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February 20, 2008

Smart pillbox and cell phone promote compliance with TB meds in India

Mycobacterium_tuberculosis_2 A person with tuberculosis (TB) is infected with a slow-growing organism Mycobacterium tuberculosis with a waxy coat that needs a long regimen of antibiotics to effectively halt its growth.

The majority of those infected are asymptomatic but the infection may progress causing lung lesions that erupt into the bronchial tree and allow the organisms to be coughed up potentially infecting others, not to mention disseminating the disease throughout the patient's body.

For these reasons, the patients need to take a regimen of antibiotics despite feeling well. for if they should stop their meds, this could help select the organisms with a higher resistance.

Public health officials have devised directly-observed therapy (DOT) programs to help ensure compliance. This means that a person is assigned to witness each time the patient is supposed to take the meds. But these programs have stirred up some controversy among ethicists and patient rights advocates.  Another approach is to use a device that can remind a patient when to take the meds, and then record if the medication was accessed. Discussion of the controversy and the use of medical monitoring devices as a solution  is highlighted in this journal article: "Medication Monitors to Treat Tuberculosis: A Supplement to Directly Observed Therapy."

MIT Prajnopaya uBox Initiative is a project sponsored by The Prajnopaya Foundation as part of its Tuberculosis (TB) Treatment & Prevention Project in India (TBTP Clinic). Their solution is to use a medical monitoring device in the form of a smart pillbox, that alerts the patient when the meds should be taken, then records if the patient takes the meds or not. It's able to lock the mechanism to prevent a double dosages.

Uboxcomb_2

Ubox2 They're serving a population in the Bihar province of India.
They hope to be able to support 250 patients with these devices.

The MIT News Office describes a cell phone to be used with this device:

The second part of the group's new system is a cell phone, called the uPhone. By using special software, health care workers can record a patient's temperature, weight, and answers to a list of questions related to symptoms, which adds to the set of detailed patient data analyzed by doctors monitoring the study.

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