WO1994004966A1 - Programmable medication dispensing system - Google Patents
Programmable medication dispensing system Download PDFInfo
- Publication number
- WO1994004966A1 WO1994004966A1 PCT/US1993/007710 US9307710W WO9404966A1 WO 1994004966 A1 WO1994004966 A1 WO 1994004966A1 US 9307710 W US9307710 W US 9307710W WO 9404966 A1 WO9404966 A1 WO 9404966A1
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- WO
- WIPO (PCT)
- Prior art keywords
- medication
- dispensing
- dispenser
- data storage
- information
- Prior art date
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61J—CONTAINERS SPECIALLY ADAPTED FOR MEDICAL OR PHARMACEUTICAL PURPOSES; DEVICES OR METHODS SPECIALLY ADAPTED FOR BRINGING PHARMACEUTICAL PRODUCTS INTO PARTICULAR PHYSICAL OR ADMINISTERING FORMS; DEVICES FOR ADMINISTERING FOOD OR MEDICINES ORALLY; BABY COMFORTERS; DEVICES FOR RECEIVING SPITTLE
- A61J7/00—Devices for administering medicines orally, e.g. spoons; Pill counting devices; Arrangements for time indication or reminder for taking medicine
- A61J7/04—Arrangements for time indication or reminder for taking medicine, e.g. programmed dispensers
- A61J7/0409—Arrangements for time indication or reminder for taking medicine, e.g. programmed dispensers with timers
- A61J7/0427—Arrangements for time indication or reminder for taking medicine, e.g. programmed dispensers with timers with direct interaction with a dispensing or delivery system
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61J—CONTAINERS SPECIALLY ADAPTED FOR MEDICAL OR PHARMACEUTICAL PURPOSES; DEVICES OR METHODS SPECIALLY ADAPTED FOR BRINGING PHARMACEUTICAL PRODUCTS INTO PARTICULAR PHYSICAL OR ADMINISTERING FORMS; DEVICES FOR ADMINISTERING FOOD OR MEDICINES ORALLY; BABY COMFORTERS; DEVICES FOR RECEIVING SPITTLE
- A61J7/00—Devices for administering medicines orally, e.g. spoons; Pill counting devices; Arrangements for time indication or reminder for taking medicine
- A61J7/0076—Medicament distribution means
- A61J7/0084—Medicament distribution means for multiple medicaments
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61J—CONTAINERS SPECIALLY ADAPTED FOR MEDICAL OR PHARMACEUTICAL PURPOSES; DEVICES OR METHODS SPECIALLY ADAPTED FOR BRINGING PHARMACEUTICAL PRODUCTS INTO PARTICULAR PHYSICAL OR ADMINISTERING FORMS; DEVICES FOR ADMINISTERING FOOD OR MEDICINES ORALLY; BABY COMFORTERS; DEVICES FOR RECEIVING SPITTLE
- A61J7/00—Devices for administering medicines orally, e.g. spoons; Pill counting devices; Arrangements for time indication or reminder for taking medicine
- A61J7/04—Arrangements for time indication or reminder for taking medicine, e.g. programmed dispensers
- A61J7/0409—Arrangements for time indication or reminder for taking medicine, e.g. programmed dispensers with timers
- A61J7/0418—Arrangements for time indication or reminder for taking medicine, e.g. programmed dispensers with timers with electronic history memory
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61J—CONTAINERS SPECIALLY ADAPTED FOR MEDICAL OR PHARMACEUTICAL PURPOSES; DEVICES OR METHODS SPECIALLY ADAPTED FOR BRINGING PHARMACEUTICAL PRODUCTS INTO PARTICULAR PHYSICAL OR ADMINISTERING FORMS; DEVICES FOR ADMINISTERING FOOD OR MEDICINES ORALLY; BABY COMFORTERS; DEVICES FOR RECEIVING SPITTLE
- A61J7/00—Devices for administering medicines orally, e.g. spoons; Pill counting devices; Arrangements for time indication or reminder for taking medicine
- A61J7/04—Arrangements for time indication or reminder for taking medicine, e.g. programmed dispensers
- A61J7/0409—Arrangements for time indication or reminder for taking medicine, e.g. programmed dispensers with timers
- A61J7/0427—Arrangements for time indication or reminder for taking medicine, e.g. programmed dispensers with timers with direct interaction with a dispensing or delivery system
- A61J7/0445—Arrangements for time indication or reminder for taking medicine, e.g. programmed dispensers with timers with direct interaction with a dispensing or delivery system for preventing drug dispensing during a predetermined time period
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61J—CONTAINERS SPECIALLY ADAPTED FOR MEDICAL OR PHARMACEUTICAL PURPOSES; DEVICES OR METHODS SPECIALLY ADAPTED FOR BRINGING PHARMACEUTICAL PRODUCTS INTO PARTICULAR PHYSICAL OR ADMINISTERING FORMS; DEVICES FOR ADMINISTERING FOOD OR MEDICINES ORALLY; BABY COMFORTERS; DEVICES FOR RECEIVING SPITTLE
