TheFoodandDrugAdministrationapprovedanewpillTuesdaythatcantrackwhetherpeoplehavetakentheirmedications—andreportbacktothepatientorthedoctor.
Theideaistohelppeopleremembertotaketheirpills,butsomecriticsarealreadycallingita“biologicalBigBrother”andaresuspiciousbecausethedrugit’scombinedwithtreatsmentalillness.
“Theproductisapprovedforthetreatmentofschizophrenia,acutetreatmentofmanicandmixedepisodesassociatedwithbipolarIdisorderandforuseasanadd-ontreatmentfordepressioninadults,”theFDAsaidinastatement.
Dr.JohnTorous,apsychiatristatBethIsraelDeaconessmedicalcenterandHarvardMedicalSchool,saidmanypatientswillwelcomethenewpill.
“Mostpeoplewithschizophreniawanttofeelbetter.Theywanttobeabletoholdjobs.Theywanttobeabletofunctionwell,”hesaid.
Related:MillionsSkipPills
Somecriticsworriedwhethersuchahigh-techapproachisnecessary.“Interesting,butisn'taplasticpillorganizermorecosteffective?Attheendofaweek/monthyoujustcounthowmanyyoumissed!”DrRichardRathe,afamilymedicinespecialistattheUniversityofFlorida,askedinapostonTwitter.
Butpatientsoftenstoptakingdrugsbecauseofside-effects,suchasfoggythinking,Toroussaid.Thentheycangetintotrouble.“Theymaynotbeabletoreachouttotheircareteamintime,”hesaid.“Thiscouldbeusedasanearlywarningsystemtohelpprovidesmallcorrectionstohelppatientsbeforetheygotoofaroff.”
ButtheFDAalsonotesthatthedrug’smaker,OtsukaPharmaceuticalCo.,hasnotshownthatpeopleusingthespecialpillaremorelikelytotaketheirdrugs.
AndTorousisworriedaboutmisuse.“Youcannotignoretheethicalissuehere,”hesaid.
“Thatisgoingtorequirealotofactivecollaborationbetweenthepatients,betweenclinicians,betweeninsurersandpolicymakerstomakesurethistechnologyisn’tusedtospyonpeople,tocoercethem.”
ThepilldeliversadrugcalledAbilify,knowngenericallyasaripiprazole.Itincludesatinysensorthattransmitstoawearablepatch,whichinturncantransmittoasmartphone.Patientscandecidewhethertosharedataviaasecurewebportaltotheirdoctors.
Thecompanysaysthesensoristhesizeofagrainofsandand“ismadeupofingredientsfoundinfood”.
It’stakenawhiletoapprove.TheFDAsaidnotoOtsuka’sfirstapplicationinAprilof2016,sayingitneededmoreinformation.
Related:TooManyPeopleStopTakingHeartDrugs
Patientswithschizophreniaandbipolardiseaseoftenhavetroublerememberingtotaketheirmedicationsormaynotwishtotakethem,inpartbecauseofside-effects.
“TheapprovalofAbilifyMycite,thefirstdigitalmedicinesystem,meansthatforthefirsttimeinmyyearsofexperienceasapsychiatrist,thereisaninnovativewaytoprovideindividualswithseriousmentalillness,andselectedmembersoftheirfamiliesandcareteams,withinformationonobjectivemedicationtakingpatternstohelpinformthepatient’sillnessmanagementandpersonalizedtreatmentplan,”Dr.JohnKane,chairmanofthepsychiatrydepartmentatHofstra/NorthwellinNewYork,saidinastatementreleasedbyOtsuka.
“Thisinformationallowstheopportunityforanopendialoguewiththepatient.”
Theissueofcompliance—whetherpatientstaketheirdrugs—isabigone.Peoplereportskippingmedicationsbecausetheirprescriptionsareexpensive,anddoctorscomplainpeoplestoptakingpillsbecausetheyhaveconditionsthatdon’tcauseclearsymptoms,suchashighbloodpressure.
Trackerspillscouldhelpsolvethisproblemandalertdoctorstopatientswhomaynotwanttoadmitthey’vebeenskippingmedicationsforvariousreasons.
ArthurCaplan,abioethicistatNewYorkUniversity,isworriedaboutwhatelsecompaniesmighttrack.
"It’snicetokeeptrackoftakingyourpillsbutwhatelseareyoukeepingtrackof?"heasked.
"Weneedsomerulesaboutwhatyoucancollect."
And,Caplannoted,thepillsdon'taddressanotherproblem.
"Itcouldsetupamorehostileenvironmentbetweendoctorsandpatients,"hesaid.
"Itisonethingtobeabletolietoyourdoctor.Itisanotherthingtobecalledaliarorbeyelledat.Itsoundsamusingbutdoctorsaregoingtohavetolearnhowtomanagenon-compliantbehaviorinawaytheyhaven’thadtodobefore The best way to reduce labour in refilling vape cartridge is by getting an oil cartridge filling machine! They have a small table top design and come with a year’s warranty. So, do some work with this machine!."
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