New Smart Pills: A Little Too 'Big Brother'?

As all NP's know, once your patient leaves the office it is up to them to comply with your medical recommendations.  Take it or leave it, you are not going home with them to administer their medications three times a day.  Or are you?  A new 'smart pill' promises to measure and report medication compliance. 

The FDA has just approved a new product called the 'Ingestion Event Marker'.  This device, the size of a grain of sand, can be integrated into a pill and safely ingested.  Once the pill reaches the stomach, digestive juices activate the sensor sending a signal through the body to a patch worn on the torso. The patch detects when the pill was ingested and wirelessly sends a signal to a program on either a mobile phone or computer.

The product's manufacturer, Proteus Digital Health believes this technology will be useful in monitoring compliance to medication regimens.  Dr. George Savage, co-founder of Proteus states "This isn't about doctors browbeating people or monitoring compliance in some sort of negative way...these are tools to help people understand their behavior and to provide directed education and other interventions to achieve their goals".  Proteus plans to market the product alongside a British pharmaceutical company using a subscription based service.  In the United States, Proteus is working with Novartis to add the sensor to immunosuppressive medications prescribed to recipients of organ transplants.

Proponents of this new technology believe it will increase medication adherence.  Studies show that one-third of prescriptions never get filled and that one-third of hospital admissions are related to non-compliance with drug regimens.  Non-adherence to medical advice results in an estimated $100 billion in healthcare costs in the U.S. alone.  But will this technology be useful in everyday practice?

To be honest, when I first heard about this new sensor I was a little freaked out. 'Big brother is watching you' are the first words that came into my mind after learning about this new smart pill.  Although this new technology is very interesting on an intellectual level- whoever thought you could swallow a sensor with your daily Lipitor (very Mission Impossible)- I think we need to let our patients make their own decisions.  As healthcare providers it can be easy to take a paternalistic attitude toward our patients.  Becasue we went to school to study medicine, we take the 'listen to us, we have all the right answers' approach.  We don't give our patients enough credit.  Our patients are smart enough to listen to our advice, know what their prescriptions are for and evaluate the positive and negative effects of taking them.  It is our job to encourage healthy behaviors and inform about medical conditions but not to enforce.