P-103 - (Poster #103) Transforming patient care by equipping healthcare providers with the iPill ecosystem, an innovative in-home solution that ensures precise medication dispensing, real-time patient and medication adherence monitoring, and an unparalleled peace of mind.

The is no security or medication adherence enforcement in the home.  75% of patients don’t take their prescribed meds correctly resulting in 125,000 deaths and $290 billion in added medical expenses per year. If opioids are involved, patients can develop opioid use disorder (OUD) and another 100,000 opioid overdose deaths and $2.7 trillion in added costs result.  Unfortunately, only 11% with OUD are able to get access to care due to barriers such as transportation.  Due to opioid litigation and medicolegal scrutiny, physicians fear prescribing opioids, pharmacies are reluctant to store or dispense opioids, and manufacturers stopped making opioids. In the last decade, opioid prescriptions for acute pain have dropped by 44% and 40% for terminal cancer pain. We have a moral and ethical obligation to safely treat pain in the home.

Purpose/Objectives:

The purpose of our research is to find a  secure and safe way to treat pain in the home in which  remote monitoring of medication adherence is possible. The solution should only allow the prescription holder to have access to medications at only the prescribed dose and time. We have found that using a mobile app to authenticate the patient using two-point biometrics and using it to operate a secure dispenser that detects missed daily doses, and alerts family, friends, and caregiver so remediation of the missed daily dose can occur.

Methods:

Six patients were chosen and consented for the study who were on a maintenance Suboxone dose of 16 mg per day. They were given a locked smartphone phone preloaded with the iPill app. They were also given the IPill Dispenser preloaded with 60 pills of 8 mg Suboxone 2 mg naloxone.  Patients were instructed on use of the iPill app authenticate their face print with two point biometrics, connect to the IPill Dispenser via bluetooth, and self dispense their daily medications at the prescribed times.

Results:

All 6 patients operated the iPill dispenser for 30 days correctly. No tampering detected iPill Dispenser was detected. 2 patients were detected to have missed their daily dose and alerts were sent to the family, friends and caregiver. Cause from the family to remind the patient to take their medications completed of the missed daily dose.   No other daily doses were missed and no other patients missed  their daily dose. Physicians were able to asynchronously review videos of patients, taking their medications as prescribed.  No patients seen in the emergency room or additional provider contact was needed.

Conclusions/Implications for future research and/or clinical care:

Though the study was small in size, it was noted that:

• A biometric secure dispenser could be used for home delivery and precise dispensing of medications in the home only the prescription holder could have access to the medications at only the prescribed dose and time


• A mobile app and secure dispenser could be used to as a method to remotely monitor and improve medication adherence


• Capture of data from remote medication adherence monitoring could be used by physicians to possibly improve patient outcome

• • iPill could possibly be used to prevent medication abuse, diversion, or accidental overdose with secure home storage and precise home dispensing.