medwireNews: A digital health feedback system (DHFS) involving the ingestion of a digital sensor could help improve medication adherence in patients with bipolar disorder or schizophrenia, study findings show.
The DHFS can also be used to measure physiologic parameters, which alongside information on medication use, “may facilitate earlier and more targeted interventions for people at risk of disease progression or relapse,” say the researchers, Lorenzo DiCarlo (Proteus Digital Health, Redwood City, California, USA) and colleagues.
The DHFS involves patients ingesting a tablet with an embedded digital sensor at the same time as their medication. On ingestion, the sensor separates from the tablet and is activated by stomach fluids, causing it to emit a unique signal that is picked up by an adhesive sensor worn on the torso. This automatically logs the date and time of each digital tablet ingestion, as well as physiologic measures including activity and heart rate.
Among 27 individuals who completed the 4-week study, 74% adhered to the DHFS and the device was 94% accurate in detecting ingestion of medication. The adherence rate for taking medication within 2 hours of the prescribed dosing time was 67%.
The researchers comment that “since a large proportion of nonadherence is not willful, conscious refusal to take medication, tools that can assist and empower patients and caregivers to play a more informed role in their own health care offer an opportunity to improve adherence.”
Indeed, their results, published in the Journal of Clinical Psychiatry, showed that 70% of study participants found the DHFS concept easy to understand, 78% said they would like to receive reminders on their cell phone if they forgot to take their medications, and 89% thought the DHFS would be useful to them.
The DHFS also measured and quantified other physiologic measures, including sleep disruption, which in patients with bipolar disorder or schizophrenia is often an early indicator of impending relapse or recurrence, the researchers note.
Sleep disruption – defined by the amount of brief arousals and postural changes that occurred during sleep – ranged from as low as 5% to as high as 43%.
“The ability to characterize sleep on a continuing basis may, in high-risk patients, provide a potential means of detecting these changes early enough to allow intervention,” DiCarlo et al suggest.
No adverse events occurred due to ingestion of the DHFS. Five patients developed minor skin irritation at the site of the wearable sensor, but this did not lead to early discontinuation. Also, none of the participants developed worsening of mood or psychosis attributable to the device.
“Our results suggest that, by providing a reliable and not overly intrusive means of assessing medication-taking and patient status in real time, the DHFS may complement existing strategies,” the team concludes.
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