title: Utilizing an Ingestible Biosensor to Assess Real-Time Medication Adherence.
abstract: Medication adherence monitoring has relied largely on indirect measures of pill ingestion including patient self-report, pharmacy refills, electronically triggered pill bottles, and pill counts. Our objective is to describe an ingestible biosensor system comprising a radio-frequency identification (RFID)-tagged gelatin capsule. Once the capsule dissolves in the stomach, the RFID tag activates to transmit a unique signal to a relay device which transmits a time-stamped message to a cloud-based server that functions as a direct measure of medication adherence. We describe a constellation of mobile technologies that provide real-time direct measures of medication adherence. Optimizing connectivity, relay design, and interactivity with users are important in obtaining maximal acceptability. Potential concerns including gut retention of metallic components of the ingestible biosensor and drug dissolution within a gelatin capsule should be considered. An ingestible biosensor incorporated into a medication management system has the potential to improve medication compliance with real-time monitoring of ingestion and prompt early behavioral intervention. Integration of ingestible biosensors for multiple disease states may provide toxicologists with salient data early in the care of poisoned patients in the future. Further research on device design and interventions to improve adherence is needed and will shape the evolving world of medication adherence.
authors.affiliation: Division of Medical Toxicology, Department of Emergency Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA. peter.chai@umassmemorial.org.
authors.forename: Peter R
authors.initials: PR
authors.lastname: Chai
authors.affiliation: Division of Infectious Diseases, Department of Medicine, University of Colorado-Anschutz Medical Campus, 17200 E 19th Ave, B168, Aurora, CO, 80045, USA.
authors.forename: Jose
authors.initials: J
authors.lastname: Castillo-Mancilla
authors.affiliation: eTect BIO, 107 SW 140th Terrace, Suite 1, Newberry, FL, 32669, USA.
authors.forename: Eric
authors.initials: E
authors.lastname: Buffkin
authors.affiliation: Department of Emergency Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA.
authors.forename: Chad
authors.initials: C
authors.lastname: Darling
authors.affiliation: Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Department of Behavioral and Social Sciences, Brown University Providence, RI, The Miriam Hospital, 164 Summit Ave, Providence, RI, 02906, USA.
authors.forename: Rochelle K
authors.initials: RK
authors.lastname: Rosen
authors.affiliation: Division of Epidemiology and Community Health, University of Minnesota, 1300 S. 2nd Street, Suite 300, Minneapolis, MN, 55454, USA.
authors.forename: Keith J
authors.initials: KJ
authors.lastname: Horvath
authors.affiliation: Department of Emergency Medicine, Psychiatry, and Quantitative Health Sciences, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA.
authors.forename: Edwin D
authors.initials: ED
authors.lastname: Boudreaux
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, 55 Fruit St, Cox 506, Boston, MA, 02114, USA.
authors.forename: Gregory K
authors.initials: GK
authors.lastname: Robbins
authors.affiliation: Division of Global Health, Department of Pediatrics, Massachusetts General Hospital, 100 Cambridge St., Boston, MA, 02114, USA.
authors.forename: Patricia L
authors.initials: PL
authors.lastname: Hibberd
authors.affiliation: Division of Medical Toxicology, Department of Emergency Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA.
authors.forename: Edward W
authors.initials: EW
authors.lastname: Boyer
mesh_terms: D015374:Biosensing Techniques; D005780:Gelatin; D006801:Humans; D055118:Medication Adherence; D057233:Radio Frequency Identification Device
chemical_list: D005780:Gelatin
keywords: Antiretroviral therapy; Biosensors; HAART; Medication adherence