The gadgets that help you keep an eye on your own symptoms — just like a real doctor
So from lung disease to heart problems and gout, which are the ones experts say are worth buying?
FROM GOUT to heart problems, around 15 million people in the UK live with a long-term condition that can be controlled, but not cured.
A study published this month in the British Journal of General Practice revealed that more than half of patients attending GP surgeries have two or more such conditions.
An increasing number of high-tech health tests are available to help people manage their chronic conditions at home — but are they really worth it? Here, experts give their verdicts on some of the latest products . . .
OXYGEN MONITOR FOR LUNG PROBLEMS
PATIENTS with asthma and chronic obstructive pulmonary disease (COPD), an umbrella term for lung diseases such as emphysema and bronchitis, may want to monitor their lung function.
THE TEST: Pulse oximeters are used widely in hospitals. They measure the amount of oxygen in the blood by checking levels of a protein called haemoglobin. Levels can drop for several reasons, including some lung problems; it can happen when there is a flare-up of symptoms or as a condition deteriorates.
One pulse oximeter that can be used at home is the Beurer PO30 (£49.99,
stressnomore.co.uk). You place the tip of your finger into a small device that looks a bit like a bulldog clip. This passes beams of infrared and red light through your finger to a detector.
infrared light is absorbed by haemoglobin carrying oxygen, while red light is absorbed by haemoglobin that isn’t carrying oxygen. The device calculates the amount of oxygen in the blood according to the amount of each type of light reaching the detector.
Blood oxygen levels of less than 94 per cent suggest you may require treatment with extra oxygen or that your current treatment may need increasing — and you might need to contact your GP or specialist.
This device is not currently supplied for home use by the NHS.
EXPERT OPINION: ‘ While some patients with COPD and asthma quite like the idea of having an oxygen saturation number, for most it doesn’t provide any useful information,’ says Dr steve Holmes, a GP and regional clinical chair for the British Lung Foundation.
‘Patients with asthma and COPD will often experience symptoms [ such as breathlessness and feeling tired] a day or more before oxygen levels fall, so this won’t help you predict the early stages of an asthma attack or COPD exacerbation, as you would already know that your condition was deteriorating by the time you noticed a drop in oxygen levels.
‘ it can, however, help a few people — and clinicians would normally advise on this.
‘importantly, if someone becomes too fixated on readings, they could be falsely reassured and not seek medical help when they need it.’
VERDICT: not worth it.
DEVICE TO CHECK BLOOD CLOTTING
PATIENTS who take the bloodthinning medication warfarin need to maintain clotting levels within a defined range to prevent complications such as excessive bleeding. However, this can be affected by diet and alcohol.
THE TEST: Doctors monitor clotting levels using the international normalised ratio (INR), a number that reflects the time it takes for the patient’s blood to clot compared with a healthy sample.
Traditionally, testing is done in GP surgeries every few months, but devices such as the CoaguChek inRange (£467.87, medisave.co.uk) allow patients to do this at home. Using a lancing device, a drop of blood from your finger is placed on a strip inserted into a mobilephone-sized reader, which displays the result after a minute.
You then ring your doctor or nurse for advice on adjusting your medication. While patients have to buy the device, the test strips can be prescribed on the NHS, though this varies around the country.
This is the only device of its kind that has been assessed by nice. EXPERT OPINION:
‘ Home INR testing offers convenience for patients and has the potential to save time,’ says Maureen Talbot, a senior cardiac nurse with the British Heart Foundation. ‘However, it’s important that it’s also affordable for all patients.’ The technology, she adds, is generally reliable. VERDICT: May be worth it — but the cost could make it prohibitive for many.
PRESSURE TEST FOR GLAUCOMA
GLAUCOMA is where the optic nerve at the back of the eye becomes damaged due to raised pressure as drainage channels become clogged.
Untreated, it can lead to blindness. People with glaucoma should have regular checks with a specialist to monitor the pressure in the eyes to see whether drops are working.
THE TEST: The icare HOME Tonometer (from £1,595 plus VAT, icaretonometer. com) checks eye pressure using a small probe that makes brief contact with the cornea ( at the front of the eye) and takes a reading. The results can be downloaded by your specialist.
A few NHS clinics will lend out the devices for home testing, but most patients will have to buy their own if they want one.
EXPERT OPINION: ‘Most people have mild glaucoma which needs monitoring only every six months,’ says Professor stephen Vernon, vice president of the Royal College of Ophthalmologists.
‘However, those with advanced disease or a rapidly deteriorating condition can benefit from detailed recordings.
‘since pressure in the eye varies over the course of the day, it is valuable to identify exactly when pressures are at their highest — and therefore when might be the best time to take the medication. ‘Patients need careful training to ensure they use the devices correctly, and there’s a small risk of causing injury to the eye.’
VERDICT: Worth it.
BLOOD-TEST KIT TO CONTROL GOUT
A TYPE of arthritis, gout is caused by deposits of uric acid in joints, resulting in inflammation and pain. Treatment usually involves the drug allopurinol to bring down levels of uric acid in the blood.
The amount needed varies widely — doctors usually start patients on a low dose and do blood tests to see if it needs to be increased.
THE TEST: Tests such as the UAsure Uric Acid Gout Monitoring starter Kit (£ 49,
amazon.co.uk) allow patients to monitor their own levels in 30 seconds. A drop of blood is taken using a lancet, then placed on a test strip and inserted into a machine that will display the uric acid level.
EXPERT OPINION: ‘Traditionally, doctors take blood samples that are sent away to be analysed,’ says Dr Fiona Watt, a consultant rheumatologist from the nuffield Orthopaedic Centre, Oxford. This takes place every four to six weeks until levels are under control, and then every six months after that.
‘it takes a while for uric acid blood levels to settle, and you don’t need to adjust the allopurinol dose on a daily or weekly basis — there’s no evidence additional home testing would bring any benefits.’
VERDICT: not worth it.
GADGET TO SPOT BOWEL FLARE-UPS
INFLAMMATORY bowel disease, the umbrella term for Crohn’s disease and ulcerative colitis, causes symptoms such as pain, diarrhoea and extreme tiredness.
THE TEST: The iBDoc gadget (from £512 for eight single-use tests,
ibdoc.net) claims to help spot flare-ups before symptoms occur, so preventing long-term damage to the bowel.
it checks the levels of calprotectin, a protein that’s a marker for inflammation, in a stool sample. studies show that calprotectin rises three months prior to symptoms, providing a window for doctors to adjust treatment.
Patients collect a stool sample using special paper and a pin. it’s mixed with chemicals in a testtube and a small amount is placed on a cassette (like a pregnancy test) that changes colour. You then take a picture of the test window using an app on your phone, which tells you whether the level is normal, moderate or high. The app can send the result to your doctor.
The test is available only through gastroenterologists, mainly privately, although the Dorset County Hospital is now offering the test on the NHS.
EXPERT OPINION: ‘This would work best for patients who are relatively well — who we don’t see that often in clinic — to flag up if they should be reviewed more frequently,’ says Dr Christian selinger, a gastroenterologist at st James’s University Hospital, Leeds. ‘it can be used to show whether bowel symptoms are due to a flare-up.’
it can also be used to monitor whether someone’s diet is affecting their symptoms.
‘However, when we’ve offered our patients faecal calprotectin tests in the clinic, where they produce the sample at home, we’ve found that only half return the sample — my concern is many find it distasteful and taking photos with smartphones may prove a step too far.’
VERDICT: not for everyone.