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[0001] This is a Continuation-in-Part application of the International Application Serial No. PCT/US96/09241 filed Jun. 14, 1996 which is incorporated herein by reference. In addition, full benefit of the filing date of U.S. Provisional Application Serial No. 60/000,232 filed Jun. 15, 1995, International Application Serial No. PCT/US96/09241 filed Jun. 14, 1996, and U.S. Provisional Application Serial No. 60/044,265 filed Apr. 25, 1997 are claimed pursuant to the provisions of 35 U.S.C. §119(e), and are incorporated herein by reference.
[0002] 1. Field of the Invention
[0003] This invention relates to an apparatus which aids patients in complying with instructions given by a physician for taking prescription medication, and more particularly, to a device which is programmable in accordance with the physician's instructions or desired regimen.
[0004] 2. Discussion of the Background Art
[0005] A variety of devices have been proposed for recording intervals at which patients, especially those under the care of an attendant, take medication at periodic intervals prescribed by a physician. If the patient or his medical care provider ignores the proper instructions and repeats the dose too frequently or fails to administer or take medication at the proper time, the concentration of medication in the patient's body may become too high or too low. In order to ensure that medications are taken at the proper time, a variety of devices, such as the one disclosed in U.S. Pat. No. 4,361,408, have been devised to generate audible and/or visible prompting or alarm signals that remind a patient or his caretaker to administer the correct dosages at the correct time. Such devices have been complex and costly, inconvenient to program, and have not been flexible enough in establishing varying time intervals at which the medication needs to be administered.
[0006] Accordingly, one object of this invention is to provide a low cost, easy to use prescription compliance device that has the flexibility of operating in accordance with various different medication-taking intervals.
[0007] Another object of this invention is to provide a prescription compliance device which is easily programmable either by activating a programmer on the device itself or by remotely programming the device via a wireless link. Multiple programming regimens which correspond to different medication-taking intervals and medication-types may also be programmed into the device.
[0008] Yet another object of this invention is to provide a prescription compliance device which records the event of taking a dose of medication and displays the time at which the next dose of medication is to be taken.
[0009] A still further object of this invention is to provide a prescription compliance device having a timer which measures the time that has elapsed since the patient last took a dose of the medication and an alarm which is activated at times when the patient is to take the next dose of medication.
[0010] A further object of this invention is to provide a prescription compliance device that maintains a count of the number of doses remaining in a patient's prescription and displays the count so that a patient will know when to have the prescription refilled.
[0011] Another object of this invention is to provide a prescription compliance device that alerts a patient when the patient has missed a scheduled dose of medication or has taken a dose of medication at a non-scheduled time.
[0012] Yet another object of this invention is to provide a prescription compliance device which records the times at which a patient takes each dose of medication in a format that can be easily accessed via a wireless interface.
[0013] These and other objects are accomplished by a prescription compliance device which includes a microcontroller, a program memory which stores data representing a plurality of pre-programmed medication-taking regimens for single and multiple medications, an oscillator which controls timing functions of the device, a selector selecting one of the regimens and programming the device in accordance with the selected regimen, a display which alternately displays the current time, the time at which a next dose of medication is to be taken in accordance with the regimen selected by the selector, and the number of doses remaining in a prescription, and an alarm which alerts the patient at times when the patient is scheduled to take a dose of medication. The device may also include a memory which records the times at which a patient takes each dose of medication in a format that can be easily accessed via a wireless interface.
[0014] The selector includes an event switch which is activated by the patient after taking a dose of medication to record the taking of the medication, the event switch causing the microcontroller to effect the display of the next time at which a dose of the medication is scheduled to be taken, in accordance with the regimen selected by the selector.
[0015] The event switch and a function button are provided for programming the regimens by which the medication is to be taken, the day of the week on which the first dose is to be taken, the time at which the first dose is to be taken or the designation of meals during which the first dose is to be taken, and the number of doses in a patient's prescription.
[0016] Programming may be done either directly by using the function button and the event switch or remotely via a wireless link. To program from a remote location, the device is provided with a wireless transmitter/receiver and an external wireless transmitter/receiver configured to be connected to an input device. The external wireless transmitter/receiver communicates with the wireless transmitter/receiver via a wireless link to select one of the regimens and to program the device in accordance with the selected regimen.
