Reducing the Risk and Economic burden of Recurrent stroke by improving medication adherence using a Novel SMART Pill CONTAINER, Cap, and Health Literacy Technologies

Stroke is the leading cause of death and disability worldwide with the strongest disparity instrokes seen in Black middle-aged persons. Black persons have incidence rates of ischemicstroke that are 2- to 3-fold higher than Whites. Additionally, over 80% of stroke survivors willhave immediate and persistent weakness of their upper limb, leaving half of the persons with achronic disability and inability to complete simple and basic manual dexterity activities,including taking medications as prescribed (Medication adherence). The greatest areas wherestroke survivors need help all of the time was in taking medicines out of a box, packet or bottle,with remaining support needed in managing prescriptions, receiving alerts of medication dosingtimes, swallowing medicines, and (d) remembering if a medication was taken. Currentcompetitors have significant design barriers that limit access to disabled persons, medicationsafety, and Social Determinants of Health (SDOH). Accurate adherence monitoring requiresdetermining whether morbidity and mortality are a result of full or partial compliance orpersistent use of medication. Multiple sensors should be attached to the pill bottle to detect andmonitor medication adherence to improve accuracy of detecting partial compliance, persistentuse, and determining correlates of stroke-risk reduction outcomes. SANO’s novel PharmacyEnvironmental Interactive Device (EID) prototype is designed to eliminate health disparities bypreventing cardiovascular complications in stroke survivors by overcoming many of thesebarriers to medication adherence. SANO’s novel and patentable EID is designed for (a) single hand use in stroke survivors (disability solution); (b) dual in-home dosing alert and adherencemonitoring system by measuring pill weight and SMART Container manipulation (medicationsafety/adherence); (c) use of a cardiovascular taxonomy classification system designed for culturally sensitive and preferred health literacy language (health literacy); (d) a reusableSMART container and cap for use with low-cost cardiovascular medications (socialdeterminants of health). SANO’s additional engineering innovation will also test two types ofstrain gauge sensors (metal alloy and graphene nanosheets synthesized using a water- assistedliquid phase exfoliation), thereby expanding the commercial load cell family of materials toinclude strain gauges as a value-based in-home prescription scale. Future health innovationsand interventions must target the population at risk, the number of persons truly at risk relativeto the size of the target group, be cost-effective in prevention and treatment, and be culturallysensitive to improve intervention use in the targeted population.