Disposable, medication-integrated tactile and motion sensor for glaucoma therapy compliance improvement

用于改善青光眼治疗依从性的一次性药物集成触觉和运动传感器

基本信息

批准号：
10010396
负责人：
Landon Ray Grace
金额：
$ 21.99万
依托单位：
RETINAL CARE, INC.
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-06-01 至 2021-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10010396
关键词：
Accelerometer Adherence Adoption Affect Age related macular degeneration American Antihypertensive Agents Behavior Behavioral Blindness Businesses Caring Cells Cellular Phone Clinical Clinical Trials Coin Communication Consumption Coupled Custom Data Data Sources Development Device or Instrument Development Devices Diabetic Retinopathy Direct Costs Dose Drops Education Educational Intervention Effectiveness Electrical Engineering Electronics Engineering Eye Eye diseases Eyedrops Failure Feedback Film Generations Glaucoma Goals Hand Health Healthcare Human Incentives Individual Intervention Kinetics Label Liquid substance Measurement Mechanics Medical Medical Device Memory Methods Mining Mobile Health Application Modeling Motion Nylons Ophthalmology Patients Performance Peripheral Pharmaceutical Preparations Physiologic Intraocular Pressure Plant Roots Polyurethanes Primary Open Angle Glaucoma Provider Psychosocial Factor Quality of life Radio Recommendation Regimen Resistance Retina Tactile Technology Testing Textiles Thinness Time Topical application Touch sensation Training Translating United States Vision Visual Fields Visual impairment Work advanced analytics analog base care coordination compliance behavior cost data integration deep learning design improved improved outcome incentive strategies individual patient innovation insight interoperability iterative design kinematics motion sensor novel patient engagement performance tests predictive modeling preference preservation prevent productivity loss prototype recruit screening sensor tool treatment adherence usability wearable device

项目摘要

ABSTRACT Glaucoma is the leading cause of irreversible blindness in the world. The number of people with primary open angle glaucoma is expected to exceed 100 million by 2040. The first-line therapy for glaucoma treatment is patient-administered hypotensive medication delivered topically via an eye drop. However, studies have consistently shown that patients rarely adhere to dosing recommendations. According to the Wilmer Glaucoma Center of Excellence, nearly 50% of individuals discontinue eye drops within six months of their first prescription. Of those that persist beyond six months, only 37% continue the therapy after three years, and only 10% of those prescribed glaucoma drops are persistent (without gaps) over the first year. Failure to adhere to dosing recommendations dramatically limits the effectiveness of eye drops in lowering intraocular pressure and delaying or preventing the progression of glaucoma. This well-known problem has prompted the development of several technological solutions for tracking adherence. Retinal Care's proposed solution is fundamentally different. The proposed device is a simple and inexpensive combination of sensors designed to provide feedback to patients, providers, payers, and care coordinators regarding the way a patient interacts with their medication. Tactile and motion data is acquired through a custom force-sensitive resistor (FSR) and a standard three-axis accelerometer. Combined, these two data sources provide significant insight into drop adherence, application mechanics, and patient behavior. More importantly, this data can inform decisions on how and when to intervene with a patient to maximize the likelihood of continued long-term drop adherence and vision preservation. The primary innovations are in the single-use design (enabled by low-cost custom FSR fabrication and the unique combination of low-cost electrical components), the novel mining of motion and tactile information for patient adherence and behavioral data, and the integration with an existing care coordination framework. Retinal Care approaches health care more holistically than traditional companies; recognizing the behavioral and psychosocial factors that are a root cause of blindness from eye diseases like glaucoma. While Retinal Care employs cutting-edge technology such as deep learning and advanced medical devices, we work actively toward implementing technology in a way that translates directly to improved quality of life for our patients by managing the entire care path. The technology proposed here, while novel in design, is not intended primarily as a tracking tool, though it will accomplish that sub-goal with greater effectiveness and at less cost than any existing product. Instead, it is designed explicitly to reduce blindness by providing the crucial data needed to tailor our interaction and intervention strategies to the individual patient; to maximize patient engagement and adherence to glaucoma care through a combination of education, incentivization, tailored communications, and personal interaction with our trained care coordinators. The goal of this project is to demonstrate feasibility (cost and functionality) of the simple device that will enable Retinal Care to effectively reduce blindness and visual impairment from glaucoma.

抽象的青光眼是世界上不可逆失明的主要原因。主要开放人数到2040年，角度青光眼预计将超过1亿。青光眼治疗的一线治疗是患者接受的降压药通过眼部滴局部递送。但是，研究有一贯表明，患者很少遵守给药建议。根据威尔默青光眼卓越中心，将近50％的人在第一次处方后六个月内停止眼睛下降。在持续超过六个月的人中，只有37％的人在三年后继续进行治疗，其中只有10％在第一年，规定的青光眼滴剂是持久的（没有差距）。不遵守给药建议极大地限制了眼滴在降低眼压和延迟方面的有效性或防止青光眼的进展。这个众所周知的问题促使了几个跟踪依从性的技术解决方案。视网膜护理的建议解决方案根本不同。这提议的设备是一种简单且廉价的传感器组合，旨在为患者提供反馈，提供者，付款人和护理协调员关于患者与药物互动的方式。触觉和运动数据是通过自定义力敏感电阻（FSR）和标准的三轴获取的加速度计。这两个数据源结合在一起，可以对下降依从性，应用提供重大见解力学和患者行为。更重要的是，这些数据可以为如何以及何时干预的决定提供信息患者最大程度地提高了持续的长期下降依从性和视力保存的可能性。主要创新是在一次性设计中（通过低成本自定义FSR制造和独特的低成本电气组件的组合），患者的运动和触觉信息的新颖开采依从性和行为数据，以及与现有护理协调框架的集成。视网膜护理比传统公司更全面地进行医疗保健；认识到行为和大会因素是诸如青光眼之类的眼部疾病的根本原因。视网膜护理采用尖端技术，例如深度学习和高级医疗设备，我们积极致力于通过管理，以直接转化为改善患者的生活质量的方式实施技术整个护理道路。这里提出的技术虽然是设计小说，但并非主要是作为跟踪工具，尽管它将以比任何现有产品更高的有效性和更低的成本来完成该子目标。相反，它是通过提供定制互动所需的重要数据来明确设计的，以减少失明和对个别患者的干预策略；最大程度地提高患者参与并遵守青光眼通过教育，激励，量身定制的沟通以及与个人互动的结合来照顾我们训练有素的护理协调员。该项目的目的是证明该项目的可行性（成本和功能）简单的设备将使视网膜护理有效地减少青光眼的失明和视觉障碍。