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

摘要 青光眼是世界上不可逆性失明的主要原因。主要开放的人数 预计到2040年，角型青光眼将超过1亿。青光眼治疗的一线疗法是 通过滴眼剂局部递送的患者给药的消肿药物。然而研究 一致表明患者很少遵守剂量建议。根据威尔默青光眼的诊断 在卓越中心，近50%的人在第一次处方后六个月内停用眼药水。 在那些坚持超过六个月的人中，只有37%的人在三年后继续治疗，只有10%的人在三年后继续治疗。 处方的青光眼滴剂在第一年内是持久的（没有间隙）。未能坚持给药 这些建议极大地限制了滴眼液在降低眼内压和延迟眼内压方面的有效性。 或预防青光眼的进展。这个众所周知的问题促使了几个 跟踪遵守情况的技术解决方案。视网膜护理的解决方案是根本不同的。的 所提出的设备是设计用于向患者提供反馈的传感器的简单且廉价的组合， 提供者，付款人和护理协调员关于患者与其药物相互作用的方式。触觉和 运动数据是通过一个自定义的力敏电阻（FSR）和一个标准的三轴 加速度计结合起来，这两个数据源提供了重要的洞察下降的坚持，应用 力学和病人行为。更重要的是，这些数据可以为如何以及何时进行干预的决策提供信息 以最大化持续长期滴注坚持和视力保护的可能性。 主要创新在于一次性设计（通过低成本定制FSR制造和独特的 低成本电子元件的组合），为患者提供新颖的运动和触觉信息挖掘， 依从性和行为数据，以及与现有护理协调框架的整合。视网膜护理 比传统公司更全面地对待医疗保健;认识到行为和 心理社会因素是青光眼等眼病导致失明的根本原因。视网膜护理 采用尖端技术，如深度学习和先进的医疗设备，我们积极致力于 以一种直接转化为改善患者生活质量的方式实施技术， 这里提出的技术，虽然设计新颖，但主要不是为了跟踪 工具，尽管它将以比任何现有产品更高的效率和更低的成本实现这一子目标。 相反，它的设计是明确的，通过提供定制我们的互动所需的关键数据来减少失明 和干预策略;最大限度地提高患者对青光眼的参与度和依从性 通过教育、激励、量身定制的沟通以及与 我们训练有素的护理协调员。该项目的目标是证明可行性（成本和功能）的 简单的设备将使视网膜护理能够有效减少青光眼引起的失明和视力损害。

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.