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by dubious66 » Tue Nov 14, 2017 5:25 pm

This pill allows patients (and others) to track whether it’s taken

Devices can already track our every move, but are pills next? The FDA has approved a drug with a digital ingestion tracking system. The Abilify MyCite tablet, meant to treat schizophrenia and bipolar disease, has a tiny sensor that sends information on digestion to a wearable patch and ultimately to a mobile app. A doctor or caregiver can also track the pill through a web portal. Freaking you out? Some experts worry there could be ethical implications with tracking devices on pills. Welcome to the future.
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by hal » Tue Nov 14, 2017 5:28 pm

I read about this and get your outrage, but I'm more interested in learning how it works. Sorry, it's just my type (INTP). :lol: :lol:
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by Lisa » Tue Nov 14, 2017 6:12 pm

Is there any reason to track whether or not a person is taking their meds? Like what do you do, force them to take a pill?
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by dubious66 » Tue Nov 14, 2017 6:24 pm

Lisa wrote:Is there any reason to track whether or not a person is taking their meds? Like what do you do, force them to take a pill?



Yep, because crazy people can't be trusted and should be forced to medicate if they want to be out in the world with the supposed normals.

Such a scary slippery slope...

Flippantly, resentfully,

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by Lisa » Tue Nov 14, 2017 7:55 pm

Dubious66 wrote:
Lisa wrote:Is there any reason to track whether or not a person is taking their meds? Like what do you do, force them to take a pill?


Yep, because crazy people can't be trusted and should be forced to medicate if they want to be out in the world with the supposed normals.

Such a scary slippery slope...

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What do you have to do to warrant that? My mom was hospitalized when I was a child, I don't even know if it was forced.
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by hal » Tue Nov 14, 2017 8:38 pm

I think dub was being sarcastic. ;)
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by dubious66 » Tue Nov 14, 2017 9:11 pm

Forewarning: a bit ranty...


hal wrote:I read about this and get your outrage, but I'm more interested in learning how it works. Sorry, it's just my type (INTP). :lol: :lol:




Noncompliant patients costs billions. This tracking will monitor compliance so that noncompliant patients can be identified and behavior modification techniques can be applied to "encourage" compliance. No privacy concerns here folks. Totally trust this. What possible (un)intended negative consequences could possibly arise? It's not like this could ever be used to say cancel insurance coverage. (Yes, I am being sarcastic...this is frightening IMO.) Instead of improving the effectiveness and reducing side effects of medication, figuring out how to be completely intrusive and potentially force compliance is a better use of money. Do you think a patient would have to consent to the behavior modification? One of the first drugs? "Abilify MyCite" Frightening... Aluminum foil hat anyone? It's not paranoia if they really are out to get ya...


For you hal...
“We are delighted that our collaborative work with the FDA continues to enable positive progress,” said Dr. George Savage, Proteus co-founder and CMO, in a press release. “We believe that ingestible devices have the potential to speed clinical trials and improve the real-world effectiveness of medicines in community settings.”

According to Proteus, 50 percent of patients do not follow their prescribed medication regimen, leading to worsening of chronic conditions and increasing healthcare costs that total $100 billion to $300 billion annually in the U.S. Proteus says it is addressing this problem through digital medicine — ingestible sensors embedded in smart pills that transmit data to skin-worn receiver patches and smartphones.

"When used with a medication, the Proteus Ingestible Sensor marks actual intake time, a quantifiable event that has allowed regulators to grant the expanded indication to the company. The Ingestible Sensor was approved by the FDA in 2012 and communicates with an adhesive patch, worn on the torso. The Proteus Patch records time of ingestion along with steps, rest and heart rate, and communicates to a mobile app via Bluetooth," states the company release.

