Big Brother is watching you – or perhaps over you, depending on the view you take with the recently FDA-approved ‘digital pill’. Proteus Digital Health is behind this new device which records whether or not a person has taken their medication.
The digital pill is just like a regular pill, except it’s embedded with a digestible sensor. This part is composed of copper, magnesium, and silicon, and generates an electrical signal upon detection of stomach fluids. The signal then connects to a patch worn above the rib cage that communicates information to an app on the patient’s smartphone, and thus, one has checked the box for taking it, along with a handy time stamp. Not only that, but a patient can record their mood, hours of rest from the night previous, and level of activity at the time of ingestion using the app.
Family members and doctors also receive the info, allowing them to keep track of a person’s medication program. This is particularly important for schizophrenia, bipolar disorder, and other mental illnesses where patients often avoid taking their medications due to the side effects. One study suggested as many as 74% quit their medication program within 18 months.
Inconsistency with medication programs costs the taxpayer billions
The cost of inaccurate and inconsistent use of medications is a major point of concern for doctors and other health professionals. In addition to the human cost with complications that arise, over $100 billion USD is lost every year in the US due to non-adherence, according to a CBC report.
The adherence issue is not unique to the mentally ill, however. A study published in the journal Anesthesia & Analgesia tracked 15 patients who were prescribed opioids after surgery. Seven of them quit within four days of leaving hospital despite being prescribed for a week, and various patterns of use were recorded from those who did complete their medication program.
“I’m enthusiastic – but probably not as enthusiastic as some advocates of the digital pill,” says CAMH psychiatrist David Gratzer. “Compliance is a major problem for people with chronic health conditions, including chronic mental health conditions. This digital pill – which relies on patient consent, of course – offers another tool in the toolkit, making it easier for some patients to take the medicine that they need.
“I think it’s important not to oversell. Patients who are ambivalent about medication management aren’t going to consent to the digital pill, and may not consent to any pill. As always, we need health care providers to engage and educate patients.”
Conspiratorial sensationalism or valid grounds for concern?
Some commentators have countered that we may be summoning the beast by placing a type of tracking device into a patient population that is prone to paranoia. Speaking to the New York Times, the former president of the American Psychiatric Association, Jeffrey Lieberman, said, “There’s an irony in it being given to people with mental disorders than can include delusions. It’s like a biomedical Big Brother.”
But Gratzer says he isn’t “fully persuaded” that sort of criticism: “At the end of the day, like with any treatment, patients must consent. Those who have reservations about the digital pill will likely decline it.”
Health Canada confirmed that they have not received an application for market authorization in Canada; so, for now, all eyes will look south of the border to see how the implementation of this device goes.