Pill With a Will

Patients often fail to take their medication properly. Technology steps in with some ideas. Amber Dance reports .

Did you take your medicine today?” Soon, patients won’t have to rely on their memories for the answer. Scientists are developing tablets and capsules that track when they’ve been popped, turning the humble pill into a high-tech monitoring machine. The goal: new devices to help people take their medicines on time and improve the results of clinical trials for new drugs.
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Doctors can already prescribe pills that release drugs slowly or at a specific time. They even have camera pills that take snaps of their six to 12-metre journey through the gastrointestinal tract. The new pills tote microchips that make them even cleverer: they will report back to a recorder or smart phone exactly what kind and how much medicine has gone down the hatch and landed in the stomach. Someday they may also report on heart rate and other bodily data.

This next generation of pills is all about compliance, as it’s termed in doctor-speak — the tendency of patients to follow their doctors’ instructions (or not). According to the World Health Organisation (WHO), half of patients don’t take their pills properly. They skip doses, take the wrong amount at the wrong time or simply ignore prescriptions altogether.

The most common reason for medication mistakes is forgetfulness, particularly among the elderly. “The number of prescriptions they get is mind-boggling,” says Jill Winters, dean, Columbia College of Nursing in Milwaukee, Wisconsin. According to a 2004 report by the Centers for Disease Control and Prevention and the Merck Institute of Aging and Health, the average 75-year-old takes five different drugs.

Often, occasional lapses don’t matter. Smart pills like these are “not for your aspirin or even simple antibiotics,” says Maysam Ghovanloo, an electrical engineer at the Georgia Institute of Technology in Atlanta. The new technology is aimed at time-sensitive or costly medications.

For certain medications, not taking every pill can have serious consequences. For example, those mentally ill may require regular treatment to stay stable. Chemotherapy drugs and antibiotics for treating tuberculosis (TB) are also time-sensitive.

Blood pressure (BP) medication works only when taken on a regular basis; suddenly stopping it can cause the BP to skyrocket, says Daniel Touchette, a pharmacist and researcher at the University of Illinois, Chicago.

With drugs for transplant patients, a person who misses a dose risks rejection of the new organ. Novartis International AG, based in Basel, Switzerland, is developing pills for transplant recipients; the pills communicate with a patch on the skin when they reach the stomach.

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And in the case of TB, treatment requires a six-month course of antibiotics that come with side effects such as nausea and heartburn. Many people don’t understand why they have to keep taking the unpleasant drugs once they feel better — but going off the medication may make patients contagious again and allow drug-resistant TB to develop.

Yet another arena where compliance is crucial is clinical drug trials. Drugmakers can only be sure their medicine works if they’re sure subjects are actually taking it as directed. For now, experimenters rely on diaries where participants record their medication use. But people may fudge the data, not wanting to admit they dropped a pill down the drain or forgot to take it for a few days. To account for those who miss their medicines, firms have to spend extra — trials cost hundreds of millions of dollars — for larger trials just so enough people will actually take the drug.

Technology already offers some solutions, with mobile phone reminders and pill bottles that record when they’re opened. But none of these actually confirms that the medicine has been swallowed.

Ghovanloo hopes to improve compliance with a necklace that records every time a special pill slides down the esophagus. He calls it MagneTrace. By sounding an alarm or sending a mobile phone message, the necklace also would inform the wearer when it’s time for another dose. Caretakers or doctors could monitor the signals too.

The system works by radio-frequency identification, or RFID. Three magnets on a choker-type necklace act like pillars, continually surveying the neck. The pill contains an RFID chip to communicate with the magnets. When Ghovanloo tested the system in an artificial neck made of PVC pipe, the necklace detected 94 per cent of pills passing through it. He hopes to get that number up to 99 per cent and is adding a microchip that will also transmit information about the specific drug taken and its dose.

Ghovanloo coats the chips with a non-reactive material so that after the medicine dissolves, the hardware simply passes through and out of the digestive tract. However, Ghovanloo says he needs make the design more fashionable. “Right now, it’s not something that a lady would be willing to wear,” he says. For men, he might embed the device in a shirt collar.

Rizwan Bashirullah, an electrical engineer at the University of Florida in Gainesville, is also working on pills that will confirm they’ve been taken. “They’re essentially little stickers,” he says of his technology, called the ID-Cap. Gainesville-based eTect is developing the product.

Each sticker contains three components: a microchip, an antenna and an acid sensor. Altogether it’s approximately half the size of a postage stamp, says eTect President Eric Buffkin. The sensor activates the device when it lands in the acid environment of the stomach, and the chip uses the antenna to send electronic signals directly through the body’s tissues to a receiver, worn on a wristband. The silver antenna and sensor dissolve into safe components; these and the microchip, about as big as a grain of sand, are flushed out of the gut. Over the next year, the company plans to test the capsule for safety in animals and people, Buffkin says.

Source :
Los Angerles Times

Published by
The Telegraph ( Kolkata India)

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