title: Developing a Digital Medicine System in Psychiatry: Ingestion Detection Rate and Latency Period.
abstract: A digital medicine system (DMS) has been developed to measure and report adherence to an atypical antipsychotic, aripiprazole, in psychiatric patients. The DMS consists of 3 components: ingestible sensor embedded in a medication tablet, wearable sensor, and secure mobile and cloud-based applications. An umbrella study protocol was designed to rapidly assess the technical performance and safety of the DMS in multiple substudies to guide the technology development.
  
  
  
  Two sequential substudies enrolled 30 and 29 healthy volunteers between March-April 2014 and February-March 2015, respectively, to assess detection accuracy of the ingestible sensor by the DMS and the latency period between ingestion and detection of the ingestion by the wearable sensor or the cloud-based server.
  
  
  
  The first substudy identified areas for improvement using early versions of the wearable sensor and the mobile application. The second substudy tested updated versions of the components and showed an overall ingestion detection rate of 96.6%. Mean latency times for the signal transmission were 1.1-1.3 minutes (from ingestion to the wearable sensor detection) and 6.2-10.3 minutes (from the wearable sensor detection to the server detection). Half of transmissions were completed in < 2 minutes, and ~90% of ingestions were registered by the smartphone within 30 minutes of ingestion. No serious adverse events, discontinuations, or clinically significant laboratory/vital signs findings were reported.
  
  
  
  The DMS implementing modified versions of the smartphone application and the wearable sensor has the technical capability to detect and report tablet ingestion with high accuracy and acceptable latency time.
  
  
  
  ClinicalTrials.gov identifier: NCT02091882.
authors.affiliation: Otsuka Pharmaceutical Development & Commercialization, Inc, 508 Carnegie Center Blvd, Ste 300, Princeton, NJ 08540. debbie.profit@otsuka-us.com.|Clinical Research & Development, Otsuka Pharmaceutical Development & Commercialization, Inc, Princeton, New Jersey, USA.
authors.forename: Deborah
authors.initials: D
authors.lastname: Profit
authors.affiliation: Clinical Research & Development, Otsuka Pharmaceutical Development & Commercialization, Inc, Princeton, New Jersey, USA.
authors.forename: Shashank
authors.initials: S
authors.lastname: Rohatagi
authors.affiliation: Clinical Research & Development, Otsuka Pharmaceutical Development & Commercialization, Inc, Princeton, New Jersey, USA.
authors.forename: Cathy
authors.initials: C
authors.lastname: Zhao
authors.affiliation: ODH, Inc, Princeton, New Jersey, USA.
authors.forename: Ainslie
authors.initials: A
authors.lastname: Hatch
authors.affiliation: ODH, Inc, Princeton, New Jersey, USA.
authors.forename: John P
authors.initials: JP
authors.lastname: Docherty
authors.affiliation: Clinical Research & Development, Otsuka Pharmaceutical Development & Commercialization, Inc, Princeton, New Jersey, USA.
authors.forename: Timothy S
authors.initials: TS
authors.lastname: Peters-Strickland
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015374:Biosensing Techniques / Q000379:methods* / Q000592:standards; D000067917:Cloud Computing; D005260:Female; D006801:Humans; D008297:Male; D008491:Medical Informatics Applications; D055118:Medication Adherence; D001523:Mental Disorders / Q000188:drug therapy*; D008875:Middle Aged; D063731:Mobile Applications / Q000592:standards; D011570:Psychiatry / Q000379:methods; D012680:Sensitivity and Specificity; D013607:Tablets / Q000592:standards; D013997:Time Factors; D055815:Young Adult
chemical_list: D013607:Tablets