24th March 2019 marked World TB Day, created to raise awareness about tuberculosis worldwide. Robert Kock discovered the cause of tuberculosis on this day in 1882 and in the 137 years since, there has been a huge effort to combat this deadly disease.1 However, despite a definite improvement in diagnosis and treatment, TB is still a major epidemic killing 1.6 million people a year.2
TB remains a serious and deadly threat but if the right
drugs are prescribed and taken properly it can be cured. Unfortunately, this is
not always easy! To help, researchers are now applying technology to change the
way TB is diagnosed and treated. Smartphones could radically transform the way
we diagnose and treat TB.
A key factor in the success of treatment is making sure that drug regimens are adhered to and patients can be closely monitored – usually for at least 6 months. Technology developed by researchers at the University of California and John Hopkins University allows patients to send encrypted videos to public health workers who can watch videos securely rather than having to travel to visit patients.3 And it worked – video monitoring improved adherence which in turn not only can improve outcomes but also reduce costs.4
The real breakthrough with smartphone diagnosis came at the end of last year, when researchers from the UK and Malaysia developed a mobile phone testing system which can detect TB specific antibodies in sputum with 98% accuracy.5 The sputum is placed on a biosensor which simply changes colour based on the result. Then, using a smartphone camera a diagnosis can be delivered in seconds.5 This technology can be used without an internet connection and the only cost would be the biosensor. Using this technology in rural, hard to reach places could transform early diagnosis of TB and help people access care. Perhaps, with technologies such as these we could make the goal of a TB free world by 2030 a reality!5
In light of all the potential of mHealth, WHO published evidence-based recommendations for the use of digital technologies for TB treatment and adherence based on text messaging, medication event monitoring systems and video supported treatment. Who knows, maybe our smartphones could be our strongest weapon against TB?6
MedDigital are thrilled to have joined the Association of the British Pharmaceutical Industry (ABPI) as general affiliate members. This allows us to share our knowledge and experience with wider industry partners, provide our opinions to dictate the evolution of the ABPI Code and to gather the latest insights for our clients.
At medDigital we pride ourselves in our understanding of the ABPI Code and our knack for delivering compelling, creative and compliant content. We subscribe fully to the principles set out in the Code and this is reflected on all aspects of our work. Joining the ABPI further cements our drive to maintain our knowledge and provide the best quality services to our clients.
Watch medDigital Founder Dr. Felix Jackson explain further why joining the ABPI is so important.
Now more than ever, the digital evolution affects every part of our day to day lives. From the way we search for information to the way that we communicate, digital innovations are constantly moulding and adapting our behaviours. With all this change, how can a pharma organisation keep ahead of the game? Events such as the upcoming Eyeforpharma Barcelona conference provide ideal opportunities to discover emerging technologies, learn from industry experts and help future proof your digital strategy.
Choose a data-driven approach
How can you ensure that you are targeting your audience via the right channels, with the right information? Anoo Mehmi, Global Digital Content Strategist for ViiV Healthcare believes that embracing a data-driven approach is essential. Using insights from key data can help you to ‘fish where the fish are’ and understand what content is actually impacting your audience’s behaviour.
Engaging healthcare professionals – what the future holds
Don’t see PV and compliance as a barrier
While healthcare compliance and ABPI Code are often talked about as a barrier to effectively using digital media in the pharmaceutical industry, this is generally not the case. Melinda Hall, Head of Regulatory Affairs for Boehringer Ingelheim, describes compliance and pharmacovigilance (PV) requirements as purely perceived barriers. Engaging medical and regulatory teams early in the content development process can help them to better understand your commercial objectives.
Making digital a reality in your organisation
Knowledge share with industry experts
Keeping updated with current trends in both digital technologies and audience behaviours is key to future proofing your digital strategy. On 12-14 March, the Eyeforpharma conference boasts a range of unmissable sessions on topics spanning ‘improving the customer and consumer experience in a digital world’ to ‘the next-generation digital congress experience’ presented by medDigital founder Felix Jackson.
Attendance at key conferences such as this encourages open conversations between industry experts, with tricks and tips to help you develop excellent strategies to deliver outstanding digital campaigns and strategies. If you haven’t already, register for your place at eyeforpharma and use our exclusive code medDigital400 for 400 Euros off! See you there!
