Did they take the pills, or didn't they?
That's often a nagging question long-distance baby boomer caregivers face when assessing the likelihood that their parents took their medication as prescribed.
Technology may have a solution. Efforts are under way to transform the little plastic pillbox into a sensor smart device that in some cases is also a portal of information. But will these changes come soon enough for this burgeoning group of adult children caregivers?
"You have situations where Mom lives in California and I live in New York and the question is, 'How do I deal with it?'" asked Lisa Gables, executive director for the American Society of Consultant Pharmacists Foundation.
The changes couldn't come fast enough for some of the 34 million Americans who are providing care to aging family members. According to a 2004 study by MetLife (PDF), 15 percent of the caregivers polled lived at least an hour away from their ailing family member.
Today's high-tech pillboxes try to satisfy a number of tasks--alerting users when it's time to take medication, organizing pills into compartments, dispensing the proper dose and monitoring users' overall medication management.
Many pillboxes on the market issue simple alerts. These range from e-pill's Pager Vibrating Medication Reminder device, which that resembles a pager, to its Cadex Medication Reminder Watch with multiple programmable alarms. But these devices do not organize, dispense or monitor pill consumption.
Dispensing features are important, stressed Majd Alwan, director of the Center for Aging Services Technologies (CAST). He noted that dispensing features serve as a mechanism for preventing overdosing by withholding medication if a patient skips a session and tries to "catch up."
More sophisticated devices try to tackle multiple tasks. For example, Aardex Group's Medication Events Monitoring Systems (MEMS) will organize and monitor whether pills are taken at the prescribed time of day, but require a trained medical professional to read the results transmitted from the user's computer.
Another device, e-pill's Med-Time XL, will remind patients to take their pills, plus organize and automatically dispense them at the prescribed time. But it but does not offer a monitoring service, Alwan said.
Pillboxes such as Honeywell's HomMed Health Monitoring System and InforMedix's Med-eMonitor Device, remind, organize and monitor, but do not include pill-dispensing features. Both devices also connect to professional health care providers who monitor the data.
InforMedix is working on a Med-eMonitor consumer version, which is expected to begin rolling out by the end of summer, said Dr. Bruce Kehr, founder and chief executive of the company.
As part of a $59 monthly service, the consumer device will allow family members to receive e-mails or text messages if there's a problem with their loved one's adherence to a medication regimen. But if the family uses the device in conjunction with a professional monitoring service, ExcelleRX, the costs will be higher and average approximately $65 per month.
"Most of us have family members who are on lots of medications, who either live alone or with another elderly person," said Kehr. "We've teamed up with ExcelleRX, who will set it up the device and program it over the Web, so family members can either get the notifications, or add ExcelleRX if they want a professional to do the monitoring."
The MD.2 pill dispenser by ePill is another consumer device that allows adult children to serve as caregivers to their parents by programming the dispenser, refilling its contents and having data about medication taken transmitted to their computers.
MD.2, however, does not come cheap. The device costs $799.95, and family members who wish to have their loved ones' medication management constantly monitored in real time, pay an additional $29.95 per month for the added service after the free two-month introduction period. Family members can also forego the professional monitoring service and set the device up to issue a phone call to up to five designated family members or caregivers if the patient fails to take their pills within 90 minutes of the assigned time.
"Crude versions of (futuristic medication management) technology exist now, but it's difficult to set up unless you have a smart teenager that can wire it up for you," said Eric Dishman, general manager and global director of the Intel Health Research & Innovation Group. Intel and Accenture are two industry titans investing in medication management research.
Alwan, meanwhile, said he expects other devices to eventually emerge on the market.
"There's a lot of development activity in this area," Alwan said. "It's well known that mediation compliance is the important issue for all three groups involved--the older adults, the adult children of these adults and the professional caregivers like aides, nurses and physicians."
More sophisticated devices try to tackle multiple tasks. For example, Aardex Group's Medication Events Monitoring Systems (MEMS) will organize and monitor whether pills are taken at the prescribed time of day, but require a trained medical professional to read the results transmitted from the user's computer.
Another device, e-pill's Med-Time XL, will remind patients to take their pills, plus organize and automatically dispense them at the prescribed time. But it but does not offer a monitoring service, Alwan said.
Pillboxes such as Honeywell's HomMed Health Monitoring System and InforMedix's Med-eMonitor Device, remind, organize and monitor, but do not include pill-dispensing features. Both devices also connect to professional health care providers who monitor the data.
InforMedix is working on a Med-eMonitor consumer version, which is expected to begin rolling out by the end of summer, said Dr. Bruce Kehr, founder and chief executive of the company.
As part of a $59 monthly service, the consumer device will allow family members to receive e-mails or text messages if there's a problem with their loved one's adherence to a medication regimen. But if the family uses the device in conjunction with a professional monitoring service, ExcelleRX, the costs will be higher and average approximately $65 per month.
"Most of us have family members who are on lots of medications, who either live alone or with another elderly person," said Kehr. "We've teamed up with ExcelleRX, who will set it up the device and program it over the Web, so family members can either get the notifications, or add ExcelleRX if they want a professional to do the monitoring."
The MD.2 pill dispenser by ePill is another consumer device that allows adult children to serve as caregivers to their parents by programming the dispenser, refilling its contents and having data about medication taken transmitted to their computers.
MD.2, however, does not come cheap. The device costs $799.95, and family members who wish to have their loved ones' medication management constantly monitored in real time, pay an additional $29.95 per month for the added service after the free two-month introduction period. Family members can also forego the professional monitoring service and set the device up to issue a phone call to up to five designated family members or caregivers if the patient fails to take their pills within 90 minutes of the assigned time.
"Crude versions of (futuristic medication management) technology exist now, but it's difficult to set up unless you have a smart teenager that can wire it up for you," said Eric Dishman, general manager and global director of the Intel Health Research & Innovation Group. Intel and Accenture are two industry titans investing in medication management research.
Alwan, meanwhile, said he expects other devices to eventually emerge on the market.
"There's a lot of development activity in this area," Alwan said. "It's well known that mediation compliance is the important issue for all three groups involved--the older adults, the adult children of these adults and the professional caregivers like aides, nurses and physicians."
From the portal, medication reminders are issued, as well as warnings should a user select the wrong medication. These warnings rely on RFID tags put on the prescription labels, which track which medicine is being removed from the cabinet.
Although some hospitals use RFID technology to track medication use, it has yet to filter down to local pharmacies and consumers.
Glaser noted what while many improvements are under way in medication management, he has yet to find a device that will confirm that a person has actually swallowed the pill they removed from the bottle.
"There's been improvements in technology from different colored caps for different medications, but there's nothing sophisticated enough to tell if the pill has been swallowed or not," Glaser said. Think of the legal consequences, and maybe that's why it's an area corporations haven't approached (for research and development)."
RFID chips, however, may one day be the answer. With RFID tags shrinking down to the size of a poppy seed, the technology may eventually be inserted into pills.
But Glaser notes challenges exist with that concept: "You have to convince people to take that kind of pill."