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PATIENT CARE
Bigchangescoming soontoaclinicnear you
In a speech to NHS bosses in 2016, Simon Stevens (NHS England’s CEO) urged doctors, nurses and NHS managers to “grab with both hands” the growing opportunities technology offers both to help promote health and tackle the service’s chronic financial problems by saving on treatment and rehabilitation costs.1
Since publication of NICE guidance DG11 in 2013, supporting the use of calprotectin as a cost effective method to differentiate between IBD and IBS, the rates of calprotectin testing in the UK have increased dramatically. Assays to detect calprotectin have also advanced since then, to assist with changing hospital requirements. These give scalable and flexible solutions that allow hospitals to evolve their calprotectin service in line with increasing demands.
Calprotectin monitoring
The possibility to use calprotectin for applications other than an IBS/IBD screen have also been investigated, with many publications suggesting its usefulness in monitoring IBD positive patients for: l Indicating mucosal healing l Predicting flares l Predicting post-operative relapse l Predicting response to biologic therapy: Allows quicker response for optimisation when starting treatment if you monitor the calprotectin; Giving patient reassurance when switching to bio- similars to ensure the calprotectin levels don’t start to rise; Withdrawal of biologics but ensuring the calprotectin levels remain low
l Keeping healthy patients out of the clinic.
It is in this monitoring environment that the advance of mobile App technology has come to Gastroenterology; and so in 2015 the first CE marked calprotectin self-test was launched by BÜHLMANN in the form of its IBDoc assay system.
IBDoc fundamentally allows patients to use the same calprotectin testing system that many laboratories employ, that is CALEX extraction and Quantum Blue lateral flow technology. Adaptions remove the requirement for technical equipment so the patient can perform the test themselves in the comfort of their own home. NICE published a review in December
2017 (Medtech innovation briefing 132), of technologies for ‘POC and home test for calprotectin in monitoring IBD patients receiving treatment’. This states that: “The evidence suggests that point-of-care and
The explosion of the mobile technology market means that healthcare based Apps are highly accessible as most people these days have a mobile device or tablet.
SEPTEMBER 2018
home- use faecal calprotectin tests have comparable accuracy to laboratory ELISA tests, but with better patient satisfaction.”2 App technology has the potential to offer a number of advantages over standard laboratory testing: l Individually customisable l Reduced turn-around-time for results l Reduced resource required l Allows access to testing in remote locations or whilst travelling
l Improved compliance through privacy l Better monitoring for active patients l Keeping well patients out of hospital.
A personalised approach
One solution rarely suits all; and so the IBDoc is customisable by individual patients to help deliver a personalised approach to monitoring: l The clinicians choose one of three options for patients to see when a test is completed: Actual quantitative result (with a value
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