- A61J7/00—Devices for administering medicines orally, e.g. spoons; Pill counting devices; Arrangements for time indication or reminder for taking medicine
- A61J7/04—Arrangements for time indication or reminder for taking medicine, e.g. programmed dispensers
- A61J7/0409—Arrangements for time indication or reminder for taking medicine, e.g. programmed dispensers with timers
- A61J7/0454—Arrangements for time indication or reminder for taking medicine, e.g. programmed dispensers with timers for dispensing of multiple drugs
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61J—CONTAINERS SPECIALLY ADAPTED FOR MEDICAL OR PHARMACEUTICAL PURPOSES; DEVICES OR METHODS SPECIALLY ADAPTED FOR BRINGING PHARMACEUTICAL PRODUCTS INTO PARTICULAR PHYSICAL OR ADMINISTERING FORMS; DEVICES FOR ADMINISTERING FOOD OR MEDICINES ORALLY; BABY COMFORTERS; DEVICES FOR RECEIVING SPITTLE
- A61J7/00—Devices for administering medicines orally, e.g. spoons; Pill counting devices; Arrangements for time indication or reminder for taking medicine
- A61J7/04—Arrangements for time indication or reminder for taking medicine, e.g. programmed dispensers
- A61J7/0409—Arrangements for time indication or reminder for taking medicine, e.g. programmed dispensers with timers
- A61J7/0481—Arrangements for time indication or reminder for taking medicine, e.g. programmed dispensers with timers working on a schedule basis
- A61J7/049—Arrangements for time indication or reminder for taking medicine, e.g. programmed dispensers with timers working on a schedule basis automatically changing in response to a schedule deviation by the patient
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- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H20/00—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance
- G16H20/10—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance relating to drugs or medications, e.g. for ensuring correct administration to patients
- G16H20/13—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance relating to drugs or medications, e.g. for ensuring correct administration to patients delivered from dispensers
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61J—CONTAINERS SPECIALLY ADAPTED FOR MEDICAL OR PHARMACEUTICAL PURPOSES; DEVICES OR METHODS SPECIALLY ADAPTED FOR BRINGING PHARMACEUTICAL PRODUCTS INTO PARTICULAR PHYSICAL OR ADMINISTERING FORMS; DEVICES FOR ADMINISTERING FOOD OR MEDICINES ORALLY; BABY COMFORTERS; DEVICES FOR RECEIVING SPITTLE
- A61J2200/00—General characteristics or adaptations
- A61J2200/30—Compliance analysis for taking medication
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61J—CONTAINERS SPECIALLY ADAPTED FOR MEDICAL OR PHARMACEUTICAL PURPOSES; DEVICES OR METHODS SPECIALLY ADAPTED FOR BRINGING PHARMACEUTICAL PRODUCTS INTO PARTICULAR PHYSICAL OR ADMINISTERING FORMS; DEVICES FOR ADMINISTERING FOOD OR MEDICINES ORALLY; BABY COMFORTERS; DEVICES FOR RECEIVING SPITTLE
- A61J2205/00—General identification or selection means
- A61J2205/50—General identification or selection means using icons or symbolic figures, e.g. by a graphical representation symbolising the type of pathology or the organ by an image
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61J—CONTAINERS SPECIALLY ADAPTED FOR MEDICAL OR PHARMACEUTICAL PURPOSES; DEVICES OR METHODS SPECIALLY ADAPTED FOR BRINGING PHARMACEUTICAL PRODUCTS INTO PARTICULAR PHYSICAL OR ADMINISTERING FORMS; DEVICES FOR ADMINISTERING FOOD OR MEDICINES ORALLY; BABY COMFORTERS; DEVICES FOR RECEIVING SPITTLE
- A61J2205/00—General identification or selection means
- A61J2205/70—Audible labels, e.g. for pre-recorded info or messages
-
- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y02—TECHNOLOGIES OR APPLICATIONS FOR MITIGATION OR ADAPTATION AGAINST CLIMATE CHANGE
- Y02A—TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE
- Y02A90/00—Technologies having an indirect contribution to adaptation to climate change
- Y02A90/10—Information and communication technologies [ICT] supporting adaptation to climate change, e.g. for weather forecasting or climate simulation
Definitions
- This invention relates to medicine-dispensing devic- es and, more particularly, to a programmable medicine- dispensing system.
- a medication-dispensing system in which prescription information is encoded into a memory card by a programming device located at a pharmacy in accordance with a physician's instructions.
