Unobtrusive Sensing of Medication Intake ("USE-MI")

 描述（由申请人提供）：在此，我们寻求将联合收割机、“可穿戴设备”和近场通信技术组合在新颖的、集成的、不引人注目的系统中，以提高个体对分别用于治疗和预防HIV感染的抗逆转录病毒疗法（ART）和暴露前预防（PrEP）的依从性。艾滋病毒治疗和PrEP需要多年持续的高水平药物依从性，以实现最佳结果。迄今为止，关于改善药物依从性的干预措施的研究最多只能产生适度的改善，而昂贵的干预措施在研究环境之外是不可持续的。对负担得起的可持续治疗的需求不仅限于艾滋病毒护理;据估计，在发达国家，慢性病药物治疗的依从性平均约为50%，而获得大部分益处需要80%或更高的依从性-而ART需要95%或更高的依从性。如果成功，这种方法可以用于改善许多慢性健康状况的管理和结果，例如心脏病、哮喘、糖尿病和癌症。该系统被称为USE-MI（药物摄入的非侵入式感测），建立在数百万美国人使用的“可穿戴”电子设备的广泛社会接受的基础上，以建立个人健康目标并提供个人表现的实时监测和反馈。在该项目中，接受ART和PrEP的患者将利用USE-MI平台：通过使用智能手机和可穿戴设备警报的组合向患者提供不显眼的提醒，系统将灵活地提供谨慎的药物提醒，而不会引起对个人或行动的注意。不受干扰地检测药物摄入-运动传感和近场通信技术将允许实时确认服用药物，并在由于错误药物或错误时间导致的药物错误的情况下提供警报，而不需要患者采取任何特殊行动。提供患者反馈-智能手机应用程序将直接向患者报告他们的药物依从性，并提供有针对性的行为干预措施，以提高依从性。通过为临床医生和患者提供对药物调度应用程序的共享访问，改善患者和护理团队之间的沟通，该应用程序利用移动终端平台明确建立药物方案并根据需要立即更改方案。加强和监测药物依从性-将向患者和治疗团队提供一个简单的“仪表板”功能，以便讨论依从性、副作用最小化策略以及基于准确数据对药物方案的改进和调整。

 DESCRIPTION (provided by applicant): Here, we seek to combine smartphone, "wearable device" and near-field communication technologies in a novel, integrated, unobtrusive system to improve individual adherence to anti-retroviral therapy (ART) and Pre- exposure prophylaxis (PrEP) for the treatment and prevention, respectively, of HIV infection. HIV treatment and PrEP require high levels of medication adherence sustained over many years to achieve optimal outcomes. Research on interventions to improve medication adherence, to date, has produced at best modest improvements with expensive interventions that are not sustainable outside of the research setting. The need for affordable, sustainable treatments is not confined to HIV care; it has been estimated that adherence to medications for chronic diseases averages about 50% in the developed world, while 80% or better is needed to obtain most of the benefits - and 95% or better for ART. If successful, this approach can be used to improve the management and outcomes of many chronic health conditions, such as heart disease, asthma, diabetes and cancer. This system, referred to as USE-MI (Unobtrusive Sensing of Medication Intake), builds upon the broad social acceptance of "wearable" electronic devices used by millions of Americans to establish individual health goals and provide real-time monitoring and feedback of individual performance. In this project, patients undergoing ART and PrEP will utilize the USE-MI platform to: Provide unobtrusive reminders to patients by using the combination of smartphone and wearable device alarms, the system will flexibly provide discreet medication reminders without drawing undo attention to the individual or the action. Unobtrusively detect medication intake - motion sensing and near-field communication technology will allow real-time confirmation of taking medications and provision of alerts in the event of medication error(s) due to the wrong drug or the wrong timing, without requiring any special action by the patient. Provide patient feedback - the smartphone application will give patients direct reports of their medication adherence and enable delivery of targeted behavioral interventions to enhance adherence. Improve communication between patients and care teams by offering clinicians and patients shared access to a medication scheduling application utilizing a mobile device platform to unambiguously establish medication regimen and to make immediate changes to the regimen as needed. Enhance and monitor medication adherence - a simple "dashboard" function will be made available to the patient and the treatment team to enable discussions about adherence, side-effect minimization strategies, and improvements and adjustments to medication regimens based on accurate data.