Every few weeks or months, the media reports on a new study that tantalisingly dangles the possibility of a new drug to give us longer, healthier lives.

The latest study centres around a drug involved in targeting interleukin-11, a protein involved in inflammation. Blocking this protein appeared to help mice stave off disease and extend their life by more than 20%.

If only defying the ravages of time could be achieved through such a simple and effort-free way – by taking a pill. But as is so often the case, the real-world significance of these findings falls a fair way short of the hype.

The role of inflammation in disease and ageing

Chronic inflammation in the body plays a role in causing disease and accelerating ageing. In fact, a relatively new label has been coined to represent this: “inflammaging”.

While acute inflammation is an important response to infection or injury, if inflammation persists in the body, it can be very damaging.

A number of lifestyle, environmental and societal drivers contribute to chronic inflammation in the modern world. These are largely the factors we already know are associated with disease and ageing, including poor diet, lack of exercise, obesity, stress, lack of sleep, lack of social connection and pollution.

While addressing these issues directly is one of the keys to addressing chronic inflammation, disease and ageing, there are a number of research groups also exploring how to treat chronic inflammation with pharmaceuticals. Their goal is to target and modify the molecular and chemical pathways involved in the inflammatory process itself.

What the latest research shows

This new interleukin-11 research was conducted in mice and involved a number of separate components.

In one component of this research, interleukin-11 was genetically knocked out in mice. This means the gene for this chemical mediator was removed from these mice, resulting in the mice no longer being able to produce this mediator at all.

In this part of the study, the mice’s lives were extended by over 20%, on average.

Another component of this research involved treating older mice with a drug that blocks interleukin-11.

Injecting this drug into 75-week old mice (equivalent to 55-year-old humans) was found to extend the life of mice by 22-25%.

These treated mice were less likely to get cancer and had lower cholesterol levels, lower body weight and improved muscle strength and metabolism.

From these combined results, the authors concluded, quite reasonably, that blocking interleukin-11 may potentially be a key to mitigating age-related health effects and improving lifespan in both mice and humans.

Why you shouldn’t be getting excited just yet

There are several reasons to be cautious of these findings.

First and most importantly, this was a study in mice. It may be stating the obvious, but mice are very different to humans. As such, this finding in a mouse model is a long way down the evidence hierarchy in terms of its weight.

Research shows only about 5% of promising findings in animals carry over to humans. Put another way, approximately 95% of promising findings in animals may not be translated to specific therapies for humans.

Second, this is only one study. Ideally, we would be looking to have these findings confirmed by other researchers before even considering moving on to the next stage in the knowledge discovery process and examining whether these findings may be true for humans.

We generally require a larger body of evidence before we get too excited about any new research findings and even consider the possibility of human trials.

Third, even if everything remains positive and follow-up studies support the findings of this current study, it can take decades for a new finding like this to be translated to successful therapies in humans.

Until then, we can focus on doing the things we already know make a huge difference to health and longevity: eating well, exercising, maintaining a healthy weight, reducing stress and nurturing social relationships.

Hassan Vally, Associate Professor, Epidemiology, Deakin University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

For many Australians the emergency department (ED) is the physical and emblematic front door to accessing urgent health-care services.

But health-care services are evolving rapidly to meet the population’s changing needs. In recent years, we’ve seen growing use of telephone, video, and online health services, including the national healthdirect helpline, 13YARN (a crisis support service for First Nations people), state-funded lines like 13 HEALTH, and bulk-billed telehealth services, which have helped millions of Australians to access health care on demand and from home.

The ED is similarly expanding into new telehealth models to improve access to emergency medical care. Virtual EDs allow people to access the expertise of a hospital ED through their phone, computer or tablet.

All Australian states and the Northern Territory have some form of virtual ED at least in development, although not all of these services are available to the general public at this stage.

So what is a virtual ED, and when is it appropriate to consider using one?

How does a virtual ED work?

A virtual ED is set up to mirror the way you would enter the physical ED front door. First you provide some basic information to administration staff, then you are triaged by a nurse (this means they categorise the level of urgency of your case), then you see the ED doctor. Generally, this all takes place in a single video call.

In some instances, virtual ED clinicians may consult with other specialists such as neurologists, cardiologists or trauma experts to make clinical decisions.

A virtual ED is not suitable for managing medical emergencies which would require immediate resuscitation, or potentially serious chest pains, difficulty breathing or severe injuries.

A virtual ED is best suited to conditions that require immediate attention but are not life-threatening. These could include wounds, sprains, respiratory illnesses, allergic reactions, rashes, bites, pain, infections, minor burns, children with fevers, gastroenteritis, vertigo, high blood pressure, and many more.

People with these sorts of conditions and concerns may not be able to get in to see a GP straight away and may feel they need emergency advice, care or treatment.

When attending the ED, they can be subject to long wait times and delayed specialist attention because more serious cases are naturally prioritised. Attending a virtual ED may mean they’re seen by a doctor more quickly, and can begin any relevant treatment sooner.

From the perspective of the health-care system, virtual EDs are about redirecting unnecessary presentations away from physical EDs, helping them be ready to respond to emergencies. The virtual ED will not hesitate in directing callers to come into the physical ED if staff believe it is an emergency.

The doctor in the virtual ED may also direct the patient to a GP or other health professional, for example if their condition can’t be assessed visually, or if they need physical treatment.

The results so far

Virtual EDs have developed significantly over the past three years, predominantly driven by the COVID pandemic. We are now starting to slowly see assessments of these services.

A recent evaluation my colleagues and I did of Queensland’s Metro North Virtual ED found roughly 30% of calls were directed to the physical ED. This suggests 70% of the time, cases could be managed effectively by the virtual ED.

Preliminary data from a Victorian virtual ED indicates it curbed a similar rate of avoidable ED presentations – 72% of patients were successfully managed by the virtual ED alone. A study on the cost-effectiveness of another Victorian virtual ED suggested it has the potential to generate savings in health-care costs if it prevents physical ED visits.

Only 1.2% of people assessed in Queensland’s Metro North Virtual ED required unexpected hospital admission within 48 hours of being “discharged” from the virtual ED. None of these cases were life-threatening. This indicates the virtual ED is very safe.

The service experienced an average growth rate of 65% each month over a two-year evaluation period, highlighting increasing demand and confidence in the service. Surveys suggested clinicians also view the virtual ED positively.

What now?

We need further research into patient outcomes and satisfaction, as well as the demographics of those using virtual EDs, and how these measures compare to the physical ED across different triage categories.

There are also challenges associated with virtual EDs, including around technology (connection and skills among patients and health professionals), training (for health professionals) and the importance of maintaining security and privacy.

Nonetheless, these services have the potential to reduce congestion in physical EDs, and offer greater convenience for patients.

Eligibility differs between different programs, so if you want to use a virtual ED, you may need to check you are eligible in your jurisdiction. Most virtual EDs can be accessed online, and some have direct phone numbers.

Jaimon Kelly, Senior Research Fellow in Telehealth delivered health services, The University of Queensland

This article is republished from The Conversation under a Creative Commons license. Read the original article.