Hey, pal, got the time? Time to take your meds
Hey, pal, got the time? Time to take your meds
New compliance monitor from Sequella
Someday soon your wristwatch might be able to tell you a lot more than whether you’re late to work.
A new compliance monitor for TB patients is designed to look and act like a standard Casio wristwatch, says Leo Einck, PhD, chief executive officer of Sequella, Inc., the for-profit half of the Rockville, MD-based foundation by the same name that "incubates" promising new TB research.
Unlike a Casio, though, Einck’s wristwatch will beep when it’s time to take your TB meds; then, once it sees you’ve done so, it politely says, "Thank you." Non-compliers (or folks who forget to put their watch back on after they take a shower) will hear another beep. Both kinds of events will be recorded on a computer chip in the watch, waiting to be downloaded and read by a health care provider.
The gadget works not by recording the removal of a pill from a blister-pack (or some other such activity), but by "seeing" the pulse of a flourescent tracer chemical released into a patient’s bloodstream after he or she swallows the pill. That’s why this one (unlike other a long string of other compliance-monitoring gizmos that have crashed and burned) can’t be foiled or fooled, Einck asserts.
Plus, the watch really does keep time and will look and cost about the same as a inexpensive wristwatch, with a Swatch-like assortment of wristbands for extra appeal. The difference is that along with the usual works, the Sequella timepiece will contain "quite an elegant optical filtering system, which essentially makes the skin invisible," Einck says.
Boxful could get DOTS program up and running
Positioned over the volar, or underside, part of the forearm (where the veins run close to the surface), the optical device will "see" a pulse of flourescine, a harmless agent added to the drug "just like cornstarch, or any other excipient," Einck says. The optical device monitors only the flourescine, not the drug itself; but since the flourescine will be mixed into the pill contents, there’s no way to trip the recording device except by taking the pill, Einck adds.
Flourescine is already used in retinal scans, he points out, and the amount that will be added to the TB drugs is so minute that it would take "years and years" to equal the amount used in a single scan.
So far, the system has been tested only in the lab, where it’s worked well in animal tissue. Sequella has secured a grant to fund the next two steps: construction of a prototype device and safety tests in humans.
Obviously, such a device, if it works, can be used to monitor compliance in many fields other than just TB, Einck says. But TB programs, habitually weighed down by the extra burdens of supervising six months of therapy (which could only be termed "short-course" in the long-suffering world of TB control), might welcome such a device even more heartily than fields such as diabetes or epilepsy, two other places Einck also sees as potential markets.
"In TB control, we’ve never really had a system for monitoring compliance that relies on anything other than some kind of enforcement, either a nurse who watches you take the pills or a judge who puts you in jail for not taking the pills," says Einck. "This way, you really have an opportunity to take a boxful of these watches and use them run an effective DOTS program.
In areas where there simply isn’t enough money to do it the old-fashioned way — poor countries, for example, where more pressing problems have kept expensive TB control programs pushed to one side — "you could really get the ball rolling with these things," Einck adds.
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