You are more likely to contract chronic obstructive lung disease (COLD) if you have a low income and below average education.

In a few years, chronic obstructive lung disease will become the third most important casue of death in the world. Today, 200,000 people in Norway have COLD and another 9000 contract the disease every year. According to the WOrld Helath Organisation (WHO) this disease will probably become one of the most frequent causes of death anywhere in the world within a few years. Long-term smoking is the most usual cause, and more and more women are becoming sufferers.

Standard of living

Scientists at SINTEF Health Research have set themselves the goal of finding out more about this group of patients, and have started a wide-ranging programme of work in this area. They are currently mapping out how COLD patients have been diagnosed and treated; the standard of living of the group will be studied, and the potential of new, improved treatments will be checked out.

Karl-Gerhard Hem is working on the standard of living survey, which aims to find out more about the lifestyle of people in this group in order to customise measures that could help them. Hem is comparing such measures as education, health, occupational status, etc. in COLD patients and a group of normal non-sufferers, as well as in patients with other chronic diseases.

"We can already say that people with COLD who are less than 67 years old have lower levels of income and education than the normal population. As far as social conditions such as contact with family and friends is concerned, however, there are few identifiable differences", says Hem. A further aim of the study is to find out what we do not know about this group at present, and Hems points out that there are many COLD sufferers in Norway who have still not been diagnosed as such. "To find them and offer them treatment is important, so a more highly customised study of COLD patients will be designed in the future".

Course of treatment

"Swedish studies have shown that the total cost to society of patients in that country is around nine billion kroner. With a population about half of that of Sweden, we can estimate that it costs Norway about NOK 4 billion", says Tommy Haugan, who leads a project that is surveying courses of treatment for this group of patients. "Identifying success factors for the best treatment of these patients which would also have an effect on society as a whole - is our aim".

The group has collaborated with a data company in developing software capable of digging out specific types of information from large databases. Five medical practices in Steinkjer and three in Trondheim have opened up their files to the project, and information on 4000 Norwegian patients with COLD, asthma and respiratory problems has been downloaded. Data about the same patients has also been fetched out of databases in hospitals and emergency services.

"It has been an exacting job to correlate the enormous number of data files", admits Haugan, "but now we possess a unique overview of of the course of treatment undergone by a large number of patients between 1995 and 2004. Here there are "soft" transitions between patients with COLD, asthma and breathing difficulty, and there are many points of similarity among these diagnoses. We know how often patients have visited hospital or emergency medical services, and what medicines they have been prescribed. This enables us to search for relationships. Can measurements of lung function and treatment with medicines have some connection with hospital admissions and acute disease?"

The scientists are now analysing the data and expect to have answers to many of their questions in the course of the summer.

Equipment

Further down the corridor, Jarl Reitan and the scientists in his department are studying equipment for COLD patients, on contract to Innomed. The scientists have performed a survey, looked at existing technology and listened to the experiences of users.

"It is when they are at home and when they are travelling that these patients have the greatest need for innovative solutions", says Reitan. "It is both a difficult process and rather embarrassing to appear in society with a nasal catheter, tubing and an oxygen flask. We want to find out whether the equipment can be made less visible. Perhaps the nasal catheter could be integrated into a pair of spectacles? SINTEF is in close contact with the medical gas supplier Aga, a useful connection where product development is concerned.

Ole Martin Winnem at SINTEF ICT has been a member of an international project called LinkCare, which has evaluated how COLD patients manage at home with their equipment and measurements. Groups of patients in Barcelona and on Cyprus have transmitted their measurements via mobile telephone and answered a set of question in the morning and evening, with good results. SINTEF's role has been to integrate a home-based monitoring system of this sort with other members of the health services.

About the SINTEF

The SINTEF Group is the largest independent research organisation in Scandinavia. Every year, SINTEF supports the development of 2000 or so Norwegian and overseas companies via our research and development activity. The abbreviation SINTEF means The Foundation for Scientific and Industrial Research at the Norwegian Institute of Technology (NTH).

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