Nonadherence to prescribed medications is a serious problem. The World Health Organization estimates that 50 percent of patients worldwide don’t take their medications as prescribed, and the costs entailed are estimated at more than $500 billion. The impacts on patient health can be devastating. But a new high-tech way of delivering those medications offers a solution.
“Medication adherence is a very old problem,” says Sara Browne, M.D., of the University of California, San Diego. Dr. Browne’s research focuses on HIV and tuberculosis treatments, as nonadherence in some areas of the world can instigate the development of multi-drug resistant tuberculosis. “Digital medicines combine pharmaceuticals and edible sensors with a platform to capture medicine ingestion in near-real time.”
A patient takes their digital medicine – their medication in a capsule with a tiny ingestible sensor – and it sends a short signal to a wearable sensor patch on their body that pairs wirelessly with a smartphone app. The app records when the medicine is taken, as well as vital signs such as blood pressure and heart rate.
“It’s really a patient empowerment and management system,” Browne says. Her trials involving digital medicines such as Proteus Discover® from Proteus Digital Health found the sensors to be extremely accurate.
Success in the trenches
These digital medicines are having an impact in the real world as well.
“We first conducted a pilot with 20 patients that used the tool,” says Amanda P. Tosto, R.N., M.S., clinical transformation officer, Office of Ambulatory Transformation and practitioner faculty in the Department of Health Systems Management at Rush University Medical Center in Chicago. “We focused on the hypertension use-case.”
The choice of use-case was made carefully. “Hypertension is an illness where we know that in the good majority of patients the medications will work,” Anthony Perry, M.D., vice president for Ambulatory Transformation at Rush University Medical Center, points out. “But consistent usage of medications can be challenging. Proteus steps into that area as a kind of behavioral tool to help people consistently take these medications — medications that work if we can really get a consistent usage.”
“After the pilot, we saw that the medication adherence rate among patients was 85.5 percent,” adds Tosto. “We found the percent of time that patients were using the tool and wore the patch was 90 percent. And we brought over 80 percent of patients into blood pressure control. As a result we are now prescribing Discover to more patients with hypertension and diabetes as a regular course of care.”
While digital medicines can improve adherence and lower costs, the real impact is felt by the patients themselves.
“I have high blood pressure, I’m diabetic and last year I had a heart attack,” says William, a Vietnam vet and patient at Rush who is using Proteus Discover® for his cholesterol and heart medications. “It’s kind of fascinating — when you take your medications you see right on your phone that you took your medicine at the prescribed time. It also records things like my blood pressure, and all that information goes to my doctor, which I love.”
William got used to wearing the patch very quickly. “I barely notice it. I forget that I have it on.” He cites the access to data as an important benefit. “Early this year I caught a flu bug, and my blood sugar was running extremely high. My diabetic team reached out to me and said, ‛We noticed that your blood sugar is running high.’ That was amazing. Psychologically,” he adds, “it gives you a feeling that you are actually more in control.”
For patients like William around the world, digital medicines represent more efficient and more effective treatment, proving that the future of medicine is wireless.