As described in a study published in the journal IEEE Transactions on Biomedical Engineering, the ingestible sensor is "the first instance of a microfabricated integrated circuit developed and approved for daily ingestion by patients." When patients ingest pills embedded with the tiny sensors, thin layers of magnesium, copper, and gold inside the circuit react with gastric fluid and trigger an electrochemical reaction that powers the sensor. The sensor then transmits a digital code containing the type of medication, dosage, and time of ingestion to the patch worn by the patient. This data is correlated with other biometric information measured separately by the patch, such as heart rate, respiration, and sleep activity. The patch then sends the combined data to a smartphone app via Bluetooth.

According to the study, in order to test the system's safety and performance, a series of clinical studies have been performed since 2008, comprising more than 20,993 device ingestions in healthy patients, as well as patients with hypertension, heart failure, diabetes mellitus, tuberculosis, bipolar affective disorder, and schizophrenia. Proteus claims the sensor recorded ingestion events with 99.1 percent accuracy, and 100 percent correct identification of the type and dose of the drug taken. No serious adverse events (SAEs) or unanticipated adverse device effects (UADEs) were recorded.

Proteus claims that, by directly measuring ingestion events, its sensors can provide clinicians with a patient's pattern of adherence to oral medication therapy regimens and provide a baseline for possible behavior modification.
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by AvantGarde » Tue Nov 14, 2017 9:42 pm

Yeah, I knew about this. FDA approved it now, or a while back?

Either way, I wouldn't agree to take that pill for sure. I remember talking to other folks with MI about this and the consensus was that it's too evasive of one's privacy. It should come with a contract between patient and prescriber, not to violate any human rights law.

In my country, not taking meds warrants hospitalization, don't know about there.

Edit to clarify, warrants hospitalization if the person has gone bezerk and is a danger to themselves or others, not if the person is okay (at least by law, I've heard stories)
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by Mocha » Tue Nov 14, 2017 10:44 pm

AG, the FDA just approved this on Monday, Nov. 14th, 2017.

I think it's bullshit, and no way would I ever consent to this crap. There's big brother, and then there's big brother. Idiots.

It's made by Japan-based Otsuka Pharmaceutical Co. for schizophrenia, BPI, and depression. Even though Abilify MyCite is to supposedly improve a patient's compliance, even the FDA says it hasn't been proven......wtf did they approve it for then.....??

I also read than neither Otsuka or Proteus (the company who developed the wearable patch, a CA company) wouldn't answer further requests for comment. hmm......Makes you wonder what they have to hide.

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by AvantGarde » Tue Nov 14, 2017 10:54 pm

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by Jemane » Wed Nov 15, 2017 1:06 am

This is really creepy. Never heard of it before. I’m guessing it wouldn’t be us medication compliant types that they would use it on. In Australia patients can be made involuntary if they are a danger to themselves or others and i think they wouldn’t be given a choice. Use it or get locked up would be the threat. It would be instead of depot injections which is what they currently use in involuntary patients.
I think the expense over depots would make it highly unlikely that it will take off here as it’s the government funded patients (ie poorer patients) who are generally involuntary and I don’t think the government would want to fund expensive medicine.
Anyway, just the Australian perspective anyway.
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by Pancake » Wed Nov 15, 2017 1:16 am

:shock: make sure the don't... get... looosssst :?

I've known a few people with schizophrenia. One thought the police had put a microchip in his head whenever his version of reality went sideways. (He liked the cops though, and would ask if they could send tech services around to take a look at it).

I don't see how *actually* making their psychoses come true is going to do anything but harm to people that are already prone to paranoia and delusions.

I guess there might be a cohort of people who request it based on their own circumstances. If they know they're prone to stop taking meds due to brain hijacking and want support to kick in if that happens, maybe?
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by AvantGarde » Wed Nov 15, 2017 2:33 am

It would definitely make me paranoid.. can't imagine what it would do to paranoid schizophrenics.

Even in a "take it or face the consequences" kinda situation, it would put too much power in the hands of pdocs.

