The era of digital medicine, "digital tablets" will solve the problem of taking medicine

This week, the US Food and Drug Administration (FDA) approved the world's first digital drug, Abilify MyCite, which was developed by Silicon Valley companies in the United States and Japan's Otsuka Pharmaceutical Co., Ltd. in the original anti-psychotic drug Abilify (Anrufan, scientific name Ripridazole is developed on the basis of sensors, which are implanted internally, not only safely through the body, but also communicate with external devices, and medical personnel can track the patient's medication.

After the digital means have successively entered the medical links such as outpatient clinics and surgery, the era of digital medicine has come. How will digital tablets develop in the future? What will the doctors and patients get from the constantly innovative technology?

What is a digital tablet?

The digital tablet Abilify MyCite, which received the first listing ticket, is a new antipsychotic drug that can be used for diseases such as schizophrenia with psychotic symptoms (illusion, delusion, etc.). Treatment of manic episodes of manic episodes and maintenance. Its "digital" is that the tablet contains an ingestible sensor made of silicon, magnesium, copper, etc. It does not contain a battery and an antenna, and only has the size of one salt.

So, does this sensor affect the human body? Wang Yong, deputy director of the outpatient department of Shanghai Mental Health Center, told the reporter that after the patient took the medicine, the sensor will be activated when it touches the gastric juice, and then send a signal to the external device, including information such as heart rate, breathing, body angle, activity, sleep mode, etc. Go to the mobile app to make it easier for medical staff to observe the patient's vital signs. After completing the above “mission”, the sensor will be discharged outside the patient's body with normal metabolism, and there is no health burden.

Digital means of monitoring resistant patients

Why are companies developing such digital tablets? Wang Yong explained that most of the common mental illnesses are chronic recurrent diseases, which are mainly treated by psychotropic drugs, and often require long-term medication or even lifelong medication. "And for various reasons, people with mental illness often have poor medication compliance. For example, patients with schizophrenia and bipolar disorder often think that they are not sick and do not want to take medicine during the onset. Even after rehabilitation, they may be over-extended. Worried about the adverse reactions of drugs, stigma, lack of knowledge of the disease, inconvenient dispensing and other reasons, it is difficult to adhere to the drug, missed the best treatment opportunity, leading to worsening or recurrence of the disease, and even prolonged unhealed."

The problem of patients not taking medicine on time or not taking medicine at all is becoming a problem in the world. In the United States alone, taxpayers spend between $100 billion and $289 billion a year on huge amounts of money, and health care workers are chronically unable to effectively monitor patients. In order to change this situation, many medical institutions and pharmaceutical companies have made various new attempts to use mobile medical models, such as mobile phone software, WeChat public number and other platforms for patient follow-up and medication reminders, or design and mobile phone software. The bound digital kit reminds the patient to take the medicine. "But some patients with mental illness are very resistant to taking drugs. They may also evade taking drugs by discarding drugs, hiding them under the tongue, getting stuck in their throats, or even vomiting." Wang Yong said frankly, "In the past, we only monitored patients. The drug concentration is used to determine the compliance of the drug, but there are obvious individual differences in the drug concentration, it is difficult to accurately reflect the drug taking situation, and it is necessary to draw blood frequently, which is very inconvenient and easily cause the patient to resent." Nowadays, the number is convenient and accurate. The advent of the pill finally solved this problem better.

Is 100% digital pills effective?

Technology has always been a double-edged sword. When the digital tablets came out, Ameet Sarpatwari, a lecturer at Harvard Medical School, said in an interview with The New York Times that although digital tablets are expected to improve public health in the future, if they are used improperly, they will “give more distrust, not trust. ".

When a digital tablet is approved for marketing, it is clearly stated that the final information of the digital tablet can be viewed by the patient on the smartphone, and the medical staff can receive the data immediately, but the information can be forwarded to the medical staff only if the patient agrees. Dr. Yin Yiqing, general manager of Shanghai Zhongshan Medical Technology Development Co., believes that such an approach overemphasizes the issue of “privacy protection”. “In the process of medical treatment, medical personnel need to be aware of some medical conditions and medical information. The limited scope of knowledge and mass communication are different. It is not beneficial to patients to inappropriately emphasize privacy protection. In this respect, it is necessary to strengthen legislation and protect according to law and regulations. And pass patient privacy information.

At the same time, he also expressed certain concerns about the effectiveness of digital tablets. Those who apply this kind of technology are mainly those who want to evade taking drugs for various reasons. For the time being, they are not a large number of chronic diseases that take the initiative. patient. "If the gastric juice environment is a condition for activating the sensors in the tablets, can they simulate an acidic environment in order to escape the medication?" He believes that the reliability of the current technology to track medications needs to be strengthened. "In addition to people with mental illness, tuberculosis and AIDS patients may also benefit in the future. Of course, digital tablet technology provides a new way to track patient compliance, and is still a valuable attempt."

As a clinician, Wang Yong also admitted that there are still some problems in the promotion of digital tablets. "At present, Otsuka Pharmaceutical has not announced the pricing of drugs, but it is estimated that the current stage is high, most patients may be unbearable; secondly, the number of patients with mental illness in China is increasing, and the resources such as psychiatrists are seriously insufficient, even if digital tablets are used. It is difficult to monitor the medication status of most patients, and perhaps more attention from family members and community-related personnel. Third, indeed, for many patients, this method may have control and discrimination components, so the most fundamental solution is Strengthen the publicity of mental health knowledge, let patients correctly understand their own diseases, and willingly cooperate with treatment."

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