A major challenge in public health is that people do not take their medications, a phenomenon known as 'medication non-adherence.' In the U. S. alone, it is estimated that this accounts for 10% of all hospital visits and costs the U. healthcare system $100 billion per year and $60 billion to the pharmaceutical industry. Now, a MIT research team thinks it has a solution to this problem and that it also will save lives worldwide. They've developed the uBox, a convenient, palm-sized, intelligent pill dispenser, 'which reminds a patient when it is time to take his medication, records when a patient has taken a dose, and prevents a patient from double-dosing.' The first large scale trial with 100 uBoxes is scheduled to begin in May 2008 in Bihar, India. The uBox will be used in a 6-month long tuberculosis (TB) treatment program. But read more.
You can see on the left the various elements of one uBox (Credit: MIT) This diagram was extracted from uBox - The Global Standard in Rural Treatment Programs (PDF format, 2 pages, 541 KB). In this document, you'll see that "the estimated cost for the basic version of the device is expected to be $7-8 in quantities of 1000 or more. The uBox is expected to last for 5 trials, thus costing under $2 per patient" -- or about one-tenth the cost of the current solutions available today.
This smart pillbox has been developed by Manish Bhardwaj, a doctoral student at MIT and the team he assembled, Innovators In Health. Here is another link showing the members of the team.
In fact, the team developed what they called "a high-tech solution in a simple, inexpensive and easy-to-use-package" with two major components. "The first part of the two-component system is a kind of "smart" pillbox, called the uBox. It has 14 chambers that can each be loaded with several pills, which it dispenses from one chamber per day. To alert the patient that it's time to take the medicine, the box flashes its lights and sounds a buzzer. When the compartment is opened, the uBox records the exact time and prevents double-dosing by refusing to open again until the next treatment is due. After two weeks, a health care worker reloads the box and digitally records and transmits the information stored in it. Doctors and public health services can then get complete data on compliance, patient by patient, in almost real time, instead of having to wait until the end of the six-month treatment."
But there is a second component. "The second part of the group's new system is a cell phone, called the uPhone. By using special software, health care workers can record a patient's temperature, weight, and answers to a list of questions related to symptoms, which adds to the set of detailed patient data analyzed by doctors monitoring the study. By looking at patterns of effects, the doctors can tell which field workers are achieving the best adherence rates with their patients and find out just what it is that those people are doing right. They can then be recruited to train additional workers."
Whenever I see the word Operation, especially Trifling Operation, I at once write off the patient as dead.
—George Bernard Shaw (1856–1950)
As I've mentioned above, the uBox will start to be tested in May 2008. You'll find additional details on this page. "The first large scale trial with 100 uBoxes is scheduled to begin in May 2008 in Bihar, India. The uBox will be used in a 6-month long tuberculosis (TB) treatment program run by the Prajnopaya Foundation in remote, rural areas with indigent populations. In 2006, Prajnopaya's directly observed therapy (DOT) program treated close to 600 patients with a 77% recovery rate."
Finally, the research team still needs about $150-200K to continue development and conduct trials to get to robust devices that can be manufactured in large quantities. So, in December 2007, it started to raise some funds online. The team wants to raise $10,000 online. And as of today, online donors have given $3,958 since December 16, 2007.
Sources: David Chandler, MIT News Office, February 6, 2008; and various websites
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I am extraordinarily patient provided I get my own way in the end.
—Margaret Thatcher (b. 1925)
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