Kirollos Hanna, PharmD, BCPS, BCOP
There have been many efforts in recent years to improve patient adherence to oncology medications. Sticking to a regime that causes adverse events is not easy, and sometimes simple forgetfulness is to blame, but intervention by providers has been shown to work.1
Now, oncologists may soon have 1 more tool in the form of digital pills that transmit from inside the stomach to portable devices whenever patients take their medication. The technology, which has been deployed in limited extent across other areas of medicine, including cardiovascular and metabolic conditions, is being tested with oral oncology medication and could potentially make a dent in the problem of patient nonadherence. Some believe outcommes may be improved and more reliable clinical trials data may result from use of digital pill technology.
“Often, patients with cancer are elderly, so their memories can fail them at the best of times, and both their tumors and ‘chemo brain’ tend to increase the problem,” said Hanna, who is also a clinical pharmacist at Mayo and at the University of Minnesota Medical Center, where he is participating in a small trial of digital pills among patients with cancer. “There aren’t reliable adherence figures, but I’d guess that 40% to 50% of oral chemotherapy users have some adherence issues. If smart pills can reduce that by even a quarter, it would greatly improve outcomes.”
Figure. How The Proteus Digital Health Smart Pill System Works
Digital Tracking Devices Proliferate
The digital pill revolution extends to the use of wireless devices for colonoscopies which enable providers to inspect previously unreachable zones and conduct less-invasive procedures. Digital pills are just 1 product in the rapidly growing area of digital medicine. The bestknown segment of that market consists of wearable devices designed to monitor health or treat disease, such as Fitbits. Last year, the FDA approved the electrocardiogram software on the Series 4 Apple Watch,4
as well as its software for detecting an irregular heart rhythm.5
Wearables that treat disease range from insulin pumps for diabetes to electrotherapy for people with glioblastoma.
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