February 26, 2024

Drugs treat diseases effectively only when patients actually take them as prescribed. That’s why pharmacists are experts not only in the science of pharmacy but also in the art of counseling and motivating patients to follow prescriptions. 

Mike Dorsch, PharmD, MS, is keenly interested in understanding how to encourage compliance with a common prescription that is not a drug at all — diet and exercise. 

Both are effective ways to help prevent or manage potentially dangerous conditions like heart disease and high blood pressure (among many others). Eating better and moving more are simple, low-cost things everyone can do, but as many of us know, it can be challenging to incorporate these healthy habits into our lives. 

Studying Diet and Exercise with Mobile Devices and Health Apps 

Dr. Dorsch, associate professor of clinical pharmacy at the University of Michigan, combines his knowledge of the power of these lifestyle interventions and his longstanding love of technology to study how mobile devices and health apps can help patients set and achieve exercise and dietary goals. 

“The problem is that it is relatively easy to prescribe the therapies we call ‘the ABC’s of cardiovascular disease prevention’ — aspirin and blood pressure and cholesterol medications,” Dr. Dorsch said. “The hard ones are the D and E, which are diet and exercise. I'm interested in how we can use technology to help patients make changes with D and E to manage their disease.”

He is an investigator in a recent study that tested whether adaptive, just-in-time nudges and reminders from a phone app could help patients with hypertension increase their daily step count and decrease the salt in their diets. The primary goal was to see whether patients lowered their blood pressure through these lifestyle changes over the six-month study.  

myBPmyLife Technology Trial Underway 

The randomized controlled trial, dubbed The myBPmyLife Trial, enrolled patients from both University of Michigan Health and Hamilton Community Health Network, a federally qualified health center network in Flint, Michigan. Patients were given Fitbit step trackers and wireless blood pressure monitors that could connect to a phone app called MyDataHelps. 

Patients were coached on connecting their devices and setting goals in the app and then received push notifications through the app to encourage behavior change. Those in the control group continued with the traditional prescribed medical treatment. 

Unlike previous studies of mobile health interventions, the myBPmyLife Trial delivered personalized, context-sensitive messages based on the time of day, day of the week (weekend or weekday), weather, community, and mobility. For instance, alerts would disrupt sedentary behavior with a reminder to stand up or stretch. Dietary notifications would arrive around mealtimes and suggest alternatives to participants who regularly purchased or consumed processed or fast foods.  

Data collection was completed in July, and analysis is underway, Dr. Dorsch said. The study, led by Jessica R. Golus, MD, MS, of Michigan Medicine, was described in a January 2024 special edition of the Journal of the American Heart Association. An accompanying article outlined the resources required to recruit subjects and implement such a trial of mobile technology. A third viewpoint article assessed the barriers to compliance with standard guideline-directed medical therapy (GDMT) and how digital health devices and interventions can help overcome those barriers. 

Will Wearable Tech Improve Health Outcomes?

The study is the latest effort of a University of Michigan initiative called WIRED-L: Wearables In Reducing Risk and Enhancing Daily Lifestyle Center. Dr. Dorsch is a co-principal investigator at the center, which is dedicated to building and testing mobile health apps with the potential to modify behavior and help people lead healthier lives. Operating within the Michigan Integrated Center for Health Analytics & Medical Prediction (MICHAMP), WIRED-L is one of five such centers across the nation funded by the American Heart Association. 

WIRED-L has built apps that encourage you to walk more — but are smart enough not to remind you to go out for a walk when it’s raining. Another app provides push notifications to order items with less salt when you walk into a restaurant. Research has shown that apps like these can change behavior in the short term. Many questions remain about longer-term change and whether app-inspired change is enough to improve health outcomes.

Studying Whether We Can Manage Disease in the Palms of our Hands.  

What leads a pharmacist to study non-pharmacological interventions like this? Dr. Dorsch said it leads back to an early infatuation with technology when computers and early spreadsheet software first became available to him in high school; he took a programming class and was hooked. He spent 13 years as a clinical pharmacist, which gave him deep experience and insights into patients’ motivations and influencing their behavior. When he transitioned to a tenure track position at the College of Pharmacy in 2018, it allowed him to combine his love of technology with research that could illuminate its potential to improve health. 

Smartphones and personal health devices are increasingly common; 85% of Americans own a smartphone, and about 50% are already tracking some aspect of their health with a digital device. These trends cut across all ages and across racial and socioeconomic groups, which means that digital health apps have the potential to deliver health information and care to groups that have often had less access to healthcare systems. 

Diet and exercise are powerful, accessible, and affordable ways that individuals can take control of their own health, so the discoveries Dr. Dorsch and his colleagues are pursuing through WIRED-L have great potential to improve the lives and health of many. If effective, such apps can put the power to manage disease in the palms of patients’ hands.  


1 Poushter J. Smartphone ownership and internet usage continues to climb in emerging economies. Pew Research Center. 2016 22:144. https://www.diapoimansi.gr/PDF/pew_research%201.pdf

2  Segura Anaya LH, Alsadoon A, Costadopoulos N, Prasad PWC. Ethical implications of user perceptions of wearable devices. Sci Eng Ethics. 2018; 24:1–28. doi: 10.1007/s11948-017-9872-8