TRUMP: A Trusted Mobile Platform for the Self-Management of Chronic Illness in Rural Areas

在发展中国家和发达国家，慢性病现在都是主要的死亡原因。这些疾病包括糖尿病、哮喘、关节炎、心力衰竭、慢性阻塞性肺病、痴呆症和一系列致残心理疾病，如抑郁症。在英国，慢性病患者的护理费用消耗了大部分卫生和社会护理资源，例如，占全科医生咨询的80%以上。虽然英国和印度在提供医疗保健方面的做法和结构截然不同，但对慢性病的有效管理是两国的优先事项。然而，农村地区的患者构成了特殊的挑战，这两个国家的医疗系统都没有很好地配置来应对。这个问题与印度特别相关，印度71%的人口在农村地区。虽然只有不到五分之一的英国人口是农村居民，但该国大部分地区人口稀少；例如在苏格兰，29%的人口生活在农村地区。这两个国家的农村医疗保健不平等是由许多因素造成的，包括运输成本和无法获得专家服务。特朗普项目的目标是通过同时考虑印度和英国农村地区的需求，探索移动技术在开发支持慢性病管理的平台方面的潜力。如果这些系统被患者和卫生工作者接受，对它们的信任是至关重要的，这个问题将成为该平台发展的核心部分。两种常见的慢性疾病--糖尿病和抑郁症--被选为平台开发和评估的样本。特朗普是一个多学科项目，涉及来自英国和印度的学术研究人员，以及来自商业和社区部门的合作组织。该团队通力合作，将：对医疗保健背景进行详细分析，设计与当地和国家医疗保健政策兼容的可持续技术解决方案，纳入现有经过验证的慢性病管理计划和培训。这意味着支持新的患者记录系统、跟踪患者(症状和行为)的机制以及患者的自我管理意识。

Chronic diseases are now the leading causes of death in both developing and developed countries. Such conditions include diabetes, asthma, arthritis, heart failure, COPD, dementia and a range of disabling psychological conditions such as depression. In the UK the cost of care of people with chronic conditions consumes the majority of health and social care resources, for example, accounting for over 80% of GP consultations. While the UK and India have very different practices and structures for healthcare delivery, the effective management of chronic illness is a priority for both countries. Patients in rural areas, however, present particular challenges that neither country's healthcare systems are well configured to address. This issue is particularly relevant to India with 71% of the population in rural areas. While less than 1 in 5 of the UK population are rural dwellers, large parts of the country are sparsely populated; for example in Scotland, 29% of the population live in rural areas. Rural healthcare inequality in both countries arises from a number of factors, including transport costs and the inaccessibility of specialist services. The goal of the TRUMP project is to explore the potential of mobile technologies in the development of a platform to support chronic disease management by simultaneously considering the needs of rural areas of India and the UK. Trust in such systems is vital if they are be accepted by patients and health workers alike, and this issue will form a central part of the development of the platform. Two common chronic conditions, diabetes and depression, have been chosen as exemplars for the development of the platform and its evaluation. TRUMP is a multidisciplinary project involving academic researchers from the UK and India, together with partner organisations drawn from the business and community sectors. Working together, this team will: perform a detailed analysis of the healthcare context, design sustainable technology solutions compatible with local and national healthcare policies; incorporate existing proven chronic management programmes and training. This implies support for novel patient record systems, mechanisms for tracking the patient (symptoms and behaviour), as well as patient awareness of self-management.