[0017] The display includes a first display area which displays a number of the regimen selected by the selector, a second display area which may alternately displays the current day of the week and a day of the week on which a next dose of medication is to be taken, a third display area which alternately displays the current time, the time or meal at which the next dose of medication is to be taken, and the number of doses remaining in a prescription, a fourth display area which alternately displays AM or PM designations for the current time and the time at which a next dose of medication is to be taken, and a fifth display area which displays an icon indicating the nature of the information currently displayed in the first through fourth display areas.
[0018] A more complete appreciation of the invention and many of the attendant advantages thereof will be readily obtained as the same becomes better understood by reference to the following detailed description when considered in connection with the accompanying drawings, wherein:
[0019]
[0020]
[0021] FIGS.
[0022]
[0023]
[0024]
[0025] FIGS.
[0026]
[0027]
[0028]
[0029]
[0030]
[0031] Referring now to the drawings, wherein like reference numerals designate identical or corresponding parts throughout the several views, and more particularly to
[0032] Prescription Compliance Device For Single Medications
[0033]
[0034] The microcontroller receives inputs from the function and reset buttons
[0035] The operation of the prescription compliance device according to this embodiment of this invention will now be described with reference to FIGS.
[0036] First, the device must be switched from an OFF state to an ON state by pressing the reset button (Step S
[0037] The event switch
[0038] The minutes tenth digit then blinks “0” and the digits “0” through “5” are scanned through by pressing the event switch
[0039] The minutes unit digit then blinks “0” and the digits “0” through “9”, are scanned through by pressing the event switch
[0040] The display area
[0041] The patient now selects the regimen by which the prescription medication is to be taken. Upon depressing the event switch
[0042] In
[0043] The patient presses the event switch
[0044] When the desired regimen is displayed, the function key
[0045] If the patient instead wants to set the time at which the first dose is to be taken, the microcontroller
[0046] The minutes tenth digit then blinks “0” and the digits “0” through “5” are scanned through by pressing the event switch
[0047] The minutes unit digit then blinks “0” and the digits “0” through “9” are scanned through by pressing the event switch
[0048] The display area
[0049] If one of the meal regimens is selected, the medication is to be taken with meals the times of which will vary from person to person. The program memory
[0050] After a meal regimen is selected, display area
[0051] After programming the breakfast time, the operation varies according to the specific regimen selected. For explanatory purposes, regimens
[0052] Once the time/meal designations have been programmed, the display area
[0053] The display area
[0054] The display area
[0055] This completes the setup process. Display area
[0056] After the device is programmed and the event switch
[0057] If the patient fails to take the dose within a prescribed time after the scheduled time while the alarm circuit
[0058] Upon taking the first dose, the patient presses the event switch
[0059] Likewise, at the end of each day the microcontroller subtracts one from the total number of days in the prescription to update the count of remaining days. This number is displayed in display area
[0060] These operating procedures are repeated for as long as the patient's prescription is valid. When the number of doses in the prescription has been nearly exhausted (i.e., six doses or less remaining), the display indicates “FILL” and the alarm circuit is activated (Step S
[0061] Prescription Compliance Device for Multiple Medications
[0062]
[0063] In addition to the central processor and supporting circuitry shown in
[0064] Referring to
[0065] As shown in
[0066] The multi-medicine prescription compliance device also includes a SNOOZE switch
[0067] The operation of the prescription compliance device according to the second embodiment of this invention will now be described with reference to FIGS.
[0068] The menu choices shown in
[0069]
[0070]
[0071]
[0072] After the PROGRAM option is selected (Step S
[0073]
[0074]
[0075]
[0076]
[0077] The information input by the patient or his medical care provider via a personal computer is transmitted by the wireless transmitter/receiver
[0078] The device of
[0079] The wireless transmitter/receiver
[0080] In addition, each prescription compliance device has a unique identification number assigned thereto and stored in its program memory
[0081] With regard to programming the device, parameters such as the day, time of day, and other parameters may be set in a global register, whereas medication specific parameters are programmed within a unique register. An additional capacity may be included to allow the user to review the information programmed into the device for each of the registers and to review any other pertinent information. This information may be reviewed at the level of the device itself and/or through the wireless computer interface.
