Chronic diseases – Integra LLC

Tag Archive for: Chronic diseases

Non-communicable diseases (NCDs): The low hanging fruit for mHealth

As the New York UN meeting on Non Communicable Diseases NCDs draws to a close, one big takeaway that everyone seems to agree on is that NCDs are reaching epidemic proportions worldwide. This may be bad news; however it does present some tremendous opportunities for mHealth in developing countries. NCDs include cardiovascular conditions, some cancers, chronic respiratory conditions and type 2 diabetes. These conditions account for 60% of all deaths worldwide, with 80% occurring in low and middle-income countries[1]. It’s time we put as much funding and emphasis on NCDs in developing countries as we do with infectious diseases. NCDs have twice the number of deaths than infectious diseases (including HIV/AIDS, tuberculosis and malaria), maternal and perinatal conditions, and nutritional deficiencies (nature link). [2]

There is no refuting the fact that there are significant problems to overcome. The fact is Global health is challenging, but not all challenges are equal, some challenges are more challenging than other. Let me elaborate: If you are attempting to find a cure for HIV or a vaccine for malaria. This would be difficult from a scientific perspective; it would also be expensive and will likely take a long time to achieve. On the other hand, if you attempt to educate a population on diets, lifestyle changes, encourage exercise and reduce smoking; then you will likely prevent an epidemic of extreme proportions that is on the way to developing nations.

There are some low hanging fruits that can be tackled right now with existing mobile technology and know-how that would make a significant impact on the future of Global health. The traditional model of NCD episodic care in clinic and hospital-based settings is inadequate in developing countries due to scarce resources. The low hanging fruit could be plucked by using a mHealth diagnostic and monitoring platform to diagnose health conditions and address the common risk factors, such as smoking, diet and sedentary lifestyles. There are a multitude of studies that show how cellphones can have a positive impact on lifestyle and behavior changes, tying this notion to medical diagnostics and monitoring (continuous or periodic)could have a profound effect. There is a need for diversity in the funding criteria to allow funds to be diverted to develop viable and sustainable innovations in urban areas to address NCDs, there seems to be too much emphasis on rural health in developing nations. Yet there is strong evidence the urban dweller will be far worse off in the future due to the growing obesity rates.[3] Mobile operators in the developing world are in a great position to use their 3G networks to exploit the new health data and services that will surely be unleashed.

[1] World Health Organization Preventing Chronic Diseases: A Vital Investment (WHO, Geneva, 2005).

[2] Nature 450, 494-496 (22 November 2007) | doi:10.1038/450494a; Published online 21 November 2007

[3] Overweight and obesity in urban Africa: A problem of the rich or the poor? http://www.biomedcentral.com/1471-2458/9/465

September 26, 2011/by actualize

Agriculture, Health, Health, Non-communicable Diseases, Originally posted on the GBI Portal

Beyond “an App for that”: Using mHealth to fight NCDs

As the global health community gears up for the upcoming United Nations High-Level Summit on non-communicable disease (NCDs), I thought it would be useful to explore the ways in which mobile technology can play a role in the efforts to reduce the burden of NCDs globally. NCDs include cardio-vascular disease, diabetes, cancer, and chronic respiratory diseases. The combined impact of these diseases contributes substantially to global poverty rates and places strain on healthcare systems worldwide.

With a growing urban population and lifestyle changes, particularly in diets where fast foods have become a greater part of the local diet, obesity and diabetes rates tend to grow rapidly. NCD rates are frequently driven by the combination of lifestyle changes and environmental shifts and require more innovative thinking around behavioral change and social movements in order to make long-term changes.

mHealth applications for NCDs are already quite common in parts of the world where diabetes rates, in particular, are high. This can be found in personalize-able mobile applications such as Glucose Buddy, or in social media campaigns such as TuAnalyze, which uses Twitter to drive higher compliance rates for hemoglobin A1c testing (a bit of a gold-standard when it comes to diabetes care).

Beyond diabetes, there are NCD prevention applications, such as the anti-smoking Text2Quit, demonstrating the potential to find interventions with the capacity to scale into national campaigns. On the respiratory disease front, Asthmapolis, is an innovative approach that combines sensors with mapping to track the contexts in which people with asthma use their inhalers and furthers our public health understanding of asthma and the environment. Tracking programs that enable dieters to monitor food intake and exercise can be effective tools for fighting obesity and cardio-vascular disease.

In order to realize the full potential of mobiles, however, we should take a few cues from the recent mass mobilizations and social movements in the Middle East where Facebook and Twitter were utilized to facilitate social change movements in Egypt and Tunisia.

Similarly, long-term efforts at prevention in public health have rarely succeeded without complementary sustained social movements that reduce the social barriers to behavioral change and create stronger enabling environments for personal lifestyle changes to succeed. This could include more walkable cities, better access to health foods, and changing environmental drivers that affect cardiovascular diseases and respiratory health outcomes.

We’ll likely need to move beyond the “app for that” ethos to engaging with social networks and technology in ways that can promote both well-being and the underlying social transformations required to sustain behavioral change in a health landscape that must navigate a long-term global financial crisis where resources are in short supply.

