Dawn of the age of wireless medicine
New technology means doctors will soon be able to regulate and
monitor drug intake remotely - as long as patients remember to
swallow their chips
by Steve Connor
Medical treatment is about to go wireless. New advances in
microelectronics have enabled doctors to contemplate the day when they
will monitor and treat their patients with medical implants that use
wi-fi, Bluetooth and other kinds of wireless technology.
The latest development in this area is a medical implant controlled
by wireless commands to release drugs at regular intervals within the
body of a patient. It has been successfully tested for the first time on
women suffering from osteoporosis, the brittle bone disease that
requires regular drug injections.
Last month, in a separate development, scientists announced an edible
microchip that records the precise details of a patient's pill regime.
Each ingestible sensor, smaller than a grain of sand, triggers the
wireless transmission of medical information from a patient's body to
the mobile phone of a relative or healthcare worker.
Both breakthroughs are part of a wider technical revolution in
medicine that exploits the miniaturisation of wireless devices and the
ability to place them inside a patient where they perform a new kind of
"telemedicine" - medical treatment from a distance.
Scientists at the American Association for the Advancement of Science
in Vancouver hailed the latest clinical trial of an implantable
microchip as an important breakthrough.
The implant is an attempt to develop ways of delivering drugs to
patients in a safe and effective manner without them having to remember
to take pills on time or to suffer the inconvenience and pain of regular
injections.
Chips
The chips, which are about the size of a pacemaker and are fitted
surgically under the skin, were loaded with 20 doses of the osteoporosis
drug teriparatide which is normally administered by daily injection
pens.
An external wireless device issued commands to the chip which allowed
each drug dose to be released in an ordered, sequential manner to ensure
that the patients received the right medication at the right time of
day.
Eventually it is hoped the technology can be developed to deliver a
range of drugs to a wide variety of patients suffering from illnesses
ranging from heart disease and diabetes to multiple sclerosis and
cancer, the scientists said.
Pharmacy
"You could literally have a pharmacy on a chip. You can do
remote-control delivery and you can deliver multiple drugs," said Prof
Robert Langer of the Massachusetts Institute of Technology.
"The drugs are in different wells [in the microchip]. Each of these
wells is covered by a nano-thin layer of gold which protects the drug
for years if needed and prevents it from being released," Prof Langer
said.
"And there is much less variation from dose to dose than injections,
so it's safer and more effective," he said.
Seven women in Denmark aged between 65 and 70 took part in the trial
where they were given the implants under local anaesthetic in an
operation lasting less than half an hour. They kept the microchips for
12 months during which time their health was monitored.
A study in the journal Science Translational Medicine at the AAAS
meeting found that microchip worked as expected and the women showed
signs of improved bone formation and reduced risk of fractures.
Conditions
"Patients with chronic diseases, regular pain-management needs or
other conditions that require frequent or daily injections could benefit
from this technology," said Dr Robert Farra, head of MicroChips, the
company set up to exploit the invention.
"Compliance is very important important in a lot of drug regimes, and
it can be very difficult to get patients to accept a drug regimen where
they have to give themselves injections," Dr Farra said.
"This avoids the compliance issue, and points to a future where you
have fully automated drug regimes.
"Physicians will be able to adjust their patients' therapy using a
computer or phone," he said. "Patients will be freed from having to
remember to take their medication and don't have to experience the pain
of multiple injections."
A similar need to ensure the admission of regular drug doses was
behind the development of the edible microchip announced in January by
the company Proteus Biomedical of California which has signed a deal
with the healthcare company Lloyds Pharmacy to begin clinical trials in
the UK this year.
Develop
The aim is to develop a suite of "intelligent medicines" that can
help patients and carers keep track of which pills are taken at what
time of day, to ensure that complex regimes of drugs are given the best
possible chance of working.
Ultimately, the plan is for every one of the many pills taken each
day by some of the most chronically-ill patients, especially those with
mental-health problems, to be digitally time-stamped as they are
digested within the body.
"There is a huge problem with medicines not being taken correctly,"
said Steve Gray, healthcare services director of Lloydspharmacy.
"Anyone taking several medications knows how easy it can be to lose
track of whether or not you've taken the correct tablets that day," he
added.
- The Independent
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