Medication non-adherence is a huge problem in the United States. Roughly 50 percent of people who have been diagnosed with chronic diseases don’t take their medications as prescribed. And, as we all know, even the best scientific advances can’t help us live longer and healthier lives if we don’t use them.
And the loss of health and life is not the only things medical non-adherence is causing. In 2013, the IMS Institute for Healthcare Informatics estimated that improper and unnecessary medication use caused an additional $200 billion in annual U.S. health care costs. Our economy suffers a blow too when we don’t treat ourselves as directed.
One recent advance in the medical world, however, might make remembering to take your medication easier, particularly for chemotherapy patients. Researchers at University of Minnesota Health have developed a special kind of capecitabine chemotherapy pill with an ingestible sensor affixed to it. The sensor is only the size of a grain of salt and contains all ingestible ingredients, such as the copper, magnesium, and other minerals found in food.
The sensor sends signals to a receiver worn on the patient’s belly, and that same information is then sent to the patient’s smartphone and to the doctor’s records. This helps the patient keep track of taking his or her medication, and it also helps doctors know whether things are going well with medication adherence.
“The therapy window — the difference between what’s too much and too little — can be pretty narrow,” said Dr. Edward Greeno, who directs the university’s oncology service line. “You want to know [the drugs are] being given right.”
Similar smart pills have been used successfully for patients with heart problems and mental disorders, other situations where the dosage and timing of medication is critical or where patient non-adherence is high. However, this is the first time the system is being used to help chemotherapy patients.
Taking chemotherapy at the appropriate times as described is vitally important, and forgetting to take it can make a significant difference in how well the medication works. But up until recently, forgetting to take chemotherapy medication was not really a problem, because it was usually administered intravenously in a hospital setting. Now that chemotherapy comes in pill form, however, it is much easier to forget, making built-in reminders more important than ever.
“Nudges that are small and incremental and frequent are much more powerful than visiting the doctor once a month and being given an eight-minute lecture,” said Andrew Thompson, chief executive of Proteus, the company that makes the federally approved ingestible sensors.
Dr. Greeno says the digital medication also gives some comfort to patients who are frightened of the monumental responsibility of remembering to administer their own life-saving medication. “They’re afraid of treating themselves,” he said. “This is sort of a way of giving patients some backup.”
Doctors can even get some information about how their patients are coping with cancer and chemotherapy treatment using the smart pill system, because the receiver worn on the belly is capable of tracking patients’ heart rates, exercise patterns, and sleep levels. This information can also help patients be more aware of how well or poorly they’re taking care of themselves so they can improve.
But most importantly, the smart pills make it easy to see when a patient isn’t taking their medication so doctors can find the underlying reason for the non-adherence and fix it. According to Dr. Greeno, these issues are often simple ones, such as a patient’s arthritis making it difficult to open bottles.
“A pretty easy problem to solve if you know about it,” he said. “Impossible [to solve] if you don’t.”
Proteus is working on getting federally approved, but each medication-and-sensor combination must be approved individually. Additionally, insurance companies are responding with caution to this relatively inexpensive digital addition to chemotherapy medication. Their response will likely influence how the technology spreads, so, for now, scientists are working on proving that the digital medication improves patient outcomes to help it get cleared by insurance.
Elizabeth Nelson is a wordsmith, an alumna of Aquinas College in Grand Rapids, a four-leaf-clover finder, and a grammar connoisseur. She has lived in west Michigan since age four but loves to travel to new (and old) places. In her free time, she. . . wait, what’s free time?