- the memory card is inserted by the patient into a dis- red which automatically releases the appropriate medi ⁇ cation at the required times and provides a corresponding alarm and visual indication on a screen.
- the dispenser includes sensors which detect the removal of medication from a delivery compartment to record compliance by the patient, but failure of the patient to remove the medica ⁇ tion will not prevent the dispenser from continuing its programmed operation but instead may send an alarm to a remote location.
- This system is intended for use by a patient at a facility where supervising personnel can observe monitors and take corrective action promptly, but is not portable or useful in an environment where the patient must follow a regimen without close supervision by others.
- the patent to Urquhart et al. No. 4,725,997 disclo ⁇ - e s a dispensing device for pharmaceutical preparations which is programmed with information concerning a dosing regimen and permits the user to deviate within limits from the regimen and monitors the deviations while pre- venting dispensing outside the predetermined limits.
- the dispensing device has a data communication interface for communicating with a physician or pharmacist and includes a display screen on which instructions and inquiries may be displayed.
- the Mclntosh et al. Patent No. 4,088,056 discloses a programmed medication clock having a plurality of sepa ⁇ rate compartments for different types of medication along with a separate indicator and acknowledgment switch adja- cent to each compartment to indicate the compartment from which medication is to be taken and to acknowledge taking of the medication by the user.
- the Lloyd et al. Patent No. 5,099,463 shows a medication alarm device with sepa ⁇ rate holders for removable medication containers and cor- responding indicator lights to designate a container from which medication is to be taken.
- a cap for a medication container includes a programmable prompting device which is programmed in accordance with the physician's prescription instructions to automatical ⁇ ly prompt a patient to take medication at prescribed times.
- the prompting device is programmed by plugging it into a pharmacist's programming station which is connect ⁇ ed to a computer for supplying programming instructions in accordance with the physician's prescription.
- the Bender Patent No. 3,871,551 discloses a pill dispenser usable by a patient with no supervision. Ac ⁇ cording to that patent, a manually-advanced pill dispens ⁇ er is provided for periodic delivery of medication at timed intervals and failure to remove a pill from the dispenser at the required time will prevent further ad ⁇ vance of the dispensing system.
- the patents to Carlson, No. 4,223,801; Boater et al.. No. 4,588,303; McLaughlin, No. 4,717,042; Cole et al., No. 4,731,765; and Shepherd et al.. No. 4,911,327 similarly disclose dispensing arrangements in which removal of medication at the appropriate time is detected.
- the Shepherd et al. patent also discloses a refill alarm, as does the Kehr et al. Patent No. 4,768,176, and the latter patent also discloses an arrangement for dis ⁇ pensing prescribed drugs at variable times in accordance with the patient's activities.
- None of the prior art provides a programmable medicine dispenser in which a separable data storage unit may be programmed by a physician or a pharmacist to provide specific instruc ⁇ tions with respect to each drug to be taken and which also requires the patient to properly confirm that he has followed the instructions or which releases a drawer con ⁇ taining medications and provides a visual indication of the location of medication to be taken.
- Another object of the invention is to provide a pro- grammable medicine-dispensing system which is appropriate for a patient who is not under immediate supervision.
- a programmable medicine-dispensing system including a removable data storage unit in which regimen-related information may be stored to make the information and appropriate medication available at re ⁇ quired times and wherein the patient must make a confirm ⁇ ing entry to permit the medication schedule to continue in accordance with the regimen.
- the regimen-related in- formation may be entered in a prescribing information storage unit by a physician or in a dispensing informa ⁇ tion storage unit by a pharmacist or a physician or the patient, or it may be entered in the dispenser by the patient.
- the location of medication to be taken in a drawer containing several compartments may be designated by an illuminated indicator.
- the system includes an arrangement for recording each con ⁇ firming entry made by the user as well as any user infor ⁇ mation such as side effect indications.
- the programmable medication-dispensing system of the invention is addressed to the management of multi-pre ⁇ scription regimens of "self-administering" or "home-care” patients with a minimum level of patient competency, for patients who might have a variety of attendants at dif ⁇ ferent times, are under the care of more than one physi- cian, and might obtain medication from different pharma ⁇ cists.
- the system in ⁇ cludes not only the dispenser used by the patient, but also the prescription card encoded by a pharmacist, a card encoder for the pharmacist, software for the phar a- cist and for the physician and the user, and various ac ⁇ cessories for communication and ancillary devices to fa ⁇ cilitate the operation.
- the dispenser can be embodied in many con ⁇ figurations, they all have certain basic design aspects and the same method of operation.
- the dispenser is a stand-alone unit which is portable, pro ⁇ grammable, interactive with the patient, simple to use, has large-scale ergonomics and includes a memory and an alarm system, which may include both sound and voice sig- nals, a TV-interrupt and a remote alarm. It may also be designed for telephonic communication, for example, with a physician or pharmacist.
