Home Environment as a Therapeutic Target for Prevention and Treatment of Chronic Diseases: Delivering Restorative Living Spaces, Patient Education and Self-Care by Bridging Biophilic Design, E-Commerce and Digital Health Technologies

Abstract

A high prevalence of chronic diseases exposes diverse healthcare pain points due to the limited effectiveness of pharmaceutical drugs and biologics, sedentary lifestyles, insufficient health literacy, chronic stress, unsatisfactory patient experience, environmental pollution and competition with commercial determinants of health. To improve patient care and long-term outcomes, the impact of the home environment is overlooked and underutilized by healthcare. This cross-disciplinary work describes perspectives on (1) the home environment as a therapeutic target for the prevention and treatment of chronic diseases and (2) transforming health-centric household goods e-commerce platforms into digital health interventions. We provide a rationale for creating therapeutic home environments grounded in biophilic design (multisensory, environmental enrichment) and supporting physical activities, quality sleep, nutrition, music, stress reduction, self-efficacy, social support and health education, hence providing clinical benefits through the modulation of the autonomic nervous system, neuroplasticity and behavior change. These pleiotropic "active non-pharmacological ingredients" can be personalized for people living with depression, anxiety, migraine, chronic pain, cancer, cardiovascular and other conditions. We discuss prospects for integrating e-commerce with digital health platforms to create "therapeutic home environment" interventions delivered through digital therapeutics and their combinations with prescription drugs. This multimodal approach can enhance patient engagement while bridging consumer spending with healthcare outcomes.

Keywords: AI; PDURS; biophilia; built environment; health at home; home care; hospital at home; lifestyle medicine; mHealth; self-management.

Figure 1

The relationships between the home environment, self-care and health. A combination of daily self-care activities, a restorative home environment, patient education and a reduced exposure to indoor environmental pollution can positively impact physiological functions and health outcomes of household occupants.

Figure 2

A comparison of diverse categories of therapeutic targets for the prevention and treatment of chronic diseases. A mobile device illustrates an ability to deliver therapies through digital health technologies, including digital therapeutics (DTx) and “prescription drug use-related software” (PDURS) framework that enables the integration of DTx with pharmacotherapies. CBT—cognitive behavioral therapy; PT—physical therapy; E-C—e-commerce.

Figure 3

Therapeutic home environments for people living with anxiety. Specific design features create multisensory experiences intended to provide restorative effects, increase relaxation and activate the parasympathetic nervous system. Unseen elements of the therapeutic home environment include personalized soundscapes (including ambient music), scentscapes and patient education delivered through an integrated household goods e-commerce and digital health platform.

Figure 4

An e-commerce platform as the delivery system for health-centric services and products to create and sustain therapeutic home environments and behavior change. QR code symbolizes technologies as the enablers of health education for household occupants.

Figure 5

Personalized communications between health-centric home environment and its occupants. (A) An example of how a biophilic bedroom environment and its individual components can communicate evidence-based knowledge and updates on the impact of quality sleep for specific health conditions. (B) An example of a patent-pending infrastructure providing personalized information to home occupants about the health benefits of specific household items fostering self-care practices.

Figure 6

Perspectives on transforming e-commerce platforms into digital/behavioral/environmental combination therapies for chronic disorders. Integration of e-commerce and the therapeutic home environment with pharmacological treatments can be accomplished through adjunctive digital therapeutics or a “prescription drug use-related software” framework. RCT—randomized control trial; PaaS—platform as a service; DHT—digital health technology, SaMD—software as a medical device; PDURS—“prescription drug use-related software” framework; DTx—digital therapeutic. * denotes that the feasibility testing can involve prospective observational studies.

Figure 7

Overview of the impact and economic burden of chronic diseases on individual households, work places and society.