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Are Ingestible Sensors the Answer to Medication Adherence Problems?

Digital medicine, with an ingestible sensor at its core, could go a long way toward improving medication adherence.

Andrew Kelly

Proteus Discover, developed by Proteus Digital Health, is designed to improve medical adherence using ingestible sensors, a wearable device, and mobile technology.

"Drugs don't work in patients who don't take them."  According to former Surgeon General C. Everett Koop, the medication adherence problem is simple and obvious. The solution, unfortunately, is not all that simple, but thanks to the recent development of digital medicine, with the ingestible sensor at its core, that solution is within our grasp.

Andrew Kelly, of Cactus Semiconductor Inc., will discuss the challenges of ingestible sensor and application specific integrated circuit (ASIC) developments, strategies to address them, and the results achieved at the MD&M East Conference and Expo in New York City, June 13-15, 2017.

To put medication adherence into perspective, a 2013 CDC report estimated that more than 150 million Americans will be using chronic medications by 2020, but 20% to 30% of prescriptions are never filled, and about 50% are not continued as prescribed. This non-adherence causes 30% to 50% percent of treatments to fail, and leads to about 125 thousand deaths every year. Clearly, non-adherence is a huge problem.

In economic terms, the same CDC report estimates the annual direct cost of medication non-adherence to be greater than $100 billion, equating to about $2,000 per patient a year. Clearly, this is also an expensive problem. 

Andrew Kelly, IC/systems architect at Cactus Semiconductor Inc.

Proteus Discover, developed by Proteus Digital Health, addresses the medication adherence problem. A prescription written by a physician for Proteus Discover provides the patient with medication with ingestible sensors designed to react with stomach acid to send a brief, real-time signal to a wearable sensor patch worn on the torso of the patient. The wearable sensor patch is designed to send a message to an app on the patient's mobile device indicating when the medicine has been taken, and the app sends the information to the patient's healthcare provider to confirm that the medication was taken.

The data can be combined with data captured by the wearable sensor patch, including heart rate, rest, and step count, to help transform information into valuable insights. This could potentially improve the efficiency of patient care, and help health systems identify individuals who need greater support.

While the mobile devices and wearable sensor electronics are reasonably straight-forward, the development of the ingestible sensor presented a whole host of technical and logistics challenges.

The primary design challenges included requirements for a high-integrity communication link to support billions of unique serial numbers, running on a low resistance, high impedance supply, in a high-loss environment - all in an extremely miniaturized form-factor.  Other challenges included managing the conflicting high-quality & reliability requirements of medical devices with the manufacturability, supply continuity, and ultra-low cost requirements of a high-volume product.

Andrew Kelly is an IC/systems architect at Chandler, AZ-based Cactus Semiconductor Inc. Prior to joining Cactus Semiconductor, he was a senior principal IC design engineer at the Medtronic Microelectronics Center. 

[Image credit: Proteus Digital Medicine]

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