An exciting trend in drug delivery is underway: the movement toward smaller, smarter, wirelessly connected electronic devices that allow patient-administered therapy. Inspired by the technological advancements driving the consumer electronics market, new methods for drug delivery show great promise for all stakeholders. Patients wishing to claim more autonomy over their drug regimens, caregivers and medical professionals wanting to more closely monitor drug compliance, health insurance organizations looking to keep costs down, and developers of pharmaceutical products interested in conducting better-managed clinical trials can all benefit from these novel, next-generation technologies.
Smart Drug Delivery, Defined
Smart technology, as illustrated by the ubiquitous smartphone, refers generally to devices that feature complex but small electronics, high functionality, embedded software, wireless connectivity, and intuitive user interfaces that include graphics, LEDs, and buttons. When applied specifically to such drug-delivery devices as inhalers and medication-delivery pens, however, “smart” describes an evolution from purely mechanical operation to electromechanical operation. Self-administration of drugs by the patient and the availability of related smartphone and tablet apps for multi-device integration represent additional smart characteristics, as does the trademarked Bluetooth Smart technology, which refers specifically to the use of the Bluetooth® low-energy, power-efficient wireless protocol.
The numerous advantages of smart drug-delivery technology include improved therapies, reduced costs for both individual patients and the overall healthcare system, and increased patient compliance, which, in turn, should yield better outcomes. (See Figure 1)
Making Conventional Drug-Delivery Devices Smart
Popular, widely prescribed drug-delivery devices such as inhalers and insulin pens play critically important roles in the effective management of such chronic conditions as asthma and diabetes. These devices can be greatly improved for some—if not all—users, however, by the incorporation of electromechanics and smart technology.
A Better Inhaler: Electronics-based improvements to inhalers can put a new spin on—and add value to—more traditional, non-automated versions, such as GlaxoSmithKline’s Advair dry-powder inhaler. Electronically enhanced, more automated inhaler therapy can cater to and be optimized for patients who cannot breathe with sufficient force, such as infants and the elderly, or who have motor or cognitive disabilities. Historically, patients unable to effectively use inhalers have received treatment via nebulizers. However, this type of therapy is time-consuming, requires setup and cleaning after each use, and often requires an additional person to operate.
Smart enhancements to inhalers can include integrating a motor drive to advance and/or dispense the drug, adding a piezo electromechanical transducer for creating vibrations to aerosolize the drug, and designing in a breath sensor to automatically trigger drug delivery as inhalation occurs. Furthermore, a graphical user interface can improve ease of use and make fault messaging apparent; dose history can be electronically logged; and wireless transmission of dosage logs to a smartphone or Web viewer can be sent to the patient, caregiver, and physician. (See Figure 2)
With all of these changes to the existing inhaler, ease of use is vastly improved and patients representing a variety of ages, abilities, and environments can successfully operate the device. Family and healthcare staff can electronically monitor device use and dosage, intervening when necessary, and dependency on a nebulizer may be significantly reduced.
A Data-Centered Insulin Pen: Conventional mechanical insulin pens represent an improvement over traditional vial-and-syringe insulin delivery in terms of ease of drug administration, portability and convenience, and discretion. Like the standard metered-dose inhaler, however, the insulin pen could significantly benefit from a smart makeover through the addition of electronics and, especially, wireless connectivity.
For the diabetic individual, appropriate and timely insulin dosing are of paramount concern, and a smart insulin pen can help. Each dose of insulin administered from a smart pen is recorded and logged, with the last-dose timestamp and dose count shown clearly on the pen’s display. Dose history can then be wirelessly transmitted—typically via Bluetooth Smart technology—to a smartphone app and made available to the patient, caregiver, and medical professional. Additionally, programmable dosing, motor-driven dose delivery, and even a sleek docking station can enhance and facilitate the user experience. (See Figure 3)