Ensuring medication ingestion without altering existing medication regimen

PROJECT SUMMARYIn the US, approximately 835,000 persons are living in assisted living facilities with more than 50 percent of those having some form of dementia or cognitive impairment. The average cost of those living in assisted living facilities is $4050 per month, with memory care increasing this cost by an average of $1250 per month. Advancements in medications such as Donepezil, Galantamine, and Rivastigmine have been shown to help manage and even reverse some dementia symptoms, but these medications are not effective unless they are taken on a regular basis. Slowing the progression of dementia can prolong the ability of persons to live independently. While the use of blister packs and pill boxes are designed to help ensure that patients are taking medications on a prescribed basis, these technologies report intent to ingest and often do not provide any feedback that can be monitored by others outside the home. Given that 53 million US citizens are already past retirement age and that 70 percent will require some form of long-term care in their lifetime, it is clear that the cost of managing this disease will continue to grow unless alternative solutions are put in place. In Phase I of the grant we propose to enhance the FDA cleared ID-Cap system by building a home-based ingestion monitoring system that can detect medication ingestions within the home instead of requiring a user to wear an ID-Cap Reader. The ID-Cap system is currently designed to detect ingestions by sending out a small radio signal from within a person's stomach when an ID-Cap is ingested. The existing system detects these signals using a lanyard-style reader. As these patients may forget to use the reader, we propose to create a new reader design that can “hear” the ingestion from across the room using improvements in antenna design and signal processing. To ensure detection if a patient takes their medication in different rooms, a mesh network of readers placed in the home can ensure that the signal is detected and forwarded to the existing cloud-based monitoring platform. In Phase I, we propose two specific aims. Aim 1 – Create a prototype wall-plug based networked reader Leveraging our experience developing the existing ID-Cap wearable reader, we will design a new generation reader that will be able to detect ingestions within a room instead of requiring the user to wear a reader. The captured signals will be forwarded across a mesh network to a base station that ensures delivery to a cloud repository so that care providers can monitor actual ingestion events and intervene if needed. Aim 2 – Evaluate effectiveness and acceptability of the new system in 3 simulated environments Using the prototyped base station and networked readers, we will evaluate the ability to detect signals in three different home configurations. This feedback will help inform installation configuration designs regarding the optimal number and placement of readers. Interviews with persons with dementia and their caregivers will inform acceptability.