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News

Sixty seconds on . . . digital drugs

BMJ 2017; 359 doi: https://doi.org/10.1136/bmj.j5365 (Published 21 November 2017) Cite this as: BMJ 2017;359:j5365
  1. Anne Gulland
  1. London

Digital drugs? Tell me more

The Food and Drug Administration in the US has approved the first drug with a digital ingestion tracking system.

What on earth is that?

It’s a pill with a sensor embedded inside which records that the medicine was taken. The sensor generates an electrical signal when it comes into contact with stomach fluid. This signal is then transmitted to a wearable patch on the patient’s body, which then sends the information to the patient’s smartphone. With the patient’s consent, their doctor and up to four other people can be alerted when the drug is ingested.

What is the pill used for?

The pill, called Abilify MyCite (aripiprazole tablets with a sensor), has been approved for the treatment of schizophrenia, manic and mixed episodes associated with bipolar disorder, and as an add-on treatment for depression.

It sounds a bit creepy

Some commentators in the US have raised concerns about the ethics of a doctor being able to spy on their patients in this way. Peter Kramer, clinical professor emeritus of psychiatry at Brown Medical School in the US, described the drug as a “tattletale.” And Paul Applebaum, director of law, ethics, and psychiatry at Columbia University, said that patients fail to take their pills for a range of reasons, often because they don’t like the side effects.

I suppose it’s a way of improving drug adherence?

Yes, failure to take drugs is a big problem and researchers have tested a range of devices designed to ensure people adhere to their drug regimens. But it’s a hard nut to crack: a recent study comparing three low cost reminder devices found that they failed to improve adherence.1

Has it worked?

Too early to say. But when I tell my children not to waste things “because money doesn’t grow on trees” or not to waste electricity “because someone has to pay for it” it has very little effect. Will the government’s initiative fall on similarly deaf ears?

References

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