Curbing NCD epidemic: Leveraging integrated point-of-care diagnostic devices

Non-communicable diseases (NCDs), often dubbed the "silent epidemic," stand as the foremost cause of mortality globally, claiming the lives of 41 million individuals annually. Cardiovascular diseases and diabetes alone account for nearly half of all NCD-related deaths. An alarming 85% of these fatalities occur in low- and middle-income nations, where restricted access to healthcare exacerbates the challenge.

A recent report from Apollo Hospitals has labelled India as the "cancer capital of the world," citing concerning statistics: one in three Indians is pre-diabetic, two in three are pre-hypertensive, and one in 10 suffers from depression. The escalation of NCDs such as cancer, diabetes, hypertension, cardiovascular diseases, and mental health disorders has reached critical levels, profoundly affecting the nation's well-being.

Compounding this issue is the asymptomatic nature of many NCDs, resulting in delayed diagnoses and severe complications. The delayed detection of conditions like diabetes and hypertension leads to irreversible organ damage, poor treatment outcomes, and fatalities. Unfortunately, healthcare systems in developing countries, including India, are ill-equipped to effectively address the burgeoning NCD burden.

Early detection and management are crucial for preventing long-term complications and mitigating the health and economic impact of NCDs. However, the high cost and limited availability of essential diagnostic tools in low- and middle-income nations hinder access to basic testing and monitoring services. Expanding access to diagnostics is essential to achieving the World Health Organization's goal of reducing the overall mortality risk from NCDs by 25% by 2030.

India faces the challenge of providing quality care to its sizable population affected by NCDs, which account for 60% of all deaths in the country. Cardiovascular diseases represent the primary cause of mortality, followed by cancer and diabetes, marking a significant departure from India's epidemiological profile in previous decades when communicable diseases prevailed. The economic burden of NCDs is substantial, with one in every four families affected by cardiovascular disease facing catastrophic health expenditures. Additionally, 10% of these families are pushed into poverty, leading to disruptions in household priorities such as education and housing. Despite this, India's public healthcare system, particularly at the primary care level, has historically focused predominantly on communicable diseases.

The management of NCDs, particularly cardiovascular diseases (CVDs), entails monitoring various parameters including blood pressure, blood glucose, and cholesterol. This necessitates multiple visits to provide blood samples, receive reports, and consult with physicians, a process that must be sustained over years due to the chronic nature of these conditions. The cumulative costs and inconveniences are significant, compounded by the lack of accessible high-quality diagnostic laboratories, hindering effective disease management.

To mitigate these challenges, the utilisation of point-of-care (POC) tests has proven beneficial. Implementing POCT for screening enables earlier disease diagnosis, management, and monitoring. Beyond merely identifying risks and prompting individuals to pursue further diagnostic investigations, screening initiatives also foster awareness and contribute valuable data to epidemiological reports.

Point of care testing (POCT) is increasingly recognised as a potent healthcare approach capable of enhancing healthcare accessibility. Its application in screening for non-communicable diseases (NCDs) is gaining prominence due to its efficacy in promoting health awareness and detecting undiagnosed or poorly managed NCD cases.

Point-of-care testing has demonstrated robust validation comparable to laboratory-based testing for various biomarkers, including haemoglobin A1c (HbA1c), creatinine, and cholesterol components such as total cholesterol, high-density lipoprotein cholesterol (HDL-C), and triglycerides (TGs). The convenience of POCT, which obviates the need for patients to visit separate laboratories or endure wait times for results, has the potential to substantially increase testing rates. Furthermore, POCT facilitates the monitoring and management of chronic conditions like diabetes, where regular HbA1c measurements every three months reduce the need for daily blood sugar testing, especially in resource-constrained settings.

Further, POC diagnostics enable healthcare providers to tailor treatment plans to the unique needs of each patient, promoting personalized and patient-centred care. By monitoring biomarkers and disease indicators in real-time, clinicians can adjust therapy regimens, accordingly, optimizing outcomes and minimizing adverse effects.

The management of NCDs, especially cardiovascular diseases (CVDs), necessitates monitoring various parameters like blood pressure, blood glucose, and cholesterol. Point-of-care (POC) tests administered at clinics or homes, are rapid, user-friendly, and enable treatment decisions or referrals in a single encounter with the patient. However, patients and caregivers often need to acquire separate devices for different parameters, leading to added costs and inconvenience. For instance, individuals diagnosed with diabetes require monitoring not only for blood glucose but also for cholesterol and blood pressure due to increased cardiovascular disease risk. This fragmented approach contributes to inconsistent or incomplete monitoring.

Integrated point-of-care devices that measure multiple parameters relevant to CVDs, such as blood glucose, haemoglobin, cholesterol, uric acid, blood pressure, capillary oxygen saturation, and pulse rate, are crucial. These devices, which combine biochemical and physiological tests on a single platform, offer unique advantages. Additionally, cloud-based data storage through these devices facilitates long-term patient monitoring. By eliminating the need for multiple devices and extensive training, they enhance convenience for clinicians and caregivers in various settings, enabling informed decision-making. This is especially beneficial for underserved communities with limited access to diagnostic laboratories. Such devices have the potential to transform disease screening and diagnosis, addressing the challenge of managing chronic conditions equitably in India and beyond.

In conclusion, Point-of-Care diagnostics represents a powerful tool in the fight against Non-Communicable Diseases. By enabling early detection, improving accessibility, facilitating personalised care, supporting disease management, and contributing to public health surveillance, POC diagnostics are instrumental in curbing the NCD epidemic and improving health outcomes worldwide.

Pritam Kumawat, CEO and Co-founder, Sanskritech Smart Solutions