One of the greatest misconceptions I had when I first got involved in telecare was that the main reason that people don’t adhere to their medication regime is that they forget to take their medicine – therefore all they need is an automated pill dispenser or perhaps even an alerting system and all will be well. If only it was so simple!
In reality there are all sorts of reasons, such as :
- A misunderstanding of how much medication to take, when
- Insufficient health literacy to understand the reasons given by the clinician for prescribing the medication
- Failure to organise when or how to take it
- Unwillingness to come to terms with having a chronic illness that requires taking medicine for a long period
- Beliefs about the medication, such as its effectiveness and long-term side effects
- Beliefs about the origin of the disease (eg if sent supernaturally as a form of punishment for misdeeds of ancestors)
- Lack of social support (eg an unsupportive partner) that undermines confidence and mood…
- …as well as sometimes just forgetting
As a result even if reminded, or actually given the pills to take, they often are not taken. It is widely estimated that only half the medicine prescribed in the Western world is actually taken as directed.
It is therefore very valuable to know whether and when medication has been taken so that appropriate steps can be taken to begin addressing some of the above issues where necessary. Mobihealth news now reports on the first trial using Proteus’s medication checking system which records when specially-tagged pills have been ingested. The trial, which involved bipolar patients who are known to be some of the hardest people to get to take their medication on time, demonstrated 94% tracking accuracy, and some pretty impressive adherence statistics too.
There is more detail on how the device works in an excellent BBC article. A nice touch is that the materials used to make the anode & cathode of the battery are trace elements needed by the body, so as they react with stomach acid to power the transmitter, they are also potentially benefiting the user directly. In the UK, Lloyds Pharmacy are selling the service, according to their PR release.
Meanwhile, for those potentially faced with the extremely unpleasant experience of a colonoscopy, the increasing acceptance of Given Imaging’s next generation PillCam, with a 30% improvement in image resolution and a more advanced video-processing engine, now underlined by FDA approval offers a much pleasanter experience. To be able to fit a high resolution videocamera and transmitter into a pill-sized capsule is impressive enough; to make it cheap enough to be disposable is even more so. (The thought of having to recover such a device after use reminds me of the point in the Monitor Me programme on Monday night when Prof Larry Smarr, “the Most Monitored Man in the world“, revealed one of the contents of his freezer, from an analysis of which he diagnosed himself as having Crohn’s Disease, the diagnosis of which just happens to be one of the uses of the PillCam too.)