Improving Medication Treatment and Care for Dementia Patients through Ingestible Sensors
by Richard O'Boyle, Editor
Technological advances have changed the way individuals interact with the world. Smartphones, social media, and e-mail make the act of sharing information as simple as pressing the send button on a screen. The most recent wave of popularity in tech which includes wearable devices has catapulted the ease of communication ahead even further; it has also had significant impact within the field of medicine.
Smart pills – ingestible sensors that allow for the monitoring of patients’ health – are embedded with tiny data-transmitting sensors that work via Bluetooth technology. As the sensor is dissolved into the stomach acid, contents of the pill generate small electric currents that effectively share data with a wearable patch on the patient’s body. Both the sensor itself and the components of the pill are easily passed through the body’s digestive system and eliminated naturally.
The data transmitted through smart pill technology has the potential to change the way patient health is monitored, especially in the realm of medication adherence. Consider an individual suffering from dementia, with a heavy tendency to forego taking prescribed medication on a consistent basis. The use of smart pills with such an individual provides a safe method to maintain a record of medication habits not only for the patient but for her medical team and caregivers. Having data quickly and accurately shared with relevant individuals can play a substantial role in decreasing complications related to prescription errors, as well as the increased cost of health care due to additional, often unnecessary, office visits.
Current Environment for Formal Caregivers
While smart pill technology has the opportunity to positively affect the care given to patients with dementia, relatively little research has been conducted on administration of medication and the errors that take place within specialized mental health settings or care units. However, an observational study provides insight into the propensity of medications errors, citing that among elderly, extended-stay psychiatric patients, errors in the administration of medicine took place in one in four doses.
Additionally, a higher number of serious to deadly medication errors have been identified in patient settings where the elderly population is more prominent, such as dementia wards. The most common type of medication administration error within the formal healthcare setting is the omission of data, including medical professionals responsible for administering prescriptions failing to sign off on a patient’s chart that the medicine was actually given and subsequently received. Omissions within formal care settings often have no valid clinical reasoning, but failure to maintain a prescription regime, especially for patients with complex healthcare needs, can lead to irreversible medical results for patients. The inclusion of smart pills within the highly vulnerable group of elderly patients suffering from dementia and other mental health issues could effectively reshape the care received and the quality of life experienced.
Impact of Informal (Family) Caregivers
Informal caregivers, such as family members or community aides, who assist dementia patients with ongoing medical needs often fall short as it relates to prescription regimens. A study conducted by associates at the University of Pittsburgh reveals the extent to which informal caregivers contribute to medication adherence concerns. Within the study, in-home observations of medication management practices were assessed across a number of cases relating to patients with dementia receiving care within the home. Problematic medication practices were found in 62% of the observed cases.
Of the medication adherence issues found within informal caregiver settings for dementia patients, the most commonly reported concern was providing prescription medication at the wrong time. Following closely behind timing, losing or dropping medications during administration, and altogether forgetting to administer medication to the patient were common issues. Given that dementia patients often have complicated medical needs, poor medication administration and ultimately adherence to prescription routines results in less than ideal outcomes for patients.
Common Medication Mistakes
A slew of medication errors take place that lead to poor medication adherence among both formal and informal caregivers of dementia patients. According to a leading firm of medical solicitors in the UK, the most common mistakes include:
Confusing multiple medications that bear similar names
Taking prescription drugs that magnify the potential side effects of other administered medications
Administering a combination of prescriptions that induce similar effects unnecessarily
Mixing alcohol or over the counter drugs with prescriptions
Administering both a generic and brand-name prescription at the same time
Allowing food choices that interact negatively with medications
Not adjusting dosage when medications interact with kidney or liver function
Administering medication not known to be safe for a patient’s age
Patients with dementia who need ongoing care from either formal or informal sources often lack the ability to monitor medication adherence in way that truly benefits quality of life. The reduction of common medication mistakes among this patient population can be realized with the assistance of medical technology like ingestible sensors.
Currently, the FDA has approved the use of ingestible sensors for monitoring; however, approval remains pending for embedding certain medications within the smart pills for the adherence to drug regimens. The biotechnology firm, Proteus Digital Health, is one of the few organizations working diligently on smart pill development and implementation, seen through its recent partnership with the drug, Abilify, used to treat schizophrenia. Although FDA approval remains outstanding for the
Proteus/Abilify platform, there is great optimism about the implications of the combined medication administration. The use of ingestible sensors in marriage with mental health prescriptions has the potential to revolutionize the way care is provided to patients with dementia, ultimately resulting in lower medication errors and the increasing cost of ongoing medical treatment.
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