Remote monitoring (also known as telemonitoring) can provide valuable feedback to healthcare providers on patients' adherence to treatment. For some conditions, combining new medicines and technologies to provide continuous or semi-continuous monitoring might enable the detection of signs of destabilization early enough to avert the need for hospitalization, which is the major cost driver in treatment of chronic disorders such as heart failure or chronic obstructive pulmonary disease.
Many forms of remote monitoring exist.
Improving outcomes with sensor-based systems
Sensor-based systems tend to consist of two main components:
A tiny, self-powered, ingestible sensor implanted in a medicine
An unmedicated receiver patch which is worn on the patient's abdomen
When a medication containing the sensor is swallowed, the sensor sends an ultralow power signal to the patch, identifying the ingested medicine and dose.
Patches can also monitor other basic physiological parameters (heart rate, skin temperature, physical activity levels and sleep). They can regularly collect this data, along with confirmation and timing of drug dosing, and send them from the patch in an encrypted format to a mobile phone. The patient alone has control over who views his or her data, including healthcare providers and caregivers.
Some sensor-based systems can capture detailed, individual adherence patterns for each patient - for example, monitoring instances of overdose, failure to take medication and activity level (for patients requiring exercise as part of a regimen). This provides an opportunity to potentially change the landscape of disease management and contribute to improved outcomes. Monitoring enabled by this technology in clinical trials could facilitate validation of Patient Reported Outcomes (PROs), a necessity for their acceptance by regulators. Its direct impact on more well-informed patient management could even facilitate reimbursement for a treatment or a disease management program.
Supporting better interaction with digital packaging technologies
Digital packaging technologies that improve adherence to treatment and support better patient/healthcare professional interaction are also interesting innovations in the area of remote monitoring.
Pillbox lids that use short-range wireless technology to monitor when a pillbox has been opened are a good example in this area. If the pillbox has not been opened, a message is sent to the patient's physician indicating that they have not taken their medication.
Smart blisters are based on the same concept - the blister packs use short-range wireless technology to monitor whether a pill has been taken. Because globally most prescription drugs are dispensed in blister packs rather than pillboxes, these blister packs enable the technology to reach a wider audience.
Novartis is committed to investing into valuable new, innovative technologies. The use of sensor-based and digital packaging technologies are being evaluated in combination with select Novartis products.
Ensuring that applications of telemonitoring remain compatible with patient privacy will be essential to broad adoption of these technologies. Despite this, the potential that remote monitoring offers to improve patient outcomes and reduce costs is immense.