Disposable, medication-integrated tactile and motion sensor for glaucoma therapy compliance improvement

ABSTRACT Glaucoma is the leading cause of irreversible blindness in the world. The number of people with primary open angle glaucoma is expected to exceed 100 million by 2040. The first-line therapy for glaucoma treatment is patient-administered hypotensive medication delivered topically via an eye drop. However, studies have consistently shown that patients rarely adhere to dosing recommendations. According to the Wilmer Glaucoma Center of Excellence, nearly 50% of individuals discontinue eye drops within six months of their first prescription. Of those that persist beyond six months, only 37% continue the therapy after three years, and only 10% of those prescribed glaucoma drops are persistent (without gaps) over the first year. Failure to adhere to dosing recommendations dramatically limits the effectiveness of eye drops in lowering intraocular pressure and delaying or preventing the progression of glaucoma. This well-known problem has prompted the development of several technological solutions for tracking adherence. Retinal Careandapos;s proposed solution is fundamentally different. The proposed device is a simple and inexpensive combination of sensors designed to provide feedback to patients, providers, payers, and care coordinators regarding the way a patient interacts with their medication. Tactile and motion data is acquired through a custom force-sensitive resistor (FSR) and a standard three-axis accelerometer. Combined, these two data sources provide significant insight into drop adherence, application mechanics, and patient behavior. More importantly, this data can inform decisions on how and when to intervene with a patient to maximize the likelihood of continued long-term drop adherence and vision preservation. The primary innovations are in the single-use design (enabled by low-cost custom FSR fabrication and the unique combination of low-cost electrical components), the novel mining of motion and tactile information for patient adherence and behavioral data, and the integration with an existing care coordination framework. Retinal Care approaches health care more holistically than traditional companies; recognizing the behavioral and psychosocial factors that are a root cause of blindness from eye diseases like glaucoma. While Retinal Care employs cutting-edge technology such as deep learning and advanced medical devices, we work actively toward implementing technology in a way that translates directly to improved quality of life for our patients by managing the entire care path. The technology proposed here, while novel in design, is not intended primarily as a tracking tool, though it will accomplish that sub-goal with greater effectiveness and at less cost than any existing product. Instead, it is designed explicitly to reduce blindness by providing the crucial data needed to tailor our interaction and intervention strategies to the individual patient; to maximize patient engagement and adherence to glaucoma care through a combination of education, incentivization, tailored communications, and personal interaction with our trained care coordinators. The goal of this project is to demonstrate feasibility (cost and functionality) of the simple device that will enable Retinal Care to effectively reduce blindness and visual impairment from glaucoma.PROJECT NARRATIVE Glaucoma is the leading cause of irreversible blindness globally and in the US, where it affects more than 3 million Americans and costs the US economy $2.86 billion every year in direct costs and productivity losses. Topical medication administered through eye drops is a common and effective first-line therapy for reducing intraocular pressure and controlling glaucoma, but patient adherence to dosing recommendations is a consistent and pervasive issue that contributes significantly to vision loss. Retinal Care Inc. intends to develop and deploy a suite of simple, disposable, bottle-integrated sensors that will continuously collect real-time adherence and behavioral data to inform the design of patient-specific intervention and incentivization strategies to improve adherence and reduce blindness from glaucoma.