The World Health Organization (WHO) defines non-communicable diseases (NCDs) as chronic conditions of long duration resulting from a combination of genetic, physiological, behavioral, and environmental factors.1 Nearly 63% of all deaths can be attributable to NCDs, making this the leading cause of mortality in the world.2 While more than 36 million people die each year due to NCDs, about 80% of NCD deaths occur in low and middle-income countries. Bangladesh is a highly populous country with a population of more than 1.3 billion which is facing an immense burden of NCDs. Demographic and epidemiological transitions over the past few decades have resulted in a shift in the national burden of diseases from infectious diseases to NCDs. In addition to contributing to mortalities and morbidities, NCDs also affect the national economy enormously. For example, the economic losses from heart disease, stroke, and diabetes were estimated to be US$54 billion in 2015.
Considering the population health and associated challenges, it is essential to explore potential avenues to alleviate the high burden of NCDs in India. Providing conventional care for NCDs in a large population can be difficult because patients living with chronic conditions need continuous monitoring and prolonged treatment. As the country suffers from a lack of adequate healthcare infrastructure and a severe scarcity of human resources for health,9 conventional healthcare delivery methods involving face-to-face doctor–patient interactions might not be available to most of the people in India. Moreover, critical challenges such as long distance from the nearest health center, lack of transportation to health facilities, lack of awareness about health services, and high cost of seeking care can affect timely diagnosis and treatment of NCDs. These problems necessitate interventions for making healthcare for NCDs more available, accessible, and acceptable to the patients who need them the most. Furthermore, chronic diseases make individuals vulnerable to mental and physical stress. Empowering patients and their caregivers can help in addressing health problems through enhanced participation and adherence to optimal care at the community level. In the era of digital technologies, many mHealth and eHealth interventions have been developed to provide a wide range of healthcare services to people living with different health conditions.
Different devices and platforms, including mobile phone, website, software, wearable devices, and tablet computers, using online and offline digital technology platforms, are increasingly being used in healthcare; these are collectively termed as digital health. The WHO recognizes the potential of digital health interventions to achieve universal health coverage and ensure high-quality care to individuals. These interventions can provide preventive, diagnostic, therapeutic, and palliative care using digital platforms such as mobile phone, portable computing devices, internet-based applications, and social media interfaces. Many such interventions are designed and implemented for people living with NCDs. For example, a systematic review by Larson et al. evaluated nine telehealth interventions for patients receiving cancer care. They found telehealth interventions to be similarly effective as usual care in terms of improving quality of life among study participants.