[By Vlad Lazar from Distributed Systems Research Laboratory / Technical University of Cluj-Napoca – July 2019] MedGUIDE project addresses the management of polypharmacy in older adults with dementia thus the monitoring of drugs intake is an important aspect. In case of our target group it is also technical as the patient drugs intake self-reporting is not always accurate and reliable.

The solution in this case is to rely on the objective monitoring provided by IoT pillboxes such as the Medido[1] dispensers. They are smart electronic devices which are capable of storing small pouches with certain medicinal drugs, being programmed with moments of time when those drugs should be taken and also delivering drugs at those specific moments.

A strong asset of a Medido dispenser is its capacity to send notifications when medications intakes are missed or forgotten, through a robust REST API, which makes it suitable for the integration with the MedGUIDE services. As result, we are able to synchronize the medication plan created by professionals using the MedGUIDE services with the real time activity of the patient related to the medication intake. We can monitor which drug was taken as prescribed and which was not, having a clear view on the patient’s progress and also enhancing the potential of understanding side effects reflection in deviations from daily activity routine.

The following flow of activities was designed to efficiently integrate the Medido dispensers within the MedGUIDE services:

1. Medido dispenser is installed at the patient’s home.
2. The id of the pillbox is associated with the id of the patient, to correctly correlate each notification of the pillbox with patient it corresponds with.
3. The dispenser is loaded with pouches containing drugs, and then programmed when to deliver those pouches.
4. A plan replicating the program of the Medido dispenser is created in the MedGUIDE services under the supervision of medical professionals.
5. Whenever a patient has to take a drug, the dispenser rings an alarm and provides the pouch which was prescribed for that time. If the patient does not take the medication within a preconfigured alarm period, a notification is sent in a message queue of the MedGUIDE services, which processes the notification and marks that specific drug and intake moment as missed.
6. The missed intake is displayed in front end application, and the information is later used to check for drug to drug combination side effects.

The integration tests conducted in the context of Norway pilot site with real dispensers programmed to deliver drugs at a specific time, were successful showing the potential in better manage the polypharmacy associated risks.

[1]                https://medido.com/