Lack of substantial patient compliance with established dosage intervals has long been recognized as a major problem in treating illness. Typically in treating a patient, a physician will desire the patient to take a needed drug on a specific schedule. The prescribed (or over-the-counter) medicine is usually obtained from a pharmacist with the actual administration of the drug left to the sole control of the patient. The patient alone is responsible for compliance with the physician’s instructions. Even a well-meaning and conscientious patient may frequently fail to take medication at the desired dosage intervals.
According to studies, only about 50 percent of American patients typically take their medicines as prescribed, resulting in a waste of approximately USD 177 billion annually in direct and indirect costs to the U.S. economy.
Compounding these problems is the impact of low health literacy and limited English language proficiency, which greatly affect the ability of patients to read, understand, and act on health information about medication use. According to published studies, 45 percent of the adult population (90 million people) have literacy skills at or below the eighth grade reading level, making it difficult for these individuals to read health information, understand basic medical instructions and adhere to medication regimens.
In other words the patient needs a bit of help to comply with his medication regimen. In recent years various mechanical and electronic compliance ideas and devices have been introduced in the pharmaceutical packaging. Although ultimately patients must make the decision to fill their prescriptions and take their medicines as prescribed, electronic reminder devices and automated medication dispensers have the potential to improve medication adherence.
1281042 Alberta Ltd, based in Winnipeg, Canada, has developed an innovative technology for the (pharmaceutical and medical) packaging industry called the Disposable Chip, which offers compliance assistance.
Encased in a plastic housing, the Disposable Chip consists of a small circuit board powered by a lithium battery. The circuit board utilizes a microprocessor, light emitting diodes (LEDs) and dependent upon the application, either a motion sensor or a reset switch.
This plastic housing can be in the form of a bottle cap or in a stand-alone form to allow for adhesive attachment to existing products.
Although the Disposable Chip can also be used as a lifecycle alert, I don’t see, to be honest, the advantages of the technology to just register the expiring date. Just counting down the time doesn’t give the guarantee that the perishable product still is in good edible shape. There are many time/temperature and other smart labels in the market, that don’t count down but by measuring the liquids or other parameters of the perishable product decide whether the product has reached the end of its lifecycle, in other words it can’t be consumed anymore.
Much more interesting however is the Chip Technology in administering the compliance of taking medicines. When programmed for compliance assistance, the Disposable Chip is designed to flash a green light each time a dose is to be taken and to flash an amber light every five seconds in-between dose alarms if a single dose or multiple doses have been missed. Three different design configurations (pre-programmed, consumer programmable and pharmacist programmable) are available to facilitate the setting of dose alarms.
The Pre-programmed Configuration
The pre-programmed configuration is designed for consumers who take medication or vitamins once per day. Removal of the plastic pull-tab energizes the circuit board and at the same time sets the daily alarm time. For example, if the plastic pull-tab is removed at 9:00 AM, the pre-programmed configuration flashes green immediately indicating that a tablet or vitamin needs to be taken. The configuration then automatically activates a flashing green light at 9:00 AM each day thereafter as a compliance reminder for the consumer. If the reset switch is not pressed during a 9:00 AM compliance alarm, the microprocessor assumes the dose has not been taken and records it as a missed alarm. The unit flashes amber once every five seconds in-between dose alarms if any missed alarms have been recorded.
Consumer Programmable Configuration
The Consumer Programmable model is designed for consumers who take medication multiple times per day. Once the plastic pull-tab has been removed, the Chip enters into a 24-hour programmable mode, which allows for dose alarm times to be set using the reset switch which is named the “Remember Me” button for this model. The “Remember Me” button is pressed and held down each time tablets or vitamins are taken in the 24-hour programmable mode. A single green flash from the unit confirms a desired alarm time has been recorded into memory. Once the 24-hour programmable mode has elapsed, the unit automatically switches to the alarm mode and flashes a green light at the desired dose times each day thereafter. Up to four different alarm times can be set in the 24-hour programmable mode. The unit flashes amber once every five seconds in-between dose alarms if any missed alarms have been recorded.
Pharmacist Programmable Configuration
The Pharmacist Programmable Configuration consists of three components; the Disposable Chip, a programmer adapter and proprietary Windows based software to allow for fast in-store programming. When the software is accessed through a pharmacy PC, a split screen provides a pharmacist with the option to either program the unit to provide compliance assistance for prescription consumers. Programmed information is transferred to the Disposable Chip through the Programmer Adapter interface.
The Disposable Chip technology adds a new dimension to retail pharmacy by implementing the philosophy that the best way to improve over-all compliance is to take a pro-active approach to the problem. The compliance assistance function of the Disposable Chip would also be ideally suited for vitamin and other regimens.
Note: The in this article stated facts and figures regarding health care, are based upon the report: “Enhancing Prescription Medicine Adherence: A National Action Plan”. Click the title to download (pdf) the report.