December 13-15, 2018

MedTech Impact 2018

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Las Vegas, NV

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Tag Archives: medication adherence

The World’s First Digital Medicine

U.S. regulators recently approved what is being termed the ‘world’s first digital medicine’: a pill with an inbuilt sensor that can be tracked inside the stomach, and communicates data surrounding whether—and when—patients have taken critical medication. The Food and Drug Administration are permitting the device to be used in an antipsychotic medication, with the overall goal of increased medication adherence, and the hope that the data can be used to help both doctors and patients better manage treatment.

The issue of medication non-compliance has been an ongoing challenge for pharmaceutical companies, healthcare systems, providers, and patients alike. This technology, which was developed over the past decade by Silicon Valley-based Proteus Digital Health, will be incorporated into the antipsychotic medication Abilify—which has been taken by approximately 7 million people in the United States since its inception 15 years ago.

Chief executive of Proteus Andrew Thompson asserts that the technology would allow people “to engage with their care team about their treatment plan in a new way,” supplemented by the ability to use a mobile phone to track and manage medication regimens. When patients swallow the tablet, which contains the sensor, a signal is sent to a patch worn on the body, which subsequently connects to an app on the patient’s phone: showing that he/she has taken the necessary dose. The prescribing physician will automatically receive the data; patients can also choose for family members and other providers to get the notifications. Moreover, the wearable patch has the capacity to track levels of physical activity—considered a key indicator of overall health and wellness—and allow patients to self-report mood and sleep quality.

This landmark regulatory clearance highlights the burgeoning high-tech evolution in the ways drugs are delivered, which can ultimately assist in curbing the estimated $300 billion in wasted medical spending caused by patient non-adherence. One of the bedrock pillars of the digital health revolution is making it easier for patients to comply with drug regimens, while simultaneously tracking their habits. Yet digital tracking is one of several outlined approaches to increase patient compliance; companies like Intarcia and Braeburn Pharmaceuticlas are pursuing other tactics, including the creation of implantable devices that contain up to one year’s worth of treatments for people with chronic medical needs.

Patient Medication Adherence: A ‘Smart’ Pill Bottle

All data and scientific literature indicate that poor medication adherence is directly correlated with increased hospitalizations, higher mortality rates, and a number of serious adverse health consequences. Approximately 50% of patients do not take their medications as prescribed, resulting in at least 100,000 preventable deaths per year. In terms of incurred costs, these numbers translate to between $100 billion and $300 billion dollars in spending, burdening the already weakened infrastructure of health care. Dr. Niteesh Choudhry, an internist at Harvard Medical School, describes the problem as “the final cascade of all of science.”

In order to reinforce the importance of taking medications as prescribed, to avoid premature death and preventable hospital admissions, a number of companies have developed wireless “smart” pill bottles: devices linked to the internet, designed to remind people to take their medications. These bottles and caps have the capability to send both email and text message reminders, in addition to notifying a caregiver if someone forgets to take medication.

AdhereTech has thousands of patients, including some diagnosed with HIV and cancer, who have turned to the company’s wireless device. Stein says, “Our system is automatically getting data sent from each and every bottle 24/7.” The bottle is equipped with sensors, which can detect not only when the cap is twisted, but also exactly how much medication is removed. A blue light pulses when it is time to take a pill; a red light flashes with the sound of a chime when a dose is missed, and the patient and/or caregiver receives a phone call or text message.

While a small, pilot study conducted by AdhereTech suggested that the pill bottle increased patient medication adherence by 24%, the system and its software is expensive to produce and maintain. Dr. Kevin Volpp, a physician and health economist who directs the University of Pennsylvania’s Center for Health Incentives, is optimistic about pill bottle technologies—yet believes that the high-tech strategy “needs to be paired with social interventions.” A study he designed demonstrated better results for patients who had their pill bottles automatically alert friends, if doses were missed or not taken properly.

Overall, most researchers and clinicians agree that “reminder technology” will be a critical part of the multi-faceted solution to patient medication adherence.