ISG 2018 - News Details
iRxReminder in the News
A. STERNS (USA), J. SMITH (USA), J. HUGHES (US). Smart Home Technologies as Cognitive Prosthetics to Extend Older Adult Independence. Gerontechnology 2018;17(Suppl.):<page>.
PURPOSE: Not properly taking medications results in 700,000 emergency room visits, 341,000 hospitalizations, and 125,000 deaths annually.1 Patients have been, for the most part, on their own when it comes to making sure medications are taken correctly once prescribed. They have had a few popular tools including the 7-day pillbox organ-izer and the digital watch. These have proven inadequate as the number of ER visits, hospitalizations, and deaths attest.
A new group of technologies has emerged to support improving medication tak-ing success. Because these technologies are designed to help overcome behavioral and cognitive challenges of medication taking we refer to them as cognitive prosthet-ics.2 The success of these prosthetics requires understanding the underlying behav-iors and cognitive challenges.
METHOD: We describe an organizing model to better understand the ability of these technologies to deliver care in the home and independent living settings bridging care and for use in self-management of chronic conditions. Our organizing model focuses on the degree of support and the degree of integration with the healthcare profes-sional.
We have developed and successfully tested a technology platform called iRxRe-minder, created for supporting patient medication adherence. iRxReminder’s platform consists of three components: 1) a cloud-based iRxControl center, 2) smartphone apps, and 3) a Internet-of-Things (IoT) medication dispensing device. Symptoms, side effects and other health information are tracked in parallel using interoperating smartphone apps. This platform is ideal for integration with healthcare-focused smart homes. The technology extends to utilize cues such as lighting (changing a bulb from white to green) as well as smart device alerting.
The platform empowers patients through the use of a dosing window. When the dosing window opens, the LED on the pod turns green, and the medication may be taken. In the middle of the dosing window plus 5-minutes the alerts are sent. The alert is always meaningful. We call this approach smart alerting.
RESULTS AND CONCLUSIONS: We present two studies that have been completed demonstrating significantly improved medication adherence to over 80% with individu-als recovering (Xage=65) from transient ischemic attacks (TIAs or mini-strokes) and patients living with heart failure (Xage=72). We share two difficult home health chal-lenges, managing complex medication schedules and wandering can be solved with technology supported medication reminding and access control technologies utilized in a home setting.
1. Viswanathan M, Golin CE, Jones CD, Ashok M, Blalock SJ, Wines RC, et al. Interventions to Improve Adherence to Self-administered Medications for Chronic Diseases in the United States: A Systematic Review. Ann Intern Med. 2012;157:785–795. doi: 10.7326/0003-4819-157-11-201212040-00538
2. Sterns, A. A., & Mayhorn, C. B. (2006). Persuasive pillboxes: Improving medication adher-ence with personal digital assistants. In Y. de Kort, & W. I. Jsselsteijn (Eds.), Persuasive technologies. New York: Springer.
3. Sterns, A. A. (2016). App development in the context of smart homes for healthcare. In (Ed.) van Hoof, J., Demiris, G., & Wouters, E. J. Handbook of Smart Homes, Health Care and Well-Being. New York: Springer.
Keywords: Medication adherence, Cognitive Prosthetic, mHealth, eHealth
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