A newly developed app targeting patients across the NHS to tackle complex diseases where two or more health conditions are present, such as diabetes and arthritis, has revealed promising results.
The project, carried out by Holy Health in collaboration with Loughborough University and Modality Partnership, found over 180 users saw a 21% increase in their efforts to self-manage their symptoms over a three-month period.
Additionally, users’ healthy habits could increase by 10%, potentially significantly improving public health at scale.
By combining behavioral science and machine learning technology within the Holly Health app, the project developed a just-in-time adaptive intervention (JITAI) system that uses machine learning to increase healthy habits (e.g., regular physical activity, adequate sleep) in patients with multiple diseases.
JITAI is a pioneering approach that provides timely, personalized coaching based on each person’s unique health patterns and behaviors. Using real-time data and machine learning models, we identify the moments of the day when individuals are most likely to benefit from support and provide that support.
JITAI systems operate on a simple daily cycle known as a “feedback loop.” It uses a type of artificial intelligence called reinforcement learning (RL). This means learning from each person’s actions over time. Based on what the system learns each day, it can better understand what support works, and uses this to plan more helpful coaching messages the next day.
Around one in three adults in the UK have a multi-health condition, with 34% of adults registering both physical and mental problems, and this combination can have a huge impact on people’s ability to self-manage their condition.
As the number of symptoms increases, care becomes more complex and costly, putting sustained pressure on health services. Multimorbidity currently accounts for around 70% of total NHS health and social care spending, with an estimated £72 billion spent on preventable diseases each year.
The 18-month project, funded by Innovate UK, focused on promoting digital self-management for people living with, or at risk of, multimorbidity.
These findings demonstrate the potential for large-scale, personalized digital self-management support to help address key challenges of NHS capacity and cost, while empowering patients to better manage their health. Following these promising initial results, the project team now hopes to test the app on a larger group of patients.
Dr James Saunders, academic lead on the project at Loughborough University and part of the Center for Lifestyle Medicine and Behavior (CLiMB), commented: “Our collaboration shows the potential for personalized, data-driven support to help people manage multiple conditions over time. By integrating behavioral change research and adaptive machine learning, we can deliver the right support at the right time, enabling people to take meaningful action to improve their health.”
Dr James Fleming, Senior Lecturer in Intelligent Control Systems at Loughborough University, added: “This project will take advanced AI technology out of the lab and put it to use in real, everyday life. JITAI systems can learn how each person responds to support, provide personal and timely coaching, and help people build healthy habits that last.”
Grace Gimson, CEO and co-founder of Holly Health, said: “This is one of our most exciting advances to date. With so much focus on developing large-scale language model AI in healthcare, this project has allowed us to innovate in a unique direction by hyper-personalizing the coaching nudges we deliver. We can’t wait to introduce it to our patient cohort and provide the compassionate, customized lifestyle health support that people need more of.”
Professor Vincent Sai, Group CEO and Partner at Modality Partnership, commented: “Bringing together AI and behavioral science will make personalized self-management possible for patients with complex needs.”
Following the success of the project, the partners plan to expand access to enhanced Holly Health services across the NHS and local communities, supporting thousands more patients with long-term symptom management and prevention of new conditions.
Notes for editors
Press release reference number: 25/175
Loughborough University is one of the country’s leading universities and has an international reputation for significant research, teaching excellence, strong links with industry and unparalleled achievement in sport and its underlying academic fields.
It has a 5-star rating on the independent QS Stars university rating system and has been named the world’s best university for sports-related subjects for the ninth consecutive year in the 2025 QS World University Rankings.
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This milestone marks 10 years since Loughborough University finished in the top 10, a feat shared only by the Universities of Oxford, Cambridge, LSE, St Andrews, Durham and Imperial.
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