Early clinical experience with networked system for promoting patient self-management

Kit Yee Au-Yeung, Greg D. Moon, Timothy L. Robertson, Lorenzo A. DiCarlo, Michael S. Epstein, Stephen Weis, Randall R. Reves, Gregory Engel

Research output: Contribution to journalArticleResearchpeer-review

24 Citations (Scopus)

Abstract

Objective: To gain early experience with a networked system designed to assess a patient's adherence to oral medication and physiologic metrics in an ambulatory, at-home setting. Study Design: Prospective, observational studies. Materials and Methods: This networked system for patient self-management consists of ingestible markers and a wearable, personal monitor. When a marker is ingested, it communicates to a monitor that time-stamps the ingestion and identifies the marker as unique. The monitor also records heart rate and activity. Data from third-party monitoring equipment (eg, sphygmomanometer, weight scale) can be integrated into the system. Collected data are summarized for patient and physician review. Directly observed ingestion (DOI) of placebo tablet markers was used to assess the system's technical performance. Markers were also coencapsulated with drugs to capture at-home adherence. A performance criterion of ≥95% was set as the objective for system performance. Results: A total of 111 subjects ingested 7144 ingestible markers; 3298 were DOIs. The system's positive detection accuracy and negative detection accuracy in detecting ingested markers were 97.1% and 97.7%, respectively. It differentiated 100% of multiple drugs and doses taken simultaneously by type and by dose. Medication adherence was >85%. The most common adverse effect was mild skin rash from the monitor's electrodes. No definitive marker-related adverse effects were reported. Conclusion: The system appears to be safe and effective in capturing and integrating adherence and physiologic data. Efforts are under way to enhance system functionalities and refine user interfaces. By providing context-rich information, this system may enhance patient-provider collaboration.

Original languageEnglish
JournalAmerican Journal of Managed Care
Volume17
Issue number7
StatePublished - 1 Jul 2011

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Self Care
Eating
Sphygmomanometers
Medication Adherence
Patient Compliance
Exanthema
Pharmaceutical Preparations
Tablets
Observational Studies
Electrodes
Heart Rate
Placebos
Prospective Studies
Physicians
Weights and Measures
Equipment and Supplies

Cite this

Au-Yeung, K. Y., Moon, G. D., Robertson, T. L., DiCarlo, L. A., Epstein, M. S., Weis, S., ... Engel, G. (2011). Early clinical experience with networked system for promoting patient self-management. American Journal of Managed Care, 17(7).
Au-Yeung, Kit Yee ; Moon, Greg D. ; Robertson, Timothy L. ; DiCarlo, Lorenzo A. ; Epstein, Michael S. ; Weis, Stephen ; Reves, Randall R. ; Engel, Gregory. / Early clinical experience with networked system for promoting patient self-management. In: American Journal of Managed Care. 2011 ; Vol. 17, No. 7.
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abstract = "Objective: To gain early experience with a networked system designed to assess a patient's adherence to oral medication and physiologic metrics in an ambulatory, at-home setting. Study Design: Prospective, observational studies. Materials and Methods: This networked system for patient self-management consists of ingestible markers and a wearable, personal monitor. When a marker is ingested, it communicates to a monitor that time-stamps the ingestion and identifies the marker as unique. The monitor also records heart rate and activity. Data from third-party monitoring equipment (eg, sphygmomanometer, weight scale) can be integrated into the system. Collected data are summarized for patient and physician review. Directly observed ingestion (DOI) of placebo tablet markers was used to assess the system's technical performance. Markers were also coencapsulated with drugs to capture at-home adherence. A performance criterion of ≥95{\%} was set as the objective for system performance. Results: A total of 111 subjects ingested 7144 ingestible markers; 3298 were DOIs. The system's positive detection accuracy and negative detection accuracy in detecting ingested markers were 97.1{\%} and 97.7{\%}, respectively. It differentiated 100{\%} of multiple drugs and doses taken simultaneously by type and by dose. Medication adherence was >85{\%}. The most common adverse effect was mild skin rash from the monitor's electrodes. No definitive marker-related adverse effects were reported. Conclusion: The system appears to be safe and effective in capturing and integrating adherence and physiologic data. Efforts are under way to enhance system functionalities and refine user interfaces. By providing context-rich information, this system may enhance patient-provider collaboration.",
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Au-Yeung, KY, Moon, GD, Robertson, TL, DiCarlo, LA, Epstein, MS, Weis, S, Reves, RR & Engel, G 2011, 'Early clinical experience with networked system for promoting patient self-management', American Journal of Managed Care, vol. 17, no. 7.

