Connecting diabetes care to the Internet of Things

New connected health technologies can boost medication adherence with smartphone apps and gamification. Heino Lennartz, Vice President and General Manager Global Pharma, West Pharmaceutical Services reveals more in an interaction with Viveka Roychowdhury

What is the impact of missed medication and irregular monitoring for a diabetic? How does this impact disease progression, both from a medical treatment as well as economic burden perspective?

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Heino Lennartz

Medication adherence in the management of diabetes and other chronic conditions is a complicated puzzle, but one that has to be solved in order to help protect patients from potentially devastating consequences. For example, if left untreated, diabetes leads to high cholesterol and hypertension, which in turn can trigger other complications including stroke, heart disease and even trouble with memory and vision.

While research indicates that a patient’s improved medication adherence is directly linked to favourable treatment outcomes for a variety of chronic conditions, including multiple sclerosis and diabetes, patient compliance with chronic medication therapies is remarkably low. In fact, the World Health Organization estimates it at 50 per cent internationally. In addition to poor clinical outcomes, this non-compliance can mean lost revenue for pharmaceutical companies worldwide (some estimates put this loss at $564 billion globally) and increased costs for many healthcare financial stakeholders, including the patients themselves.

What kind of features are being explored to improve patient adherence and monitoring?

For patients with chronic conditions, self-injection systems can provide newfound freedom to self-manage their diseases outside of traditional healthcare settings, like the doctor’s office or clinic. To account for this trend, self-injection systems must be designed with a patient-centric focus. For example, West Pharmaceutical Services’ SmartDose platform was developed with extensive human factors testing to address potential obstacles to compliance:

  • Improved patient comfort: The SmartDose platform was designed to maximise comfort throughout the drug delivery process thanks to the hidden 29 gauge needle featured in the automatic needle protection design that prevents accidental needle injuries. Upon safely completing the injection, SmartDose can be easily removed.
  • Discreteness: Many patients prefer a delivery mechanism that is not visible to others. Special consideration was taken with the SmartDose platform to ensure that it is easily concealed to avoid calling undue attention to the system, creating distractions to others or feelings of stigmatisation for the patient.
  • Ease of use: Because injectable medications are administered completely by the patient with the SmartDose platform, the process needed to be so intuitive that only minimal instruction is required. To this end, the SmartDose platform currently permits the patient to load the cartridge containing the drug. A user-friendly activation button on the front of the device and LED indicator let the patient know that the dose delivery is in progress.
  • Dose notification: A critical aspect of the SmartDose platform is its patient-focussed design elements that address the possibility that a user did not receive the full dose, or did not receive their medication at all. To account for these possibilities, the device is equipped with a microprocessor that is designed to offer immediate feedback via a dose confirmation window and visual and audible cues indicating whether the prescribed medication was delivered.

What are the advantages of deploying IoT (Internet of Things) to improve monitoring and patient adherence, in general and specifically in diabetes?

We see bright prospects for diabetes care through connected self-injection systems and wearable injectors. For example, connected health systems may offer new options for doctors and nurses who need to confirm the patients are following home medication regimens.

New connected health technologies can boost medication adherence with smartphone apps and gamification, which has been studied in diabetes treatment. By incorporating the power of a smartphone app with an integrated wearable drug delivery system, there is an opportunity to improve and reward medication adherence with unique gamification technologies that not only capture when and how much of a medication was taken, but incentivise self-treatment with rewards. Doing so creates a patient-friendly injector that allows for system configurations that not long ago seemed part of the distant future.

Are any such products on the market and are there studies that show improved outcomes for IoT monitoring, gamification apps, etc?

To help address barriers to adherence, West collaborated with HealthPrize Technologies to develop a connected health offering that is designed to improve and reward medication adherence with unique technologies in a gamified environment.

As a concept, gamification has made inroads in online marketing by applying elements of game playing, such as scoring points, competing with others, setting a hierarchy of rules and, of course, reaping rewards for success. But it is showing promise in other sectors as well, including fitness and healthcare, helping patients find a new way to meet the daily challenges managing diabetes and other chronic conditions. According to HealthPrize data, adherence increased 57 per cent among patients using the HealthPrize app in a study of diabetic medication usage.

West is a specialist in containment and delivery solutions, so what kind of collaborations are necessary to incorporate features like IoT and gamification apps?

The West and HealthPrize offering integrates HealthPrize’s Software-as-a-Service (SaaS) medication adherence and patient engagement platform into injectable drug delivery systems with an app that tracks and rewards patients for taking their medication. This type of rewards-based patient motivation and engagement can be tied into delivery system training regimens as well.

In the first offering from West and HealthPrize, patients will manually scan barcodes or otherwise enter data about their medication compliance into a smartphone/tablet app, or on an Internet browser from a computer if they don’t have a wireless device. In the near future, app use will be even more automated, streamlined and interactive. For example, drug delivery systems or packaging will be able to signal a smartphone to confirm, in real time, that a particular dose was used, the syringe safety system was deployed, all the medication was injected and other details.

By leveraging connected health in chronic disease management, including incorporating apps and other systems that add positivity or ‘gamify’ treatment regimens into integrated drug delivery, patients will have new motivation for caring for themselves, in both incentive and accountability, and clinicians will be able to better monitor patient data and medication adherence.

viveka.r@expressindia.com

Reference: http://www.who.int/chp/knowledge/publications/adherence Section1.pdf