Proteus Ingestible SensorA California health system has announced plans to begin prescribing ingestible sensors for medication adherence tracking in patients with poorly controlled hypertension.

Hypertension affects upwards of 70 million Americans and, by some estimates, anywhere from a third to a half of these patients don’t have their blood pressure under control. For those of us that care for patients with hypertension, it’s apparent that medication adherence is just one of many factors at play here. With each patient, the challenge is figuring out what combination of those potential factors is driving poor control and come up with a game plan accordingly.

That’s where the ingestible sensors come in. This medication tracking platform, developed by Proteus Digital Health, includes an ingestible sensor and wearable patch. Prescribed medications, say lisinopril, are combined into a pill with a sensor. When a patient takes their medication, the pill dissolves in the stomach and the stomach acid activates the sensor to send a signal to a skin-worn patch that the pill was taken. That information is then sent from the patch to a smartphone app and from there to the EHR. The patch itself can also collect a variety of data like heart rate and activity.

Barton Health, based in California, is going to use this platform to try to improve medication adherence among patients with uncontrolled hypertension. According to Barton Health, physicians and their care teams can access the data collected on medication use through an online portal before a clinic visit. That can then drive discussions in the clinic with the patient about how best to better control their blood pressure.

As of now, Barton Health is covering the cost of Proteus’ sensor; patients just pay for the cost of the medication. The support system being built around the adherence data being collected by the Proteus sensor seems fairly thin at this point, relying on existing clinic infrastructure and support services with review of data around clinic visits.

And when it comes to effectiveness, knowing whether your patient is taking their medication is just the first step. If a clinician were to learn that a hypertensive patient is taking their medications only half the time, the only way that helps is by taking the time to understand why – cost, complexity, and forgetfulness require very different interventions.

And those interventions can’t just be a counseling session every three months. Rather, ongoing follow up that reassesses adherence frequently and adjusts support accordingly is critical. For example, reminder texts could be generated when a patient hasn’t taken their medication within an hour of the anticipated time. Or a nurse could be alerted when there is a sudden drop off in adherence to check if the patient needs a refill or had difficulty paying for their medication.

It will be interesting to see how this program evolves over time and what sort of impact is realized. Hopefully they will share some of that data publicly though our only feedback on effectiveness may be either continuation or cancellation of the program.

Reference: Press release