So many of the studies on medication adherence are based on self reporting, that you can never really get an accurate account of when someone actually takes their medication. If you have a two way enabled device, the patient can text back that they took their pills, without taking them. If you have a pill bottle top monitor, it just lets the researcher know that someone has taken off the top of the pill bottle. With pillboxes that automatically dispense medications, again, you don't know if the patient has taken the pills, just that they were dispensed.
This article from the UF website, cites a breath monitoring device developed by UF scientists to monitor medication compliance. I have so say it is a pretty good concept for individuals who are housebound. It reminds me of the breathalizers that convicted DUI felons have to have installed in their cars if they want to drive again. They breathe in, and if there is no alcohol, they can start the car.
Here is a excerpt:
“The machine sits in your home and when it’s time for you to take your medication, it makes a beeping noise. If you don’t hit a button after about five minutes, it’s going to beep louder and louder until you come,” Melker said. “If you don’t come after a certain amount of time, the machine can call the clinical trial coordinator and indicate that subject or patient didn’t take the medication as prescribed.”
The device, which is slightly smaller than a shoebox, records the results of each breath test, allowing patients to bring a memory card or USB key to the clinic once a month and receive a printout of their results. Eventually, the researchers hope to reduce the size of their detection device to fit inside a cell phone. But for now, they’re satisfied that the technology works.
“The doctor can see how often you took it and exactly what time. If it made the patient really sick or dizzy and they didn’t take it, they can find out why,” Melker said. “It’s not just a question of did I or didn’t I take it, but when you took it or why you didn’t take it.”
The researchers developed the adherence monitor by incorporating minute amounts of an alcohol into a gel capsule. The additive, called 2-butanol, is one of many GRAS — Generally Recognized as Safe — compounds approved by the Food and Drug Administration for use in foods.
“We wanted (patients) to swallow a chemical and have it transform into something else that’s easy to monitor,” said Matthew Booth, an assistant professor of anesthesiology at the UF College of Medicine and an investigator in the study. “When it hits the stomach lining and liver, an enzyme converts the alcohol to a gas that can be measured in the breath.”
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