[0082] The activation of the event switch
[0083] In addition to or as an alternative to identifying the individual registers by characters or symbols, the device may also provide user-friendly information, such as information identifying the specific medication associated with a register by name or description (i.e. yellow pill, water pill, etc.). Additionally, instructions may be provided in conjunction with an alarm providing the user with useful information (i.e. take with food; avoid milk, etc.). Both types of such additional information would be accessible to each register to recall and display at appropriate times in either voice or character formats as discussed below.
[0084] The wireless emissions of the device can also be used as transducing the elements to activate secondary apparatuses. Thus, the emission of a wireless signal in conjunction with an alarm can be used as a signal to activate secondary alarms. The secondary alarms can be used to alert individuals who are hearing or vision impaired, to alert delivery systems to dispense medication to individuals who are mentally or physically handicapped, or to activate any of a variety of other types of apparatuses.
[0085] Within institutional settings, emissions from the prescription compliance device which are triggered by the alarm logic, may be used in conjunction with medication or therapy dispensing stations, or similarly, to alert staff that the time has arrived to provide a specific medication or therapy to a patient. Thus, according to the present invention, scheduling and planning of therapy regimens in the pharmacy, by the physician, or by any other care provider, may be programmed into the prescription compliance device. In this embodiment, the device can perform a function of instructing staff to provide medication or therapy in a prescribed manner and/or at prescribed times.
[0086] In the present invention, this prescription compliance device is equipped with a capacity for wireless emissions that are output in conjunction with activation of the event switch or passively by opening the medicine bottle, etc. The wireless emissions carry the unique unit specific signature and can be collected by independent receivers. Therefore, collection of emission data can be used to evaluate and monitor the appropriate dispensing of medication and therapy, and to provide an alert/alarm condition if serious omission or error occurs (e.g., a medication was not dispensed properly).
[0087] Wireless emission output may also be used to effect concurrent signal emission by another apparatus or device. Concurrent wireless emission by the prescription compliance device and other apparatuses could be received by an independent recorder in very close time sequences, thus allowing temporal and proximity relation of action and instruments to be established. For example, the activation of the “Event Switch” on a prescription compliance device would emit a signal that would be collected by the independent receiver and would also cause an appropriate patient identifying device to emit a signal. This signal would also be collected by the receiver. Through correlation of the receiver identity, prescription compliance device identity, and patient identity, a data set can be generated establishing a relationship between a specific action, a specific place, a specific medication, and a particular patient.
[0088]
[0089] Thus, the prescription compliance device according to this invention may be attached to medication containers by adhesives, straps, velcro, mechanical attachment, integration as a component of the container itself, or by any other manner of attachment. The device also operates freestanding, and need not be attached to a medication container.
[0090] The device can be utilized in conjunction with or as a part of a wide array of medicine delivery systems and free standing units. Free standing units independent of the medical container include use as, or as a part of a clock, pendent, key chain or watch. Other free standing applications include configurations similar to those used for beepers or cellular telephones or any other similar configuration that can easily be carried by a person. In addition to attaching the device to the medicine container or integration as a part of the medicine container, the current invention describes prescription compliance devices that can be used with or are a part of blister packaging, medicine cabinets, pill box or any other container intended for distributing medication. Additionally, the device can be integrated with, or used in conjunction with a cabinet, cart or other similar apparatus that is used in conjunction with dispensing medicine or therapy in an institutional setting.
[0091] As discussed above, the device triggers circuits to alert the patient when to take a dose of medication. These alarm capabilities include, in addition to audio and visual signals, tactile signaling, such as a vibrator or comparable mode of signaling, voice signaling achieved through a recording or digital generation, and the use of a wireless output as a transducing element to activate a triggering of secondary devices (e.g., alarms, patient assistance equipment, etc.) or to alert medical personnel or other personnel that some form of action should be taken (e.g., providing medication or therapy). The avenue via which the prescription compliance device communicates information to the user includes tactile and visual and auditory signaling.
[0092] The use of tactile stimulation, such as the vibrator used in a pager, or some similar stimulus will provide the user with a discrete signal that can alert the user without alerting others in his/her company. Operation of a tactile stimulation will occur in a manner analogous to that described for the visual and auditory stimuli.
