improves physical and mental empowerment and becomes an exercise device for patients.
Packaging music into music streaming software to be used as a medical treatment. See published research paper below:
See UpMusing.net for use of music in treatment of depression and pain. upmusing.net/
Music and Physical Exercise are very effective in treating pain. Recommended treatment for chronic low back pain now is physical exercise, tai chi, or yoga. If no relief from this regimen after several months, then physicians may prescribe meds.
Fish oil (omega 3) can also be useful for pain management in combination with other modalities.
Mozart Sonata K448 has been shown to reduce seizure activity in humans and rodents if performed per the original composition. 10 min/day seems to be an adequate amount of time for listening to be effective. It can also improve sleep and reduces stress. OK to listen to the music while sleeping.
If music is packaged in a mobile app, and approved by the FDA as a medical device, it can be reimbursable by third party payers
Dr. Bulaj’s final thoughts and comments:
“Alone we can do so little. Together we can do so much.” Helen Keller.
Digital Medicine may be efficacious as a preventive treatment because this is where behavior changes can most influence the disease outcome.
Challenges to Acceptance:
- Cyber security fears
- Power requirements
- Patients willingness to be actively engaged in their own therapy
After an enlightening discussion with Dr. Bulaj earlier this week he sent the following links for additional information related to his projects including harnessing medicinal properties of Mozart music for people with epilepsy.
- This article describes a rationale for integrating Mozart music with digital/mobile technology and antiseizure medications: www.frontiersin.org/articles/10.3389/fneur.2014.00126/full
- This is a link to our digital therapeutics startup – Epicadence Public Benefit Corporation – epicadence.com/ – focused on developing Mozart-music based digital therapy for epilepsy.
- This publication describes how to “repurpose” music streaming as digital therapeutic for depression/anxiety/bipolar: www.frontiersin.org/articles/10.3389/fpubh.2016.00217/full
- This is a link to our commentary to educate our biomedical research and health care colleagues that breathing exercises are effective even when antidepressants fail: www.frontiersin.org/articles/10.3389/fmed.2017.00037/full
For more information contact Greg Bulaj at firstname.lastname@example.org
My thanks to Dr. Bulaj for his suggestions and edits to this posting for clarity and accuracy of his presentation.