A pilot medical study by the University of California, Los Angeles, or UCLA, uses mobile phones to help diabetes patients in South Africa. Our correspondent spoke with the physician behind the study, Neal Kaufman, about the expanding role of technology in personalized health care.
The UCLA project uses texting on mobile phones to encourage patients with type 2 diabetes to adopt more healthful lifestyles.
Dr. Kaufman, a professor of pediatrics and public health at UCLA, says this form of the disease, called adult-onset diabetes, is becoming common, even among children. He says the problem is in our genes.
"Our genetics have programmed us to want to eat sugar, salt and fat, and to be as inactive as possible," he said. "And that's what allowed us to survive when there was famine and when there was not enough food, when we didn't want to burn any calories."
Today, he says fat, salt and calories are too readily available and that health care practitioners must find ways to urge patients to avoid them. Text-messages provide one way to do that.
The South African study pairs low-income women with type 2 diabetes and links them by cell phone. Each day, a computer program sends an automated message to prompt a conversation between the women. The message might ask whether they ate a healthy breakfast or simply how they are feeling.
"The text message will ask them a question. That question, they answer to their peer as a way to begin a conversation or to encourage a conversation between peers," said Dr. Kaufman. "And what we find is that a lot of these women who would otherwise be isolated and not have someone they could talk with are texting back and forth to each other, which they've never done before, in a way that's really quite supportive."
The text messages are supplemented by group meetings to help educate patients and provide face-to-face support.
Dr. Kaufman developed the program through a company he co-founded called DPS Health - one of many initiatives that uses technology in health care.
The South African project fosters peer-to-peer support and Dr. Kaufman says it has the advantage of being inexpensive. If the program proves successful, it can be expanded to a larger population at low cost. Most important, Dr. Kaufman says, it does not require a computer or Internet connection.
Other technologies connect patients to physicians or offer online chat rooms moderated by a trained medical practitioner. Internet sites provide prenatal advice for mothers or allow patients with specific medical conditions to share advice and comments. Some sites are moderated by trained professionals.
Dr. Kaufman says this type of technology will be an increasingly important link between patients and medical providers.
"We basically believe that most outcomes from chronic conditions can be improved if you help patients to help themselves," said Dr. Kaufman. "Some people call that self-management support - managing their daily lives, helping them take their medicines, helping them to be more active, helping them to adopt health behaviors."
Dr. Kaufman says the South Africa study will yield important information on how a population of middle-aged diabetes patients responds to text prompts from mobile phones. He says results so far show that patients are interacting and encouraging each other.
The UCLA researcher says the project is part of a trend to connect patients.
"We know that social support is the wonder drug of the 21st century, that connecting people to other people - whether it's in person, whether it's online, whether it's through a cell phone - is really a very, very powerful medicine," he said.
The World Health Organization says six people die every minute from complications from diabetes and that the prevalence of the disease is rising rapidly. It says the largest number of diabetes patients is in India, followed by China.
Dr. Kaufman says that if the UCLA project is successful, it can be applied to low-income diabetes patients around the world, including in the United States, where the disease is also a major problem.