Here, once you're forcefully locked up and get out, you have to go to court for the judge to determine if you're going to be under forced supervision of a pdoc for an indefinite period of time, or are free to make your own choices regarding treatment. And I already think that is a human rights violation.

I do admit to it being handy in extreme circumstances.
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by hal » Wed Nov 15, 2017 7:00 am

Thanks for the technical information, dub. I still can't imagine how they get all the electronics on a capsule. And I question the routine ingestion of magnesium, copper, and gold. Swallowing chips??? Plus the cost must be astronomical.
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by dubious66 » Wed Nov 15, 2017 12:45 pm

hal wrote:Thanks for the technical information, dub. I still can't imagine how they get all the electronics on a capsule. And I question the routine ingestion of magnesium, copper, and gold. Swallowing chips??? Plus the cost must be astronomical.


Several years ago, my mom had a medical procedure done that required her to swallow an itty bitty camera that took pictures all the way down. I didn't get how that could. be either, but it was fascinating.
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by Mocha » Thu Nov 16, 2017 7:58 am

dubious66 wrote:Several years ago, my mom had a medical procedure done that required her to swallow an itty bitty camera that took pictures all the way down. I didn't get how that could. be either, but it was fascinating.

I've had this done several times with the little camera...called an upper endoscopy......

All the way up too, if you get my drift........ :twisted: ...
(Not so fascinating....:roll:)

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by dubious66 » Thu Nov 16, 2017 10:42 am

Mocha, was that with the scope? My mom was a fan of that too. This was a pill that took pictures all the way through from start of areas covered by endoscopy to areas covered by colonoscopy.She once also had a simultaneous (maybe they did those consecutively) endoscopy and colonoscopy. My mom was pretty easy going about letting people poke and prod her. To even things out, I refuse to let anyone look at anything more than my mouth. Regression to the mean :)
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by Mocha » Fri Nov 17, 2017 8:10 am

dubious66 wrote:Mocha, was that with the scope? My mom was a fan of that too. This was a pill that took pictures all the way through from start of areas covered by endoscopy to areas covered by colonoscopy.She once also had a simultaneous (maybe they did those consecutively) endoscopy and colonoscopy. My mom was pretty easy going about letting people poke and prod her. To even things out, I refuse to let anyone look at anything more than my mouth. Regression to the mean :)


Dub, I could have sworn I replied to your post....and it was a good reply too....lol...but somehow I deleted it by accident, and was too tired to start over last night.....sigh. Let's see if I can hit the high points before I have to run errands this am.

In the US.....and I'm sure other countries, not for sure though...pretty sure......docs use the 'pill' in place of the regular endoscopy and colonscopy. Not just for MI patients to see if they are being med compliant and all that, some docs/patients just find it easier. And as I'm sure you know, colonoscopy is not most peeps favorite thing to do, so if they are offered an easier way, they'll probably take it. As one of you guys mentioned above thousands of images are taken and recorded as the pill passes though the gastro system. All the way through, and eventually is 'pooped' out. And it can take days for that to happen.

Personally, I'm not in favor of it. I prefer the old skool way. I have a history of ulcers, gastritis, a hiatal hernia, etc, and I have the usual endoscopy......tube with camera down the throat.

And I prefer the regular colonoscopy. Not because it's the most fun in the world, but because if they find anything 'bad', they can take care of it right then. With the pill, if they see anything on the recordings, they're going to have to go back and do a colonoscopy anyway. And with the pill, it could take quite some time to get the results......what if it's something urgent, something doc could have seen right away during colonoscopy. And taken care of immediately if necessary.

That's why I use a surgeon for each procedure, not a gastro. I want someone who can go ahead and take care of business as fast as possible if needed. Not have to wait on another referral from a gastro to a surgeon.


Dub wrote: To even things out, I refuse to let anyone look at anything more than my mouth. Regression to the mean :)

:lol: .....I don't normally let anyone touch me period......no no no.....at least three feet of personal space and sometimes that's not enough.
But I'm ok with medical staff/issues. Probably because I've had so much to deal with.