- the dispenser which is programmable by either a PC or a "Smart Card” or simi- lar module, can devise the optimal daily schedule for taking medication and can use a variety of loading strat- egies, either daily or cyclical, from bulk supplies or prepackaged or from bottled inventories.
- the dispenser identifies the medication to be taken, speci- fies the quantity to be taken and provides instructions with respect to the taking of medication. Also, at pre ⁇ determined intervals, the dispenser can query the patient as to any present symptomatic state and any drug re ⁇ sponse. Moreover, the dispenser requires active, posi- tive "confirmation" from the patient that the medication was taken or specific instructions were read and fol ⁇ lowed, or that a response to a specific inquiry has been made. Furthermore, the system records the actual time and date when each medication was taken or any failure to take medication when scheduled and each confirmed event relating to the medication and any event for which con ⁇ firmation by the patient is required.
- the schedule is based on prescribed interval tolerances and the dispenser may provide a variety of alarms, for example, of variable frequency and tone. It also dis ⁇ plays the next scheduled taking, provides anticipatory alarms for "critical-to-take” medications and, if any medication is taken early or delayed, it can reschedule all of the remaining drugs to be taken during that day.
- the dispenser further distinguishes between a "postponed” taking of medication and a "late” taking of medication, and has an iterative procedure for scheduled but “moving" events and can also adjust dosages.
- the system can display the limits on cumula ⁇ tive daily dose and frequency and can condition dispens ⁇ ing on responses to specific inquiries, such as prior symptomatic states.
- the system can also intervene at any time by, for example, alerting the patient with respect to a "criti ⁇ cal” failure to take medication or toxicity, i.e., ad- verse drug reaction situations and can provide instruc ⁇ tions to the patient regarding stoppage of medication and calling for aid.
- the system can also allow the patient to select any one of several applicable drugs.
- the system can be arranged to adjust dosages de ⁇ pending on the response of the patient to symptomatic inquiries and can recall and display stored information such as the last drug taken and the last time any drug was taken, for example, and can also provide more elabo- rated instructions if the patient is unable to understand abbreviated instructions provided periodically.
- the medication-dispensing system may provide information about dressings, patient temperature, blood pressure, appointments and the like, and the patient can enter information regarding his condition or situation, i.e. , the times of sleep, of mobility, of eat ⁇ ing, of bodily functions and the like.
- the patient's dispenser may also be arranged to receive telephonic transmission of data and instructions, and a remote alarm and locator for the dispenser can also be provided.
- the dispenser can also maintain an inventory of pills within the dispenser and in the patient's bottled supply and can provide alarm signals alerting the user to reload, refill or reorder medication.
- the system is especially adapted for the regulation of prescribed pharmaceuticals in which the timing, se ⁇ quence and dosage of medication needs to be continuously adjusted or where the complexity of such management is greatly compounded by the prescription of more than one drug and where there is a wide range of patient competen ⁇ cy for self-administration such as may occur in connec ⁇ tion with patients over the age of sixty who require mul ⁇ tiple medications for chronic conditions.
- the medication-dispensing system of the present invention has direct applicability to any regimen that requires a re ⁇ sponsive and flexible drug strategy and a high confidence of patient compliance, it is particularly addressed to the prescription, coordination, interaction, instruction and periodic monitoring and special compliance problems relating to complex mono- and poly-pharmaceutical regi ⁇ mens.
- the medi ⁇ cation-dispensing system of the invention includes a pre ⁇ scribing data entry station at which instructions are encoded by a physician into a portable prescribing mod ⁇ ule.
- the prescribing module may, for example, be a mi- crocomputer cartridge containing an appropriate memory in which instructions are stored and from which a physician may retrieve compliance information indicating the extent to which the patient has complied with instructions.
- the prescribing module is encoded by using a personal computer attached to a prescribing adapter into which the prescribing module is plugged.
- the system also includes a dispensing data entry station at which a dispensing data storage module is programmed by a pharmacist, for example, to store drug-specific information relating to the medica ⁇ tion, including times and dosages and refill information.
- the system includes a medication dis ⁇ an operable by the patient in which the prescribing data storage module and the dispensing data storage mod- ule are received and which is responsive to the stored data to display appropriate medication information and permit loading and dispensing by the patient of the spe ⁇ cific drugs prescribed by the physician.
- the dispenser requires confirming entries to be made by the patient at each step in the process. If desired, the dispenser may have, for example, separate drawers for drugs to be taken on demand and drugs to be taken only at specified intervals, each drawer containing a series of compartments for different drugs with indicating lights designating the compartment containing the drug to be taken or loaded by the patient.