Early clinical experience with networked system for promoting patient self-management. / Au-Yeung, Kit Yee; Moon, Greg D.; Robertson, Timothy L.; DiCarlo, Lorenzo A.; Epstein, Michael S.; Weis, Stephen; Reves, Randall R.; Engel, Gregory.

In: American Journal of Managed Care, Vol. 17, No. 7, 01.07.2011.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - Early clinical experience with networked system for promoting patient self-management

AU - Au-Yeung, Kit Yee

AU - Moon, Greg D.

AU - Robertson, Timothy L.

AU - DiCarlo, Lorenzo A.

AU - Epstein, Michael S.

AU - Weis, Stephen

AU - Reves, Randall R.

AU - Engel, Gregory

PY - 2011/7/1

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N2 - Objective: To gain early experience with a networked system designed to assess a patient's adherence to oral medication and physiologic metrics in an ambulatory, at-home setting. Study Design: Prospective, observational studies. Materials and Methods: This networked system for patient self-management consists of ingestible markers and a wearable, personal monitor. When a marker is ingested, it communicates to a monitor that time-stamps the ingestion and identifies the marker as unique. The monitor also records heart rate and activity. Data from third-party monitoring equipment (eg, sphygmomanometer, weight scale) can be integrated into the system. Collected data are summarized for patient and physician review. Directly observed ingestion (DOI) of placebo tablet markers was used to assess the system's technical performance. Markers were also coencapsulated with drugs to capture at-home adherence. A performance criterion of ≥95% was set as the objective for system performance. Results: A total of 111 subjects ingested 7144 ingestible markers; 3298 were DOIs. The system's positive detection accuracy and negative detection accuracy in detecting ingested markers were 97.1% and 97.7%, respectively. It differentiated 100% of multiple drugs and doses taken simultaneously by type and by dose. Medication adherence was >85%. The most common adverse effect was mild skin rash from the monitor's electrodes. No definitive marker-related adverse effects were reported. Conclusion: The system appears to be safe and effective in capturing and integrating adherence and physiologic data. Efforts are under way to enhance system functionalities and refine user interfaces. By providing context-rich information, this system may enhance patient-provider collaboration.

AB - Objective: To gain early experience with a networked system designed to assess a patient's adherence to oral medication and physiologic metrics in an ambulatory, at-home setting. Study Design: Prospective, observational studies. Materials and Methods: This networked system for patient self-management consists of ingestible markers and a wearable, personal monitor. When a marker is ingested, it communicates to a monitor that time-stamps the ingestion and identifies the marker as unique. The monitor also records heart rate and activity. Data from third-party monitoring equipment (eg, sphygmomanometer, weight scale) can be integrated into the system. Collected data are summarized for patient and physician review. Directly observed ingestion (DOI) of placebo tablet markers was used to assess the system's technical performance. Markers were also coencapsulated with drugs to capture at-home adherence. A performance criterion of ≥95% was set as the objective for system performance. Results: A total of 111 subjects ingested 7144 ingestible markers; 3298 were DOIs. The system's positive detection accuracy and negative detection accuracy in detecting ingested markers were 97.1% and 97.7%, respectively. It differentiated 100% of multiple drugs and doses taken simultaneously by type and by dose. Medication adherence was >85%. The most common adverse effect was mild skin rash from the monitor's electrodes. No definitive marker-related adverse effects were reported. Conclusion: The system appears to be safe and effective in capturing and integrating adherence and physiologic data. Efforts are under way to enhance system functionalities and refine user interfaces. By providing context-rich information, this system may enhance patient-provider collaboration.

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M3 - Article

VL - 17

JO - American Journal of Managed Care

JF - American Journal of Managed Care

SN - 1088-0224

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Au-Yeung KY, Moon GD, Robertson TL, DiCarlo LA, Epstein MS, Weis S et al. Early clinical experience with networked system for promoting patient self-management. American Journal of Managed Care. 2011 Jul 1;17(7).