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Making a difference with mobile health

Sanofi talks to PME about its latest mHealth initiative and tackling the diabetes epidemic
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When it comes to pharma's work with mobile health (mHealth) technologies, Sanofi's work within diabetes has established the company as one of the front-runners.

Its GoMeals healthy eating iPhone app, released in 2009, was one of the first pharma attempts to harness the then-still-nascent power of Apple's smartphone. Another standout initiative from the company was the iBGStar, an iPhone-compatible device that launched three years ago. The first blood glucose monitor to sync with the iPhone and iPod Touch, it was also the first to allow users to input their own data and notes via a specially designed app.

Continuing this trend, the company last month joined a World Health Organization (WHO)-backed mobile health partnership called 'Be Healthy, Be Mobile' becoming the sole pharmaceutical partner for its diabetes arm.

Pierre Chancel, senior VP of Sanofi's global diabetes division, explained: “Our vision for the development of diabetes is really about making sure that people have better health, better access and better lives.

“This epidemic is skyrocketing and the vast majority of people that desperately need [their diabetes] to be managed or taken in charge are in emerging countries. Two-thirds of people living with diabetes are undiagnosed and the one third of treated patients are out of control.

“The most promising, most pragmatic channel to reach them is, indeed, this mobile health technology.”

mDiabetes
Be Healthy, Be Mobile covers a number of therapy areas and is led by the International Telecommunication Union (ITU) in collaboration with the WHO. It focuses on ways to harness mobile technologies to improve the prevention and treatment of non-communicable diseases like diabetes, cancer, cardiovascular and chronic respiratory diseases, in low- and middle-income countries.

The initial phases of the partnership's mDiabetes programme are taking place in Senegal, where a pilot that ran for the month of Ramadan saw some 80,000 SMS messages sent to approximately 3,500 participants to help patients with diabetes manage their disease. This was followed up by a six-week phase that ran until January 2015 and involved further one-way SMS messaging, with texts send roughly once-a-day.

Senegal is an interesting choice for the pilot. In common with many African countries mobile phones play a particularly important role and in the last year mobile penetration in Senegal reached the 100% mark. “When you look at the number of cell phones, mobile phones that are already existing in these geographies,” Chancel said, adding: “this is the channel to be used in trying to help people living with diabetes.”

A new model of healthcare
Sanofi's senior medical officer and vice president of global medical affairs for its diabetes division Riccardo Perfetti added: “Managing chronic diseases presents problems that are very different from the way healthcare systems worldwide were established for.

“Diabetes is going to be the example, the experiment in public health that is going to prove that that model needs to be integrated with other means to provide three different components, diagnosis, education and management that otherwise would not be accessible just because of the dimension of the disease. 

“One of [our] approaches [is] to be a little bit more pragmatic and understand that the numbers of the disease cannot be addressed by the existing model.”

The mDiabetes initiative is, Perfetti said, “a very tangible and rational way to get closer to patients”. He continued: “So to have devices that may help them to diagnose the disease or tell them what they are doing is sufficient is a critical step.”

This is the channel to be used in trying to help people living with diabetes

- Pierre Chancel, Sanofi

Changing behaviour
Patients were recruited to take part in the Be Healthy, Be Mobile's mDiabetes initiative through patient groups or their physician, after which they would be asked to give their consent to receiving the SMS messages.

With Sanofi onboard the next phase of initiative will involve 'two-way' SMS messaging, offering reminders to patients on topics such as their blood glucose levels and food intake.

The 'two-way' part of the initiative will see patients receiving messages such as 'have you thought about monitoring your glucose', and it could also focus on lifestyle habits and eating habits.

“In this area, so many things can be done, but the only thing that counts concrete initiatives, that start, that have a beginning and that have an end,” said Chancel. “So that's where we can get key learnings that can then be developed in order to realise an impact.”

While the pilot and first phases of the initiative were based only on SMS reminders, the second phase - which Chancel told PME is due to commence this month - will be looking to incorporate some mobile app technology.

On Sanofi's plans for this part of the programme Perfetti added: “Clinically, we'll need to be a little bit more ambitious [with the second phase], because if the objective of phase II or step II is really to change behaviour, we really need to collect that [data], so it will need to be a little longer.”

Although this second phase of the initiative will again take place in Senegal, Sanofi's ambitions for this work aren't limited to just one country. “The objective of all of this will be to build something that could be scalable, and this is the whole spirit of the initiative,” Perfetti explained.

“Among the countries we're considering as expansion, Tunisia and the Philippines are some of the countries where this may be a modifier of the way diabetes is managed,” he added.

As to whether Sanofi will bring its mDiabetes initiative to Europe and other large markets eventually, Perfetti said that was also a possibility, with some modifications to account for the region's different technological habits.

“Europe and the US, in terms of familiarity of people with technology, are a little bit more advanced. Perhaps it will need to be tailored to meet the expectation of those countries. But the principle of providing information in an innovative way is still valid.”

Article by
Dominic Tyer

21st April 2015

From: Healthcare

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