But then again, that's probably why I put stuff off as long as I do..........broken bones and all....... :lol:




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by Tigger » Fri Nov 17, 2017 7:55 pm

I really do get the outrage. But the thing is, you have to consent to taking the pill in the first place. So, this is a self-selecting group.

I have serious mental illness in my family. And serious non-compliance. I can see how this kind of tracking helps to understand the issue of compliance vs. non compliance.

As a parent who is responsible for my kid and an aunt who may be responsible for my brother's kids in the future, this can give important data. We manually chart meds intake, moods and environmental factors. We're like mini research assistants. So this info is helpful.

But I truly do get the issue with autonomy. I still see it as helpful because I firmly believe that no one *really* cares what you do individually, just collectively.

Hope that helps.
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by AvantGarde » Fri Nov 17, 2017 9:21 pm

Tigger wrote:I really do get the outrage. But the thing is, you have to consent to taking the pill in the first place. So, this is a self-selecting group.


Not really, no. I never consented to go on a injection without trying the pills first to see if I could tolerate it, but yet here we are. Once you're forcefully commited you have very little say in the matter of your treatment..

I do understand that it would be easier for caretakers, but it's too much control. In my country there's a saying "passing an assessment of disability" when there isn't that need, the grand majority of mentally ill people know how and when and why they take their meds.
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by Pancake » Fri Nov 17, 2017 9:27 pm

But the thing is, you have to consent to taking the pill in the first place. So, this is a self-selecting group.

Only in an ideal world would that be the only way this goes down.

Aside from what AG says, there are also drs who will find it convenient, and refuse their patient other options. Not everyone has the luxury to access another dr, especially those, as Jemane mentioned, involuntary patients are more likely to be more disadvantaged. Sometimes it's not going to be a matter 'if you don't agree, there's the door', because if you want treatment, that's the only dr/choice you have.
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by AvantGarde » Fri Nov 17, 2017 9:41 pm

Pancake wrote:Sometimes it's not going to be a matter 'if you don't agree, there's the door', because if you want treatment, that's the only dr/choice you have.


That happened to me with previous pdoc and Li. And it was a public doc. I'm one of the fortunate ones who could switch to private.

My friend with schizophrenia doesn't really have a voice in a matter of his treatment, diagnosis or whatever it needs to be said. He has changed docs 10, 15 times and it's always the same deal, ones worse than others.

There in that treatment center, they shove everyone who just got out of a forced hospitalization for psychosis with the same med and hope for the best. If that med doesn't work out, they try haldol.

There are so many human rights violations in mental health that it is appaling. No matter if it's 3rd world countries or 1st world countries, if you're mentally ill and you have no money it's most likely that you'll have a problem trying to stand up for yourself.

Plus, this reminded me of a situation on another board with a person with schizophrenia who's father was abusive. The pdoc didn't believe them, forcefully commited them for "paranoia" and "being a danger" to the father when they only defended themselves, upped all their meds and put the father on the loop of every little step. When they got out of the hospital, the only thing they could do was rely on a charity housing service to get out of there, and eventually switched pdocs. This was in the US.
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by Jemane » Fri Nov 17, 2017 11:18 pm

AG, just wondering what was your concern about Li? I’ve been on it awhile now. Are you concerned about kidney problems as I often worry about this?
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by AvantGarde » Fri Nov 17, 2017 11:25 pm

I didn't want to try Lithium, all my pdoc friends advised me against it. Previous pdoc was big on high doses, which I'm very much against.

He also only asked for bloodwork once every 6 months, when I asked, so I'm not sure he would check for toxicity as regularly as needed. Didn't want to find out the hard way.
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by Jemane » Fri Nov 17, 2017 11:27 pm

Fair enough. My pdocchecks my level regularly so I’m feeling pretty safe.
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