Chronic Disease Diagnosis Essential for Better Outcomes

Chronic diseases are imposing a high burden on global health systems and on individuals themselves. The well-being, productivity and financial stability of countries are being affected by death tolls dominated by cardiovascular diseases, cancer and diabetes. If preventive action is not taken, a fatal scenario will be inevitable, experts say.

Chronic diseases affect all age groups in all regions and countries. These diseases are usually associated with older age groups but data show that 15 million of all deaths attributed to these diseases occur at ages ranging from 30 to 69 years. Over 85 percent of these premature deaths occur in low and middle-income countries, according to WHO.

In Mexico, the Global Burden of Disease (GBD) found that ischemic heart disease, diabetes and chronic kidney disease (CKD) were the leading causes of death in 2019, just like they had been for a decade. High-fasting plasma glucose, high body mass index and high blood pressure combined drive the most death and disability in Mexico.

Chronic diseases lead to costly medical expenses. The Medical Expenditure for Chronic Diseases in Mexico: The Case of Selected Diagnoses Treated by the Largest Care Providers study by PLOS One, found that the most expensive chronic disease for Mexico’s Ministry of Health (SSA) and IMSS was CKD, with an annual unit cost per patient of US$8,966 for SSA and US$9,091 for IMSS. CKD, arterial hypertension, Type 2 diabetes and chronic ischemic heart disease accounted for 88 percent of the total chronic disease financial burden (US$1.42 billion) of SSA and 85 percent (US$3.96 billion) of IMSS.

Children, adults and the elderly are all vulnerable to risk factors related to chronic diseases, such as unhealthy diets, physical inactivity, exposure to tobacco smoke or harmful use of alcohol. To control chronic diseases, WHO says it is important to focus on reducing these risk factors by creating a comprehensive approach that considers health, finance, transport, education and agriculture.

Creating an ideal environment for social determinants of health to have an impact on individuals can take years. While this happens, investing in better management of chronic diseases, including their detection, screening and treatment, as well as access to palliative care, is essential. “Data shows that primary care interventions for early detection are an excellent financial investment because. Early detection can reduce the need for more expensive treatments,” says WHO.

Early stages of chronic diseases are less studied than later stages. Nevertheless, there is strong evidence that shows delayed diagnosis and management are frequent and often affect patients and society, explains the Academic Hospital and the University of Nice.

In Mexico, the rates of diagnosis and treatment of chronic diseases are considerably low. WHO estimates that Mexico has around 8.7 million people suffering from diabetes but there might even be 12 million people living with the disease without a diagnosis. The latter not only increases risks for people with the disease but it also raises costs and impacts the country’s productivity.

This low tendency to seek a diagnosis has driven care providers to develop novel solutions that make access easier and that help detect any anomalies prior to advanced stages of the disease. Experts call this approach unconventional medicine. “This approach focuses on addressing the root cause of the disease. Each symptom or diagnosis may be one of many contributing to an individual's illness,” says Gustavo Rodríguez, Founder and CEO of NutriADN.

Unconventional medicine is closely supported by technology as it not only enhances access opportunities but it also provides more certain results that can later be entered in databases to identify risk factors more easily. “Tech-supported diagnosis, or smart diagnostic solutions, supported by a secure informatics backbone, can bring together patient data in one comprehensive view, spanning the patient’s full history,” says Fernando De Obeso, CEO of Salúd Fácil.

According to De Obeso, in the treatment of heart patients, bringing together different types of patient data can help interventional cardiologists to decide, guide, treat and confirm successful outcomes.

Technology advancements, such as mobile health, which is healthcare supported by mobile systems and devices, have made real-time detection of health changes a reality. This is essential in chronic illness management to improve health outcomes, quality of life and cost-effective healthcare. For in-hospital or facilities solutions, tech is also revolutionizing diagnostic solutions by creating more patient-friendly devices. One example is Mamotest, for breast cancer screenings. This is a telemedicine-based solution that uses remote state-of-the-art mammographs to enhance access to a proper, timely diagnosis. It does not depend on an in-person visit, as it virtually reaches out to specialists to obtain a professional diagnosis. Mamotest can be used by anyone no matter where they live, whether in the capital or a rural community. Through this solution, women in any location can receive the same quality results from a recognized specialist.

“Mamotest is comprehensive of Latin America’s barriers to early diagnosis, which are due to shortages of mammographs and outdated technology used to perform a screening. Moreover, access to specialists is also lacking as they mainly work in urban areas,” explains Guillermo Pepe, CEO of Mamotest. This technology, according to Pepe, is already receiving funding from the Mexican government to facilitate and strengthen diagnoses of breast cancer.

IMSS is also investing in novel Protocols of Integral Attention (PAI) for Chronic Diseases, which focus on promoting early detection and diagnosis of these diseases. “The PAI will provide primary attention. Medical and nonmedical professionals will be enrolled in preventive activities: diagnosis, treatment and integral rehabilitation,” says Gabriela Borrayo, Coordinator of IMSS. The PAI was created after years of scientific research to offer quality medical attention to patients affiliated with the institute.

Nevertheless, patient associations, through the Network for Comprehensive Attention to Chronic Diseases, are still demanding the government guarantee universal access to health through early diagnosis, management and comprehensive care of these diseases. Still, to make this a reality, it is essential to migrate from specialized to primary healthcare. “This way, we can foster the concept of earlier detection and implementation of preventive medicine at different stages of the disease,” says David Kershenobich, Director General of the National Institute of Health Sciences and Nutrition Salvador Zubirán.