- FIG. 1 is a schematic perspective view illustrating the arrangement of a representative prescribing data en ⁇ try station for use by a physician in accordance with the invention
- Fig. 2 is a schematic perspective view illustrating the arrangement of a typical dispensing data entry sta ⁇ tion for use by a pharmacist;
- Fig. 3 is a schematic perspective view illustrating the arrangement of a representative medication dispenser arranged in accordance with the invention
- Fig. 4 is a schematic block diagram showing the ma ⁇ jor components of a typical medication dispenser in ac ⁇ cordance with the invention.
- Fig. 5 is a perspective view illustrating the ar ⁇ rangement of another representative embodiment of a medi- cation dispenser according to the invention.
- a prescribing data entry station shown in Fig. 1, includes a prescribing adapter 10, connected to a conven ⁇ tional personal computer 11 or the like, which is ar ⁇ ranged to encode data and prescribing instructions, typi ⁇ cally under the control of a physician, in a prescribing module 12 regarding the specific regimen, including the timing and dose of each of a plurality of drugs to be taken by a patient.
- the prescribing module may, for ex ⁇ ample, be a microcomputer cartridge of the usual type. The patient then uses the prescribing module to control the operation of a medication dispenser such as described hereinafter with reference to Fig. 3.
- the computer 11 receives data from a series of diskettes 14 containing basic instructions and other in ⁇ formation and displays the data as selected by the physi- cian on a screen 15 to assist the physician in determin ⁇ ing the drug regimen.
- diskettes may include the medication history and most current prescribing instruc ⁇ tions and schedule for the patient, specific information relating to each of the medications to be prescribed, including recommended dosages, interactions, counterindi- cations, and the like, and condition- or disease-specific information, including a checklist or menu of choices that allows the physician to select dosage and time vari- ables, to screen for specific drug interactions, to de ⁇ lineate particular symptoms, conditions, responses, in ⁇ structions and the like, which are appropriate to the drugs prescribed, the patient competency level and the diagnosis.
- Such diskettes may be prepared, for example, under the guidance of a "physician (scientific) advisory committee" whose members include disease- or condition- specific doctors, gerontologists and polypharmacists.
- the same type of information may be supplied in the form of magnetic cards or other electronic or magnetic storage devices having a capacity sufficient to store all of the required information.
- Electronic storage devices may be in the form of "smart cards" containing embedded integrated circuits.
- the prescribing module 12 and the dispensing module 18 described hereinafter may consist of any type of in ⁇ formation storage device, such as a magnetic card or disk or an electronic storage device, which may be received in and read by an information-handling system.
- the computer displays the necessary information on a screen 15, such as the competency level of the patient, and, for each drug prescribed, a menu is displayed from which the physician keys in the dosage and timing selec ⁇ tions, limits and special instructions.
- a disease-spe ⁇ cific menu is then displayed and the computer then con- ducts a drug interaction and counterindication review and displays any possible incompatibilities.
- the physician enters any changes to the ini ⁇ tially-established regimen and selects the appropriate features or operating mode from the level of simplicity menu derived from the patient information file.
- the selected regimen and its schedules which have been checked by the computer or the encoder for consis ⁇ tency, redundancy and efficiency, are displayed on the screen 15.
- the prescribing module 12 is en ⁇ coded and the patient's information diskette is updated.
- the encoded prescribing module 12 can then be used by the patient to control the operation of the dispenser 13.
- the patient provides a pharmacist with a written prescription from the physician.
- the pharmacist uses a dispensing data entry station, such as shown in Fig. 2, including a computer 16 with a dispensing module adapter 17 to encode a dispensing data storage module 18 with dispensing instructions.
- the dis ⁇ pensing module 18, which may also be in the form of a smart card or the like, is a one-time use item which is supplied to the patient with a specific quantity of medi ⁇ cation. After that quantity has been used, the patient must have the original module or card reprogrammed or obtain another dispensing module or card, along with the appropriate quantity of the medication, from the pharma ⁇ cist.
- the typical embodiment of a programmable medicine dispenser 13 according to the invention, illustrated in Fig. 3, includes a rectangular box-like housing 19 having two drawers 20 and 21 slidably received in the sides of the housing and a hinged cover 22 containing a screen 29 which is adapted to be folded down on the top of the housing.
- One receptacle 23 at the bottom of the front of the housing is arranged to receive the prescribing module 12 which has been encoded by the physician's computer 11 in the manner described above with respect to Fig.
- a keyboard 25 is provided on the top of the housing 13 to enter information necessary for the opera- tion of the dispenser.
- a computer (not shown) may be connected to the dispenser to enter the necessary information and, in this case, the prescribing module 12 and the dispensing module 18 may be replaced by diskettes to be used with the computer.
