Utilizing an Ingestible Biosensor to Assess Real-Time Medication Adherence

Abstract

Medication adherence monitoring has relied largely on indirect measures of pill ingestion including patient selfreport, pharmacy refills, electronically triggered pill bottles, and pill counts. Our objective is to describe an ingestible biosensor system comprising a radio-frequency identification (RFID)-tagged gelatin capsule. Once the capsule dissolves in the stomach, the RFID tag activates to transmit a unique signal to a relay device which transmits a time-stamped message to a cloud-based server that functions as a direct measure of medication adherence. We describe a constellation of mobile technologies that provide real-time direct measures of medication adherence. Optimizing connectivity, relay design, and interactivity with users are important in obtaining maximal acceptability. Potential concerns including gut retention of metallic components of the ingestible biosensor and drug dissolution within a gelatin capsule should be considered. An ingestible biosensor incorporated into a medication management system has the potential to improve medication compliance with realtime monitoring of ingestion and prompt early behavioral intervention. Integration of ingestible biosensors for multiple disease states may provide toxicologists with salient data early in the care of poisoned patients in the future. Further research on device design and interventions to improve adherence is needed and will shape the evolving world of medication adherence.

Evaluation of Adherence Should Become an Integral Part of Assessment of Patients With Apparently Treatment-Resistant Hypertension

“…Such behavior may be over-represented in the subgroup of difficult-to-treat patients referred for RDN. 63,64 This intrinsic disadvantage can be overcome by the use of an ingestible sensor 65,66 but the latter is expensive, is invasive, has not been validated on a large scale, and is not free from possible side effects, such as skin allergies caused by the patch and possible gut retention of its metal components.…”

Wearable Devices and Biosensing: Future Frontiers

“…As bedside diagnosticians who care for a wide variety of patients in person and remotely, our experience evaluating biosensor data can improve our ability to care for our patients, anticipate adverse events, and monitor medication safety [3,4,6,9]. Capitalizing on these experiences provides a good opportunity for research evaluating and helping to develop new devices.…”

“…Head-mounted wearable computers can provide a toxicologist with a firstperson view of a poisoned patient, while a wrist-mounted sensor can stream key biometric data (e.g., heart rate, respiratory rate, skin temperature, and electrodermal activity). Ingestible biosensors can provide historical records of medication ingestion, and linked webcams can stream toxicology lectures to centers seeking expertise on the poisoned patient [2][3][4]6].In an era of integrated care and bundled payments, toxicologists and fellows in training have a unique opportunity to develop novel technology-based methods that respond to a need in our specialty. Creating novel applications using everyday technology requires a contemporary approach-integration of patients, physicians, engineers, and software developers into a multidisciplinary research team.…”

“…Head-mounted wearable computers can provide a toxicologist with a firstperson view of a poisoned patient, while a wrist-mounted sensor can stream key biometric data (e.g., heart rate, respiratory rate, skin temperature, and electrodermal activity). Ingestible biosensors can provide historical records of medication ingestion, and linked webcams can stream toxicology lectures to centers seeking expertise on the poisoned patient [2][3][4]6].…”

Oxycodone Ingestion Patterns in Acute Fracture Pain With Digital Pills

“…12–17 Iterative improvements in data transmission and signal strength have made digital pills feasible and acceptable to pateints. 13 Formative data on the use of digital pills have demonstrated the ability to detect ingestion of antidiabetic agents, antipsychotics, and antituberculosis medications.…”