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Digital Pill. Schizophrenia drug.

Source: Otsuka

The U.S. pharmaceutical drug regulator  (Food and Drug Administration, FDA) approved this week (on Nov 13) the first drug with a digital ingestion tracking system. Abilify MyCite (aripiprazole tablets with sensor) has an ingestible sensor embedded in the pill that records that the medication was taken. The product is approved for the treatment of schizophrenia, acute treatment of manic and mixed episodes associated with bipolar I disorder and for use as an add-on treatment for depression in adults.

The NY Times raises privacy and coercion concerns. The FT and NYT both discuss problems around compliance and adherence* of taking drugs.   Adherence to prescription drugs is remarkably low at only about 50%** (in one study, though I’ve seen 75% in others which I can’t locate)  Although a tracker might only address one part of the myriad of problems with adherence.

There are other two points, I view, as more intriguing.

The two other aspects not picked up are (1) Branded drug defence [generic makers won't have this] and (2) The historic (arguably still be present) of use of anti-psychotic drugs to keep patients sedated in care homes to make it easier for the patients to be handled but not in the patients’ best interests.  This has included patients with autism, learning disabilities and dementia.

The positive news here is that better awareness is driving this abuse of drugs as a chemical restraint down.  The bad news, is that is still seems prevalent.

A UCL study here on the abusive practice in UK. A NPR report on same issue here in US.


**See this Mayo Clin paper here.   

“approximately 50% of patients do not take their medications as prescribed. Factors contributing to poor medication adherence are myriad and include those that are related to patients (eg, suboptimal health literacy and lack of involvement in the treatment decision–making process), those that are related to physicians (eg, prescription of complex drug regimens, communication barriers, ineffective communication of information about adverse effects, and provision of care by multiple physicians), and those that are related to health care systems (eg, office visit time limitations, limited access to care, and lack of health information technology).”

*There is some healthcare philosophy behind these terms.  Often, the terms adherence and compliance are used interchangeably. However, their connotations are somewhat different: adherence presumes the patient's agreement with the recommendations, whereas compliance implies patient passivity. As described by Steiner and Earnest,5 both terms are problematic in describing medication-taking behavior because they “exaggerate the physician's control over the process of taking medications.”


If you'd like to feel inspired by commencement addresses and life lessons try:  Neil Gaiman on making wonderful, fabulous, brilliant mistakes; or Nassim Taleb's commencement address; or JK Rowling on the benefits of failure.  Or Charlie Munger on always inverting;  Sheryl Sandberg on grief, resilience and gratitude or investor Ray Dalio on  on Principles.

Cross fertilise. Read about the autistic mind here