- the righthand drawer 20 (“Drawer I") is arranged to contain and provide access to drugs which are to be taken on a specific time schedule
- the lefthand drawer 21 is arranged to contain and permit access to drugs which may be taken on demand or as needed.
- the dispenser In response to depression of a "Load" key 28 by the patient or at a prescheduled time, the dispenser displays on the screen 29 all medications scheduled for the day according to the drawer in which they are to be loaded. For each drug listed, the name, dose, number of pills to be loaded, type (pill or capsule) and color is shown. In addition, a clock 30 is provided to indicate the current time.
- the screen When the user depresses the "Load” key 28, the screen also displays the inquiry "Ready to load Drawer I? (time-scheduled drugs) " When the user has the specified drugs ready, he depresses a "Yes/Enter” key 31. As a result, the drawer 20, which has a series of twelve com ⁇ partments 32 arranged in three rows, is extended. Each compartment has an indicating light 33 and the compart ⁇ ment to be loaded first is designated by flashing of the corresponding indicator light.
- the screen 29 displays a highlighted command "Load (name of drug) " and a low-lighted and flashing "Loading” as well as a highlighted and flashing "Confirm” and a low-lighted "(name of drug) not yet confirmed”.
- the different graph- ic character of each of the screen displays emphasizes the responses required from the user. After placing the proper drug in a specified compartment, the user must depress a confirm key 34 on the top of the dispenser housing. If a confirming entry has not been made, the compartment light and the load instruction on the screen 29 continue flashing and the drawer 21 cannot be closed nor can further dispensing operations proceed.
- an audible alarm 36 is initiated and an appropriate message is flash-displayed on the screen.
- the audible alarm may be a tone or ring ⁇ ing sound or it may consist of a vocal synthesis or re ⁇ cording providing specific instructions.
- the instructions and information displayed on the screen 29 may be supplemented by or substituted by corresponding vocal information.
- the flashing compartment light is turned off and the screen 29 dis ⁇ plays "You have just loaded (name of drug) " and "Ready to load next drug?".
- the screen indicates the next drug to be loaded with the same type of display used for the first drug, and the corresponding compartment light 33 begins flashing and, after loading of that drug in the appropri ⁇ ate compartment, the user again depresses the confirm key 34. This procedure continues until all of the time- scheduled drugs have been loaded into corresponding com ⁇ partments in the drawer 21 in the manner indicated on the screen 29.
- the screen shows "All time-scheduled drugs have been loaded and confirmed” along with a com ⁇ mand-prompt "Close Drawer I". Thereafter, the time- scheduled drawer 21 can be closed.
- the screen displays
- the screen 29 displays "All drugs loaded and confirmed” and "Ready to set time-scheduled drugs?".
- the screen dis ⁇ plays:
- the screen will dis ⁇ play the "Time-Set” procedure. Once the time is set, it reads: “Ready to Dispense: Take first pill(s) at: (set time)". If "As [first] needed” is selected, the display reads: “Ready to dispense: Take first pills when need ⁇ ed”.
- the foregoing options can be preset by the prescribing instructions in the prescribing module 12 and thus not be available as a choice.
- the screen 29 will display, in a "Message” or “Reminder” sec ⁇ tion of the screen, next to these last two choices, a flashing side-line: "Must be taken before first meal”.
- the iterative procedure allows setting and changing of mealtimes, bedtimes and special times according to the user's changing schedule.
- the dispenser's alarm 36 will go on at the scheduled time and remain on until "Dispense" key 40 is pressed, or until a preset number of minutes has passed. The alarm will be repeated a preset number of minutes later and continue to go off and on intermittent- ly until the "Dispense" key is operated.
- the drawer 20 slides open, optionally only far enough to ex ⁇ pose the first row of compartments, and the indicator light 33 in the appropriate compartment 32 emits a flash- ing light.
- the screen 29 displays a high ⁇ lighted command-prompt: "Take (number of pills and name of drug) " and instructions for taking it along with a low-lighted and flashing "Dispensing", a highlighted flashing prompt “Confirm (name of drug) " and a low-light ⁇ ed "(name of drug) not yet confirmed”.
- the user removes the specified number of pills from the indicated compart- ment 32 and takes them according to the displayed in ⁇ structions.
- the screen then reads "You have just taken (name of drug)" and prompts "Ready to take next drug?”.
- the screen displays the next drug to be dispensed and the same procedure will be fol ⁇ lowed until all of the drugs to be taken at that time have been taken and confirmed. If desired, a list of all those drugs, indicated “Confirmed", can then be dis- played.
- the screen 29 then reads "Time-group #1 is dispensed and confirmed” and prompts "Close drawer I". When the drawer 21 is closed, the screen then displays continuous ⁇ ly the next scheduled dispensing time and a list of pills in the next group to be taken.
