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- Volitional factor: Breath test will help control medication intake for schizophrenia
Volitional factor: Breath test will help control medication intake for schizophrenia
The regularity of medication intake by patients with schizophrenia was suggested to be determined by exhalation. The device was developed by Russian specialists for this purpose. The device analyzes the chemical composition of respiration using infrared radiation. At the same time, blood collection and injections are not required. The method will allow to identify procedure failures — events that are dangerous for exacerbations of the disease, which lead to accelerated destruction of the patient's brain. However, the path from a laboratory sample to clinical practice will be a long one, experts warned. Among the obstacles are ethical limitations and the difficulties of calibrating the device.
How does a breath test indicate a violation of the regime
A device that will help check how patients suffering from schizophrenia take their prescribed medications has been developed by scientists from Moscow State Technical University together with specialists from Moscow Psychiatric Clinical Hospital (PKB) No. 1.
The device is based on the principle of optical spectroscopy, the researchers explained. The device illuminates the exhaled human air with infrared rays and determines its chemical composition. This makes it possible, without injections and blood collection, to find out how the patient is following the treatment regimen.
— The basic idea is to determine the patient's metabolic profile by analyzing exhaled gas. It is a set of molecular compounds (metabolites) that are present in the body. This "snapshot" reflects the current state of metabolism. This is similar to a blood test, but in the blood we examine large organic molecules — proteins, and in the breath — light volatile compounds, " Igor Fufurin, the responsible executor of the project, head of the research department at the Center for Applied Physics at Moscow State Technical University, told Izvestia.
The advantage of the method is that there is no need to disrupt the integrity of the skin and mucous membranes. This is more convenient when the analyses need to be done constantly, the developer explained.
Currently, scientists have created a laboratory sample of the device and described the sampling procedure. In the future, the researchers intend to perform 3.6 thousand analyzes, which is necessary to accumulate the necessary amount of statistics and verify the correctness of the indications.
Why do patients with schizophrenia skip medications
— One of the problems in the treatment of schizophrenia is that patients, feeling healthy and denying the pathology, can proactively skip taking medications. Sometimes this is due to forgetfulness or fear of complications due to side effects of drugs," said Denis Andreyuk, senior researcher at the Clinical Research Center for Neuropsychiatry at PKB No. 1.
However, this is dangerous, because as a result of non-compliance with the treatment regimen, exacerbations may occur. They have a detrimental effect on the patient's brain and nervous system and lead to self-destruction of personality. Each such event reduces the duration and quality of life, so doctors are fighting to avoid relapses. Complications can also trigger suicide attempts or aggressive actions towards others.
— Schizophrenia is a fairly common ailment. It affects about 0.5% of people in the world. Moreover, the disease more often affects the young. Such patients lose their ability to work, and healthcare systems spend significant resources on their treatment and care. That's why it's so important to prevent the development of severe forms," Denis Andreyuk explained.
According to him, the research and testing of the technique will last for a year. This will allow us to check whether it will be possible to reduce the proportion of repeat hospitalizations in the experimental group. The success of the project will lead to the creation of an inexpensive diagnostic tool. In the future, this approach can also be used to solve other medical problems.
Why schizophrenia is an expensive disease
— In psychiatry, the proportion of patients who regularly skip taking antipsychotic medications is approaching 40-50%. A decrease in criticism of one's own condition is especially characteristic: a person sincerely does not consider himself sick and does not understand the need to continue treatment," Albert Rizvanov, head of the Personalized Medicine Center of Excellence at Kazan (Volga Region) Federal University, explained to Izvestia.
However, violation of the therapy regime increases the risk of exacerbations, repeated hospitalizations and generally worsens the long-term prognosis, the expert emphasized.
— The difficulty may be that for the reliability of the analyses using the device, you need to collect a large database of spectra. And these are human tests. Such studies require appropriate permits. It may take time to receive and approve them," said Alexey Karfidov, Head of the Department of Technological Equipment Engineering at NUST MISIS.
If a patient refuses to take medications, he is more likely to refuse additional examination, the specialist added. Therefore, the new device should be considered as an auxiliary tool.
Alexandra Kolina, associate professor at Nizhny Novgorod State Technical University, pointed out that from an engineering point of view, developers face the classic task of isolating a useful signal from noise. However, difficulties may arise when implementing the development in practice. Technical limitations may play a role, for example, when the target signal is weak. In addition, medical facilities may not be ready to implement equipment that requires frequent calibration and maintenance.
— In terms of the burden on society, schizophrenia is one of the most expensive diseases. Often, people suffering from such a disease become disabled at an early age. This means that the budget will not receive taxes from them for the rest of their lives, but the state will pay for their medical treatment. At the same time, if patients do not comply with the regime, it increases the cost of their therapy," said Alexey Pavlichenko, associate professor of the Department of Mental Health and Clinical Psychiatry at the Faculty of Psychology at Moscow State University, director of the Institute of Mental Health at Moscow Medical University "Reaviz".
According to him, during the implementation, it is necessary to work out how the technology will be implemented at a doctor's appointment, and propose rules of use and clinical recommendations. There are many clinical and ethical issues when working with patients with schizophrenia. Forcing people to blow into a tube may violate the rights of patients. Perhaps it is more correct to look not for control methods, but for ways that guarantee taking medications.
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