Utilizing an Ingestible Biosensor to Assess Real-Time Medication Adherence
- 374 Downloads
Medication adherence monitoring has relied largely on indirect measures of pill ingestion including patient self-report, pharmacy refills, electronically triggered pill bottles, and pill counts. Our objective is to describe an ingestible biosensor system comprising a radio-frequency identification (RFID)-tagged gelatin capsule. Once the capsule dissolves in the stomach, the RFID tag activates to transmit a unique signal to a relay device which transmits a time-stamped message to a cloud-based server that functions as a direct measure of medication adherence. We describe a constellation of mobile technologies that provide real-time direct measures of medication adherence. Optimizing connectivity, relay design, and interactivity with users are important in obtaining maximal acceptability. Potential concerns including gut retention of metallic components of the ingestible biosensor and drug dissolution within a gelatin capsule should be considered. An ingestible biosensor incorporated into a medication management system has the potential to improve medication compliance with real-time monitoring of ingestion and prompt early behavioral intervention. Integration of ingestible biosensors for multiple disease states may provide toxicologists with salient data early in the care of poisoned patients in the future. Further research on device design and interventions to improve adherence is needed and will shape the evolving world of medication adherence.
KeywordsMedication adherence Antiretroviral therapy Biosensors HAART
- 2.Institute NEH. Thinking outside the pillbox: a system‐wide approach to improving patient medication adherence for chronic disease. New England Healthcare Institute Research Brief: New England Healthcare Institute 2009.Google Scholar
- 7.BIO E. Etect. http://etectbio.com. January 2015.
- 8.Kane JM, Perlis RH, DiCarlo LA, Au‐Yeung K, Duong J, Petrides G. First experience with a wireless system incorporating physiologic assessments and direct confirmation of digital tablet ingestions in ambulatory patients with schizophrenia or bipolar disorder. J Clin Psychiatry. 2013;74(6):e533–40. doi:10.4088/JCP.12m08222.CrossRefPubMedGoogle Scholar
- 9.Boyer EW, Smelson D, Fletcher R, Ziedonis D, Picard RW. Wireless technologies, ubiquitous computing and mobile health: application to drug abuse treatment and compliance with HIV therapies. J Med Toxicol Off J Am Coll Med Toxicol. 2010;6(2):212–6. doi:10.1007/s13181-010-0080-z.CrossRefGoogle Scholar
- 11.Moore JO, Boyer EW, Safren S, Robbins GK, Boudreaux ED, Rosen R, et al. Designing interventions to overcome poor numeracy and improve medication adherence in chronic illness, including HIV/AIDS. J Med Toxicol Off J Am Coll Med Toxicol. 2011;7(2):133–8. doi:10.1007/s13181-011-0149-3.CrossRefGoogle Scholar
- 12.Rosen RK, Ranney M, Boyer EW. Formative research for mHealth HIV adherence: the iHAART app. Annual Hawaii International Conference on System Sciences. Hawaii: IEEE & Computer Society Press; 2015. p. 2779–85.Google Scholar
- 14.Frehill P, Chambers D, Rotariu C. Using Zigbee to integrate medical devices. Conference proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society IEEE Engineering in Medicine and Biology Society Conference. 2007; 2007: 6718–21. doi: 10.1109/iembs.2007.4353902.
- 26.Acierno R, Carata E, DePascali S, Fanizzi F, Maffia M, Mainetti L, et al. Potential effects of RFID systems on biotechnology insulin preparation: a study using HPLC and NMR spectroscopy. IEEE/ICME Conference on Complex Medical Engineering; Gold Coast, Australia: IEEE; 2010. p. 198–203.Google Scholar
- 29.Klein CE, Chiu YL, Awni W, Zhu T, Heuser RS, Doan T, et al. The tablet formulation of lopinavir/ritonavir provides similar bioavailability to the soft-gelatin capsule formulation with less pharmacokinetic variability and diminished food effect. J Acquir Imm Def Syndr (1999). 2007;44(4):401–10. doi:10.1097/QAI.0b013e31803133c5.CrossRefGoogle Scholar
- 30.Acierno R, DePascali S, Fanizzi F, Maffia M, Mainetti L, Patrono L, et al. Investigating potential effects of RFID systems on the molecular structure of the human insulin. 5th Cairo International Biomedical Engineering Conference; 2010; Cairo: IEEE; 2010.Google Scholar
- 31.Kozakova S, Gonec R. RFID technology in preparation and administration of cytostatic infusions, deploying RFID—challenges, solutions, and open issues. InTech. 2011. http://www.intechopen.com/books/deploying‐rfid‐challenges‐solutions‐and‐open‐issues/rfid-technology-in‐preparation‐and‐administration‐of‐cytostatic‐infusions. Accessed May 11, 2015.
- 33.Royce W, editor. Managing the development of large software systems. IEEE WESCON; 1970: Proceedings of IEEE WESCON.Google Scholar
- 34.Whitworth E, Biddle R. The social nature of agile teams. Agile Conference IEEE; 2007. p. 26–36.Google Scholar
- 36.Carroll A, G H. An analysis of power consumption in a smartphone. USENIX Annual Technical Conference; 2010; Boston: Proceedings of the 2010 USENIX Annual Technical Conference; 2010.Google Scholar
- 38.Haynes RB, McDonald H, Garg AX, Montague P. Interventions for helping patients to follow prescriptions for medications. The Cochrane database of systematic reviews. 2002;(2):Cd000011. doi:10.1002/14651858.cd000011.
- 39.Castillo‐Mancilla JR, Searls K, Caraway P, Zheng JH, Gardner EM, Predhomme J, et al. Short communication: tenofovir diphosphate in dried blood spots as an objective measure of adherence in HIV‐infected women. AIDS Res Hum Retrovir. 2015;31(4):428–32. doi:10.1089/aid.2014.0229.CrossRefPubMedGoogle Scholar
- 40.Organization WH. Adherence to long‐term therapies: evidence for action. Geneva: World Health Organization; 2003.Google Scholar