- This procedure is repeated for each time group throughout the day as long as all scheduled drugs have been taken and confirmed.
- the alarm 36 continues to go on and off, the screen 29 shows a flashing "Dispensing de ⁇ layed" and displays the delayed drugs, the last time tak- en, the time scheduled to be taken, and the number of minutes late are displayed.
- the display 29 indicates which drugs dispensed from the drawer 20, if any, require a dosage adjustment, any special instructions, and prompts any
- the user may wish to take a scheduled drug early.
- a list of the next drugs to be taken is displayed on the screen 29.
- the desired drug is selected by operating the Select key 38 and the Yes/Enter key 31 is depressed.
- the screen may dis ⁇ play a warning that it is too early to take that drug and that the user should wait a specified time before taking it.
- the screen will display a statement that the drug is being taken a specified length of time prior to the scheduled time and the user will be asked if he wants to take that drug now. If the user then depresses the
- the drawer 20 will open and the appro ⁇ priate indicator light 33 will flash.
- the usual confirming entry by depression of the Confirm key 34 is required to close the drawer.
- the dispenser will then reset the schedule for that drug so that the prescribed interval between taking of the drug remains constant and the remaining schedule conforms to instructions.
- the medication dispenser 12 accommodates as-needed drugs in the drawer 22 as described above for which there is no fixed scheduling and/or variable dosages.
- the pre ⁇ scribing instructions specify the parameters for each drug, such as minimum intervals, cumulative maximum dos ⁇ age, daily, etc.
- the drawer 22 opens and from then on the on-demand drug is treated like any scheduled medication.
- the medication dispenser can present specific prompted requests or messages for the patient's response to medication which are selected by the physician from a menu of such messages or devised by him when the pre ⁇ scribed instructions are set.
- Such messages can include prompted inquiries as to efficacy, counterindications, interactions and the like. Responses to such inquiries are required and are equivalent to confirming entries in that a nonentry is unacceptable and will prevent further operation of the dispenser.
- Specific response entries can be set to cause alarms and the display of responding instructions, such as an instruction to stop taking a specific drug, a delay in the next time for taking the drug, a change in the dosage or an instruction to call the physician, as well as rescheduling messages.
- the programmable medication dispenser 13 of the in ⁇ vention can also be used for logging of symptoms or con ⁇ ditions of the patient. This can be scheduled at specif ⁇ ic times during the day, at which times the alarm 36 is sounded and the screen 29 displays a menu of possible symptoms, or it can be patient-initiated in response to depression of a Log key 46. In either case, a list of possible symptoms such as nausea, headache, blurred vi- sion, pain and the like is displayed and the user can select the appropriate symptom and enter it by depressing the Yes/Enter key 31 or, if a computer is connected to the dispenser, a description can be entered through the computer keyboard. The resulting information, requiring a confirming entry, is recorded in the prescribing module 12.
- Drugs which are taken based upon events that are independent of specific times, such as at mealtimes, upon waking or retiring, after a bowel movement or the like, can be displayed continuously on the screen 29 with ap ⁇ intestinalte instructions. Such drugs are loaded in the lefthand drawer 21 and are displayed and treated like any on-demand medication. Times can be reset as events change.
- the medication dispenser has a continuously running clock 30 and, if desired, a calendar (not shown) . Any time a confirming entry or a response entry is executed, the entry which it confirms can be set by the prescribing instructions to be time-recorded into the medication dis ⁇ organic memory and in the prescribing module memory.
- the dispenser 13 can also maintain a count of the number of pills remaining within each compartment of the dispenser, as well as a running count of bottled invento- ry, and provide alert signals for reordering drugs for which there is less than a specified supply, such as three days.
- the user can at any time call up on the screen 29 any information available in the mem ⁇ ory such as the next scheduled or previous time-group or a drug-by-drug record or schedule.
- the phy ⁇ sician can encode in the prescribing module 12 appropri ⁇ ate instructions for nonprescription medication, which will then be displayed on the screen 29 prior to use of that medication.
- the dispenser 13 can also be programmed to display laboratory test data, specific procedures such as bandage-dressings, topical applications, therapies, appointments and the like upon request by the user and other information relating to the patient or to other drugs, prescriptions or emergency procedures.
- the alarm 36 in the dispenser is loud enough to be heard by a user in another part of the house or apartment in which the user is living.
- a handheld locator can be car ⁇ ried by the user to activate the alarm 36 to enable the user to identify the location of the dispenser.
- the dispenser can be arranged to transmit alarm signals to the locator which is carried by the user.
- the data recorded by the patient's dispenser regarding usage, symptoms, answers to questions and the like is supplied to the physician by simply bringing him the patient's prescribing module 12. This data is retrieved by the physician's computer 11 to up ⁇ date the patient's file card diskette.
