“Digital Pills” – Answer to Compliance, or Slippery Slope?
Node Smith, ND
Could “digital pills” be the next big ethical question in medicine?
Digital pills, ingestible sensors encapsulated in a gelatin coating, can now be taken along with medications to track drug use patterns.1 Clinicians at Brigham and Women’s Hospital are currently using the new technology to monitor patient usage of prescribed opioids.2
Digital Pill Study
The study looked at 15 patients who received prescriptions to take oxycodone digital pills as needed for pain management of an acute fracture. They found that opioid-naive patients self-administered the drugs for only a brief period of time, and only took a fraction of the total number of pills prescribed. The thought that this technology could be used to monitor the growing opioid usage crisis is realistic, according to the researchers.
Study Utilized the “eTectRx ID-Cap” System
The study utilized the “eTectRx ID-Cap” system. Pills in the system have a unique radio-frequency emitter within a standard gelatin capsule containing the medication to be delivered, an oxycodone tablet in the case of this study. As the capsule dissolves, the medication is released and chloride ions energize the emitter. A patch is worn by the patient on their abdomen, which is attached to a cable reader (about the size of an iPhone) that stores data on pill ingestion. The technology is interfaced with smartphone technology and ran through an app. Individuals do need to wear the monitor in order for the process to work.
A Compelling Idea to Manage Potential Opioid Addiction
The idea that this technology would, or could, help manage potential opioid addiction is certainly compelling. The senior author of the study at BWH, Edward Boyer, MD, PhD, said “This technology may also make it possible for physicians to monitor adherence, identify escalating opioid use patterns that may suggest the development of tolerance and addiction and intervene.” Yet, the question of using these digital pills to monitor other drugs is also being explored. In fact, the FDA has approved the first digital pill for use with the antipsychotic drug, Abilify – not an opioid.
- Wang J, Fang H, Carreiro S, Wang H, Boyer E. A New Mining Method to Detect Real Time Substance Use Events from Wearable Biosensor Data Stream. Int Conf Comput Netw Commun. 2017;2017:465-470.
- Chai PR, Carreiro S, Innes BJ, et al. Digital Pills to Measure Opioid Ingestion Patterns in Emergency Department Patients With Acute Fracture Pain: A Pilot Study. J Med Internet Res. 2017;19(1):e19.
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Node Smith, ND, is a naturopathic physician in Portland, OR and associate editor for NDNR. He has been instrumental in maintaining a firm connection to the philosophy and heritage of naturopathic medicine among the next generation of docs. He helped found the first multi-generational experiential retreat, which brings elders, alumni, and students together for a weekend camp-out where naturopathic medicine and medical philosophy are experienced in nature. Four years ago he helped found the non-profit, Association for Naturopathic ReVitalization (ANR), for which he serves as the board chairman. ANR has a mission to inspire health practitioners to embody the naturopathic principles through experiential education. Node also has a firm belief that the next era of naturopathic medicine will see a resurgence of in-patient facilities which use fasting, earthing, hydrotherapy and homeopathy to bring people back from chronic diseases of modern living; he is involved in numerous conversations and projects to bring about this vision.