A Digital Solution Tracks Pill Adherence with 98% Accuracy

Researchers at the Brigham and Women’s Hospital in the U.S. have successfully demonstrated the use of a digital solution to track pill adherence to a prophylactic measure against HIV, European Pharmaceutical Review reported. 

Men who have sex with men (MSM) and have a history of substance abuse are at greater risk of contracting HIV. Previous clinical trials have recorded lower than average adherence to prophylactic measures in these individuals. Therefore, the researchers investigated if a digital solution could improve adherence to pre-exposure prophylaxis (PreP) regimens. 

In the study that consisted of 16 participants, the researchers used specially manufactured capsules that each contained a radio transmitter. The pill was coated in gelatin so that stomach acids could dissolve it and release the transmitter. Once released the transmitter sent out a signal that could be received with a special wearable receiver when placed with three feet of the participant. 

The wearable device could not only track the activation of the transmitter but also pair with the participant’s smartphone and send the data to the phone and to healthcare providers. The study was conducted over a 90-day period and the participants returned their unused pills at the end of each month. The researchers verified the accuracy of the reader device by cross-referencing the leftover pills as well as measuring the concentration of tenofovir diphosphate, an active ingredient in the pill. 

When used correctly, the reader showed 98 percent accuracy in recording the pill ingestion data. In a survey conducted after the trials were concluded, the participants said that the system was easy to learn and adopt into their daily routines. The pill ingestion confirmation provided by pairing a smartphone also offered them peace of mind. 

Dr. Peter Chai, one of the researchers of the study, said that recording the non-adherence patterns could be correlated with changes in participants’ personal lives, structured routines, and substance use behavior. While some users found the wearable device a burden, others found them to be a useful reminder in taking their pills. In the future, researchers plan to use simpler wearable wristbands to monitor drug ingestion. 

Limitations of the Study

Among the limitations of the study, Dr. Chai noted that sexual minorities and women were not part of their study that was otherwise accurate and acceptable as per norms of PreP adherence monitoring. The technology used for the study was rather expensive but the costs could be reduced drastically if it was adopted at a large scale, Dr. Chai added. 

Even then, the technology is unlikely to be used for regular medications or those with less impact. One could expect them to be adapted to life-saving medications such as those for heart failure, hepatitis, or diabetes. 

The study was published in The Journal of Acquired Immune Deficiency Syndromes.

Author

Ameya Paleja