On the lead up to Valentine’s Day hearts are everywhere. Cards, text messages and cradled by fluffy teddy bears. So, what better time is there to start taking care of your heart? But getting check ups with your physician is not always convenient. You need to take time out of your day, schedule appointments in advance and sometimes wait for weeks to get the results. However, with current technological advances, checking up on your heart has never been easier, especially for those with a high risk of more serious heart conditions.
The Apple Heart Study is an example of how medicine is integrating with technology to provide a reliable, accessible and interactive experience. This study is a collaboration between Stanford Medicine and Apple with the aim of determining whether data generated from the heart monitoring feature of the Apple Watch, can be used to identify irregular heart rhythms, including those with the potential to develop into serious health issues such as atrial fibrillation.
The study was initiated back in 2017 and has recruited over 400,000 participants with Apple Watches. The Watch uses LED lights and light-sensitive photodiodes to measure changes in blood flow and estimates a pulse based on these measurements. Pulse rates over time are then reported as tachograms and an in-built algorithm determines whether participants have regular or irregular pulses. If a subsequent video conference with a physician confirms the Apple Watch readings, participants are provided with an ePatch that generates electrocardiograms for up to 7 days for further monitoring. Relevant care is then provided if required.
This virtual screening process made with the patient in mind is unique in that it allowed for large-scale recruitment in a relatively short period of time while also relieving the burden on healthcare providers and services. However, it also has its drawbacks. Misdiagnosis, unnecessary testing and overtreatment are the main concerns of having a patient-centric screening program like the Apple Heart Study.
Despite these concerns, this study is a major step in understanding the potential of technology in modernising how we approach medicine in the real world. Wearables in particular are becoming more and more popular with wearables dominating major technology events such as CES and even having their own conferences in the Wearable Tech Summit 2019 and Wearable Technologies Europe 2019. Just listen to an interview of Paul O’Donohoe, Scientific Lead for eCOA at MetaData Solutions who describes the current state of wearables and devices in clinical trials.
The digital evolution in clinical trials
The results from the Apple Heart Study are expected to be available in 2019. In the meantime, read more about the Apple Heart Study from Stanford Medicine or the full study publication from the American Heart Journal.
By Ricky Tsang
Meta Title: The Apple Heart Study
Meta Description: A blog on the Apple Heart Study, a collaboration between Apple and Stanford Medicine
Electronic patient-reported outcomes (ePRO) have the potential to improve many facets of cancer patient treatment and survivorship. ePRO may allow quicker identification and treatment of medically significant symptoms and so minimise patient anxiety regarding relapse.1 It could also enhance patient-healthcare professional (HCP) communication to facilitate better treatment decisions and potentially improve the quality of life for patients.1,2 It is hoped that ePRO can achieve these improvements and help HCPs deliver better holistic care for patients.
A group from Leeds comprised of patients, staff and IT specialists, developed a new ePRO technology called “eRapid”, Electronic patient self-Reporting of Adverse-events (AE): Patient Information and aDvice. This is a secure, integrated electronic platform for patients to report AE which can be accessed from any web-enabled device, including tablets and smartphones.3
When a patient accesses eRAPID and enters details of low and moderate AE, advice on self-management is provided. Whereas, entry of a severe AE triggers advice that the patient should immediately contact their hospital. When severe AE are reported the patient’s HCP also receives an email notification.3 This rapid escalation of concerning symptoms could lead to more positive outcomes for patients. eRAPID will be examined via randomised controlled trials in patients receiving systemic treatment for colorectal, breast and gynaecological cancers, so that the value of this new digital technology can be determined.3
In respect to cancer survivorship, ePRO can minimise patient anxiety regarding relapse. Depending on the severity of the symptoms recorded by the patient, reassurance or advice regarding immediate action is provided.1 Another feature of the ePRO system is that it tracks patient mental health so that support can be provided if necessary.1 However, the success of this function depends on mental health services being available.1 It is hoped that greater attention to patient symptoms via ePRO, rather than just clinical recurrence of cancer, will improve the quality of life for cancer patients.4
Innovative ways of tracking patient symptoms can be of particular importance for certain cancer types. For example, relapse of aggressive lymphoma is better detected through symptom monitoring than routine blood tests.4 Therefore, regularly tracking these signs could be invaluable. Additionally, ePRO prompts patients to periodically report symptoms and book tests when needed.4 This allows quicker identification of medically significant symptoms1 and can improve patient-HCP communication, so more informed treatment decisions can be made.2
We hope that the e-PRO will continue to advance, helping to support patients during diagnosis, treatment and survival. With the expansion of effective treatment options for cancer patients it’s important that cancer treatment is holistic and patient individuality during and after treatment is considered throughout the patient journey.
