Do-It-Yourself
Medical Testing Makes Inroads
Not so long ago, a woman had to visit her physician, leave
a urine sample and wait by the phone, sometimes for days, to find out whether
she was pregnant.
But over-the-counter home-pregnancy tests - which first
hit the market in the late 1970s - make the process quick, convenient, and
private.
In fact, those pregnancy kits, as well as glucose-monitoring
tests for persons with diabetes, were in the vanguard of a health care revolution
that continues to gain momentum.
New and better tests for detecting and managing a plethora
of conditions have made their way to pharmacy shelves in recent years, the
fruit of both scientific advancement and consumer demand.
Diabetes is a good example of a disease for which self-testing
has made enormous strides, says Dr. Barbara P. Yawn, at the University of Minnesota
in Minneapolis.
People with diabetes used to check the sugar in their urine
at home to monitor their condition. It was not a very useful test, she says,
because a person's blood sugar might have to be 250 or even 300 mg/dL - well
above optimal levels - for sugar to be present in the urine.
The introduction of blood-glucose meters and testing strips
in the late 1960s vastly improved efforts by patients to monitor fluctuations
in their blood sugar and make needed adjustments to their diet and medication.
And painful finger pricks have gotten less so in recent
years with the introduction of finer lancets and meters that require less blood.
There is even a non-invasive watch-like device that automatically
measures blood glucose levels up to six times an hour.
"Home monitoring [of diabetes] has been improved again and
again and again," says Dr. Yawn, who credits manufacturers for heeding patients'
wants and needs. "They've paid attention to what makes people use it or not
use it. Pain was a big deterrent."
If you include the bathroom scale or the thermometer, home
testing has been around longer than people realize.
But today, there are home-test kits that women can use to
see whether they are ovulating or not. There are also kits for screening for
urinary tract infections, colon cancer, and even HIV.
There are home cholesterol tests that can give you a total
cholesterol count. The problem with these screens is they cannot break down
that number into its more useful components - like HDL (the good cholesterol),
and LDL (the bad type) - so many physicians still recommend that a health professional
check your cholesterol count.
Home health tests have to be fairly simple to perform, easy
to interpret, and used with some frequency to be useful to people, says Dr.
Paul S. Frame, at the University of Rochester School of Medicine.
Home glucose monitoring meets that definition, in his view.
So does home blood pressure monitoring.
Having a blood pressure cuff handy may be a good idea for
patients who have "white coat" hypertension, meaning their readings are always
high when they come to the physician’s office, but when they check their
blood pressure at home, "it's generally quite good," he says.
Dr. Frame is also a "fairly big fan" of the fecal occult
blood test, a screening test for colorectal cancer. Physicians often give patients
a test kit to take home with them.
The test, which involves taking a series of stool samples,
may also be purchased at pharmacies, says Elissa Passiment, of the American
Society for Clinical Laboratory Science.
But are Americans anxious to self-screen for this disease? "I
can promise you that they are not jumping off anybody's shelf," she says.
On the other hand, "Many patients would much rather do the
fecal occult blood test than have a colonoscopy," says Dr. Frame. In fact,
when patients repeatedly fail to perform the at-home test, he gives them a
choice.
"I say, well, you know, if you don't want to do this, if
this isn't working for you..., we can do a colonoscopy," he says.
For a glimpse at the future of at-home testing, look to
the baby boomers, notes Passiment. That generation, whose oldest members are
turning 60 this year, is anxious not to age the way their parents did and eager
to avoid disease.
"I think you're going to see more over-the-counter tests
for prevention," including sexually transmitted diseases, she predicts, "rather
than just management of the already diagnosed."
Always consult your physician for more information. |
