1 Ophthalmic Dose Compliance Monitor BME 200/300 University of Wisconsin – Madison October 19, 2005 Team: Arinne Lyman—Team Leader Anita Zarebi—Team Communicator Becky Koszalinski—BSAC Michael Alexander—BWIG Client: Christopher Murphy DVM, PhD School of Veterinary Medicine Advisor: Wally Block Assistant Professor Department of Biomedical Engineering Department of Medical Physics2 Abstract: A device is needed to record the date and time an eye drop medication is administered, unbeknownst to both the patient and client. Prior to the design process, research was conducted to find current devices in literature. Kass et al. has a medication monitor from the 1980s that our client would like us to improve upon. Following our client’s specifications, we came up with many components that could be integrated into a device that will measure when medication was administered. These components include a power source, microprocessor, gyro sensor, tactile sensor, and cap removal sensor, as well as integration to a computer USB port. The tactile sensor records when the bottle is squeezed, the gyro sensor records when the bottle is inverted and the cap removal sensor will consist of wire to record when the cap is removed. We would like to include at least two of these sensors on our device along with the power source and microprocessor. After ordering components, testing protocols will be written and implemented to decide which two are best suited for our design. Once an integrated circuit is developed, further testing will determine the overall effectiveness of our design. Finally, miniaturization will be considered if time permits.3 Table of Contents: Abstract 2 Table of Contents 3 Problem Statement/Motivation 4-5 Design Constraints 5-7 Current Research 7-8 Design Components 8-15 Power Source 8-9 Microprocessor 9-11 Gyro Sensor 11-12 Tactile Sensor 12-14 Cap Removal Sensor 14-15 Evaluations 16-19 Future Work 19-20 References 21 Appendix 22-23 PDS 22-234 Problem Statement/Motivation: Chris Murphy, a Dr. of Veterinary Medicine, is our client. He has provided us with guidelines for the development of an ophthalmic dose compliance monitor that is similar to a device used by Kass et al, but with some improvements. Our device will be used in Dr. Murphy’s research to monitor patient compliance to a doctor’s instructions for medication, specifically for eye infections and other eye related diseases of pets. Initially, the device will be used primarily for pet eye medications; however, human subject testing will eventually be implemented. The motivation behind this particular research study is to provide data that Dr. Murphy can use to validate or invalidate his hypothesis: “Patients treat their pets as well as or better than their own children when it comes to medication compliance.” Dr. Murphy attributes much of this hypothesis to the availability of health insurance. While children are covered under insurance, pet health costs come directly out of pocket, a fact which likely influences compliance to doctor’s orders. Research results can also be used to compare patient compliance between different types of medications, and could potentially validate pharmaceutical research and effectiveness for ophthalmic disorders. For example, if a known medication for glaucoma has some undesirable side effects, research using our device could test the known medication alongside a newer medication to see which one has better results with fewer side effects. The advantage of using our device in the research of the two drugs is that patient compliance can be accurately recorded to compare the medications without the bias of accuracy on the part of the patient. As such, the device will need to be virtually invisible to the client and the patients to protect client rights and confidentiality, as well as negate bias on the part of the client or the patient. Improvement upon the past5 design, Kass et al., will include, but not be limited to: cost, versatility, size, sterility, accurate sensing, and transmission of results [4]. Background Info: Patient compliance is the degree to which patients follow their doctor’s orders, especially with regard to taking medication. Doctors in many disciplines have long since wondered whether or not patients adhere to the medical regimen given to them. Specifically, ophthalmologists are particularly concerned because the use of prescription eye drops in treating infections can only be effective if the patient complies directly with doctor’s orders. It has been found that 50% of patients do not follow prescribed medical regimens [8]. This poor compliance could be the result of a variety of reasons, including: inconvenience to the patient, difficulty remembering to administer medication, and uncomfortable side effects experienced by the patient. Studies have been carried out that try to measure patient compliance, but there have been problems related to the exact measurement. For example, interviews with patients have been conducted but the accuracy has been low due to human error [2]. Doctors have also calculated the number of missed doses—a factor that is particularly hard to measure [8]. Both studies agree that a medication monitoring device may offer the most accurate assessment of patient compliance. Additionally, Norell concluded that the spacing between doses may also be related to how effective a treatment is [8]. A solution to both of these problems is a medication monitor that can record every time a patient takes his or her required dose. These monitors could offer accurate information6 on drug taking habits as well as allow investigators to study patient compliance to new drugs whose side effects are not yet known. Current Research: Norell et al. designed a medication monitor that recorded the date and time when a medication bottle was opened. The device consisted of a plastic box that held a medication bottle. An elastic flap connected to a switch in the box signaled when the cap was taken on or off. Disadvantages to this design included its bulkiness and a limited memory capacity of only three weeks
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