September 20, 2011/by actualize

Agriculture, Health, Originally posted on the GBI Portal

How to convey the new WHO Mental Health Intervention Guide to workers in the field?

On paper? Online? On smartphone apps? Via SMS or voice?

This 89 pages mhGAP-IG is issued in 2010 and now available in several languages. The guide consists of decision trees for the most important psychiatric conditions.

1. Use of paper versions:

Reading: Additional shipping and transport costs can be a hurdle in low and middle income countries (LMIC). One can download the guide from the WHO website, but then one faces the high costs of (color) print and copies.

Training: Face2face trainings seem the most ideal option, but the in most LMIC there is a shortage of health tutors. And a face2face training necessitates the movement of the health worker away from the field, which interrupts the delivery of services and is expensive.

2. With the internet/desktop/laptop:

Reading: Distribution on CDs is cheap. Online reading offers also the use of go-to tabs, notes storage, information charts and a find-utility. The main disadvantages of internet/computer is the constant need of a computer nearby and standby, which is a rarity in most LMIC.

Training: Beside the benefits of no travel and no interruption of the daily work, the internet gives health workers also the opportunity to study on own pace and preferred time.

3. With mobile apps on smartphones:

Reading: Smartphones can have a high added value for previously unconnected people. Smartphone prizes drop and they are growing in popularity in LMIC. The guide can be read on an app.

Training: Education via a smartphone apps offers the same benefits as the internet learning, like nice attractive tools and designs. The extra advantages are the pocket format; easy taking it with you.

4. With mobile phones (no wireless internet):

Reading: Service in developing countries will rely heavily on text messaging and voice in the years ahead. One can convey parts of the guide by SMS or voice, piece by piece, or certain parts on request. One can even run an automated SMS reply manager.

Training: Conducting a training in the mhGAP-IG solely by mobile phones is possible, but only an option of one really can’t reach the health worker via another channel.

Conclusions and recommendations:

-Not one of the 4 distribution channels is the best of all, so create materials in all 4

-Concert international and implement what’s most suitable on a local level

-Connect and cooperate with innovators in LMIC

-Look for creative funding channels, including NGOs and telecom providers

-Learn, lend and copy from other health fields, which are a long way ahead in technical innovations.

Full article with links and examples on the in2mentalhealth website

September 20, 2011/by actualize

Agriculture, Health, Originally posted on the GBI Portal

Technology’s Role in Self-managed Diseases

Closeup of a digital blood glucose meter reading

As a person living with type 1 diabetes, technology has been a medical part of my daily life for more than ten years. Diabetes is largely a self-managed disease, meaning that the person living with diabetes must manage the day-to-day balance between severe short-term effects and equally severe long-term effects. Technology can be a great help in this – in the last ten years I’ve tried at least about ten different types of blood glucose meters, four different insulin pumps, and I am always wearing a continuous glucose monitor.

I’ve also tried some of the mobile apps available to assist with diabetes management – tracking blood glucose levels, calculating carbohydrate and the amount of insulin to take with each meal, recording exercise events and so much more. I know I’m not the only one who has tried these devices; when technology plays a part in your own chronic disease management, you tend to incorporate technology from non-medical devices as well.

It should be no surprise to me, then, that a popular Twitter Chat group organized as Diabetes Social Media Advocates, or #dsma, recently devoted an entire hour-long discussion to the topic of mHealth earlier this month. Questions ranged from “What would you like your mobile device to help you with managing your diabetes?” to “What are your thoughts on the FDA regulating mobile apps that uses platforms for medical device functions?”

The answers were all over the place – some people weren’t interested in using their mobile phones for anything but making calls and receiving email, others wanted to see all of their devices, including medical devices and mobile phones, have the ability to communicate with one another. One person even said that he’d love a phone that could take a picture of a meal and estimate the amount of carbohydrate for you. Initially he was joking, but someone quickly told him that that function is in development, although struggling with accuracy right now.

Of all the topics and crazy ideas that came up, only one question received consensus: “Does mHealth have the potential to change the way we take care of our health or manage diabetes?” Everyone answered yes. But these are all smartphone-owning, diabetes-tweeting, tech-savvy folks. What about the rest of the 346 million people with diabetes around the world?

A quick check at the HUB Database will show you that 15 technologies, programs, and organizations have contributed to the database and tagged diabetes. Some focus on medication reminders, others provide vital information to health care workers. One program even developed a game-like system that monitors interaction with a virtual pet to let friends or relatives know that the person is active – allowing more opportunity for an independent lifestyle.

This is one of the great aspects of mHeatlh: it focuses on the health problems and identifies innovative solutions. Not remembering to take your meds? Your phone can help! Not checking in with your loved ones despite the fact you could fall into a coma? Your digital pet can help! In this day and age, when 70% of mobile phone subscriptions are in developing countries, phones can be seen as health tools – especially for those of us with self-managed diseases.

September 20, 2011/by actualize

Tag Archive for: Chronic diseases

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