Want to get in involved with World Cancer Day? On the 4th February, #WorldCancerDay and #IAmAndIWill can be used on the day to share your messages of support for cancer patients and their carers.
3- Holch P., Warrington L., Bamforth L. C. A., et al. (2017) Development of an integrated electronic platform for patient self-report and management of adverse events during cancer treatment. Ann Oncol. 28(9), 2305–311.
4- Linder, O. C., Velikova, G. and Stark, D. P. (2019) Digitally enabled patient-reported outcome measures in cancer care. Lancet Oncol. 20(1), e2.
5- Gourd E. (2018) Routine blood tests have low utility in lymphoma surveillance. Lancet Oncol. 19(9), e442.
By Rivka Marks-Maran
Meta title: ePRO for improving cancer care
Meta description: A blog on using ePRO for cancer diagnosis, treatment and survival
How do you future-proof the NHS for the decade ahead? Not an easy question. However, it is one NHS England Chief Executive Simon Stevens sought to address as he launched the NHS Long Term Plan last week. The plan focuses on offering practical solutions to a wide range of key issues from how services will be delivered, to tackling health inequalities and ensuring staff have appropriate backing. But with the ongoing staffing crisis affecting the NHS and the fast-approaching cloud of Brexit uncertainty, will it be sustainable?
The prime minister announced an additional £20.5bn for the NHS over the next ten years. Using this fund, the plan looks to relieve some of the pressure on NHS staff by shifting the focus to earlier in the healthcare journey, to more preventative and community-focused strategies of improving population health. This approach is certainly welcomed. It is hoped that through the commitments set out in the plan to improve prevention, we will start to see increased collaboration between local governments, community services and the NHS.
Also welcomed is the focus on digitally-enabled care. The plan even sets out a vision for the NHS in ten years’ time:
‘The NHS will offer a ‘digital first’ option for most, allowing for longer and richer face-to-face consultations with clinicians where patients want or need it. Primary care and outpatient services will have changed to a model of tiered escalation depending on need. Senior clinicians will be supported by digital tools, freeing trainees’ time to learn. When ill, people will be increasingly cared for in their own home, with the option for their physiology to be effortlessly monitored by wearable devices. People will be helped to stay well, to recognise important symptoms early, and to manage their own health, guided by digital tools.’
It is great to see a realistic and practical approach to digital in the NHS, building on the vision of Matt Hancock, Health and Social Care Secretary, to develop ‘the most advanced health and care system in the world’. The Long Term Plan outlines ten top level steps to drive digital transformation including using decision support and artificial intelligence (AI) to help clinicians apply best practice, and using intuitive tools to capture data in order to empower clinicians and reduce administrative burden.On a more tangible level, the plan explains that WiFi is being installed across the NHS and rollout of the NHS app has begun, which will provide people with online access to NHS 111, their GP record and the ability to book appointments from their phone.
Elsewhere, the plan outlines commitments to drastically improve cancer survival, provide much improved services for mental health and halving maternity-related deaths.
Overall, the NHS Long Term Plan has gained a positive response from many key stakeholders, including Macmillan Cancer Support, Mind and British Heart Foundation. However, there are concerns over long term sustainability. Success of the plan relies on adequate NHS staffing, however recent research by the King’s Fund has highlighted an estimated staff shortage of 250,000 or more by 2030. And, while initiatives have been proposed to solve this issue, attracting essential overseas workers may become even more complex depending on what instance of Brexit is delivered. Waking up to a no-deal reality on 29th March may well leave people asking the question ‘where will the money and the workers to deliver these NHS commitments come from?’
Despite this uncertainty, the NHS Long Term Plan does provide a pragmatic and practical approach to improving health and care services of the next ten years. Future-proofing the NHS is not an easy task, however we hope that this plan will benefit the health of all for the years to come.
 Health Foundation, King’s Fund, Nuffield Trust. The health and care workforce in England: make or break? 2018. https://www.health.org.uk/publications/the-health-care-workforce-in-england
By Alex Teckkam
Meta Title: The NHS Long Term Plan
Meta Description: Blog post on the strengths and weaknesses of the NHS Long Term Plan