[0093] The device according to the present invention also includes the use of recorded signaling to provide the user with identification and/or instructional information. In order for prescription devices to achieve these capabilities, they may be equipped with a microphone, speaker and solid state recording device. In the recording mode, the user can provide vocal input regarding identification of medication and/or proper usage. Utilization of user (or medical care provider) recorded information will occur per logic employed at the level of the device's microprocessor(s) and may incorporate prerecorded information in addition to that recorded by the user. Thus, with the multi-medicine device described, the logic in a specific register may be used to dictate playback of a recorded sequence such as “10 PM; Take Yellow Pills; Take with food.” Such a sequence may combine user recorded and prerecorded signaling to alert the user to therapy identification, the time of utilization, special instructions, and any other parameters that might be appropriate. Such sequences are appropriately utilized within specific registers in multi-medication devices, thus providing the user with the proper timing and practical advice for the correct use of specific medications.
[0094] In addition, a user initiated action may be required to initiate the display of either visual or recorded identification and instructional information. Thus, the prescription device may first emit an audio, visual or tactile stimulus, and then an action by the user will cause the device to display the appropriate audio and/or visual information. Display of such audio or visual information may be accomplished in a manner so as to preserve the privacy of the user in hearing or viewing such information (e.g., an ear phone).
[0095] TABLE 1 summarizes dosing time intervals for morning, midday, afternoon, etc. Normally a patient is awake for 14 hours and it is over this interval that a patient is most likely to take medication prescribed in a given day. The 14 day is divided into a series of time intervals desirable for the patient to take medication. Alternatively, the dosing time intervals may correspond to meal times (e.g., with, before, and after breakfast, lunch, etc.).
TABLE 1 DOSAGE TIME INCREMENT TIME (example) 1st (Morning) 0 hr 8 AM (first dose of day) 2nd (Mid day) 4 hr 12 PM 3rd (Afternoon) 7 hr 3 PM 4th (Evening) 9 hr 5 PM 5th (Late evening) 12 hr 10 PM 6th (Bedtime) 14 hr 10 pm
[0096]
[0097] Utilization of the specific times generated in such a matrix as shown in Table 1 allows simple definition of appropriate times for the patient to take medication under the most common regimens identified in
[0098] Programming the regimens shown in
[0099] For Regimen
[0100] For Regimen
[0101] For Regimen
[0102] For Regimen
[0103] For Regimen
[0104] For Regimen
[0105] The event switch shown in the first and second embodiments should be of a size such that activation by an elderly person would not be difficult while at the same time safeguarding against accidental activation. The reset button is of a size such that activation thereof requires a thin, needle-shaped object so as to safeguard against the accidental turning off of the device. Accidental depression of the function button is harmless since this button has no effect when the device is not in the setup mode except to de-activate the alarm circuit.
[0106] Provision is also made for a low battery indication. After the passage of a certain number of days from when the battery was last replaced, the display displays “BAT” to indicate that the battery should soon be replaced.
[0107] This invention may be conveniently implemented using a conventional general purpose digital computer or microprocessor programmed according to the teachings of the present specification, as will be apparent to those skilled in the computer art. Appropriate software coding can readily be prepared by skilled programmers based on the teachings of the present disclosure, as will be apparent to those skilled in the software art. The invention may also be implemented by the preparation of application specific integrated circuits or by interconnecting an appropriate network of conventional component circuits, as will be readily apparent to those skilled in the art.
[0108] The present invention includes a computer program product which is a storage medium including instructions which can be used to program a computer to perform a process of the invention. The storage medium can include, but is not limited to, any type of disk including floppy disks, optical discs, CD-ROMs, and magneto-optical disks, ROMs, RAMs, EPROMs, EEPROMs, magnetic or optical cards, or any type of media suitable for storing electronic instructions.
[0109] Obviously, numerous modifications and variations of the present invention are possible in light of the above teachings. The specific parameters mentioned in conjunction with the description of the invention have been set forth solely for illustrative purposes and are not limiting of the scope of the invention in any way. It is therefore to be understood that within the scope of appended claims, the invention may be practiced otherwise than as specifically described herein.