- an accessory modem may be provided for direct telephonic transmission to the physician. This allows data from the patient's dispenser to go directly into the physician's computer and, conversely, the physician can transmit prescribing instructions directly to the dis- an for recording in the prescribing module 12.
- FIG. 4 A schematic block diagram showing the operative com ⁇ ponents of a typical dispenser is illustrated in Fig. 4.
- the dispenser includes a control unit 46 containing a conventional microprocessor programmed in a conventional manner to control the above-described and other functions of the dispenser in response to informa ⁇ tion read by a module reader 47 from the prescribing mod ⁇ ule 12 and instructions entered by operation of the keys on the top of the dispenser unit.
- the control unit in- teracts with release mechanisms 48 and 49 for the drawers 20 and 21 of Fig. 3 and with indicator light control units 50 and 51, respectively, for those drawers.
- control unit 46 interacts with the keyboard 25, the screen 29, the alarm 36 and the clock 30 and with a remote communicator unit 51 which may, for example, communicate with one or more of a handheld loca- tor, a telephone interface modem, an external printer, an infrared control unit and the like.
- the dispenser also includes an appropriate memory unit 52 and a power source 53 containing, for example, a battery and charging unit to permit operation during power failures, while travel- ling or at remote locations.
- a simpler version of the dispenser 13 may be provided. This may be accom ⁇ plished by preprogramming the dispenser or by appropriate entries through a personal computer or by plugging in a programming module such as a smart card containing both prescribing data and dispensing data. In this case, the prescribing module is not necessary and no separate draw ⁇ er need be provided for demand-only drugs. Consequently, only one compartment is required for each type of drug. The remaining operation and display functions are the same as described above and the dispensing module sup ⁇ plied by the pharmacist may or may not still be neces ⁇ sary.
- the dispenser keyboard may also be pro ⁇ vided with a "Postpone” button which may be depressed by the patient if for any reason it is desired or necessary to postpone the taking of scheduled medication. This has the effect of resetting the alarm for the postponed medi- cation after a predetermined delay such as five minutes and, if not taken, then every five minutes thereafter or scheduled for a later time within allowable limits and also rescheduling the taking of medications for the re ⁇ mainder of the day. Any delay beyond the allowable limit will cause the screen to display "Call the doctor".
- the "Postpone” key may also be used during loading if the medication to be loaded is not ready.
- the dispenser may also provide an anticipatory alarm for "critical-to-take" medications where, for example, no postponement can be permitted.
- the dispensing module 18 is arranged for one-time use by the patient in conjunction with the medication supplied by the pharmacist.
- the module would be arranged to permit only a single or a se ⁇ lected number of loadings of medication into the dispens ⁇ er, after which it would no longer be operable either for a selected drug or for all drugs and would require a new prescription and reprogramming by the pharmacist. In this way, the patient would be required to have periodic check-ups by the physician before continuing with the regimen.
- Fig. 5 illustrates a simplified dispenser 60 de ⁇ signed to be conveniently portable and having dimensions, for example, of about 5cm by 10cm by 15cm.
- the dispenser includes a bottom portion 61 hav ⁇ ing five medication storage compartments 62-66, each hav- ing its own dispense indicator light 67 to indicate the compartment into which a particular medication is to be loaded or from which a particular medication is to be taken.
- Each of the compartments 62-66 has a bottom wall 68 which slopes upwardly toward the outer edge of the compartment to facilitate removal of pills 69 stored in the compartment and a transparent sliding or folding cov ⁇ er 70.
- the dispenser also has a top portion 71 joined to the bottom portion by a longitudinal hinge 72 to permit the parts to be folded together.
- the top portion 71 in- eludes a display panel 73 and a series of buttons 74 hav ⁇ ing functions similar to those described above with re ⁇ spect to Fig. 3.
- the top portion has a slot 75 into which a single prescribing card 76 is inserted.
- the single card 76 may be arranged to perform the func- tions of both of the cards 12 and 18 described above with respect to Fig. 3.
- the bottom end of the dispenser has an audio alarm 77 and a visual alarm indicator 78 to per- mit hearing and observation of alarms when the unit is closed.
- the dispenser also has a battery compartment 79 containing rechargeable batteries and a low-battery indi ⁇ cator 80 to warn the user to recharge the batteries.
- the upper portion 71 also includes a port 81 for connection to a telecommunications line.
- Each of the transparent covers for the compartments containing scheduled medication may normally be locked in closed position and released only for loading purposes or when medication contained in the compartment is scheduled to be used or when the patient indicates early or late taking of that medication and may also be arranged to prevent the patient from closing the cover unless the confirming entry button has been pressed.
- the card 76 which is inserted into the slot 75 in the upper portion 71 of the unit may contain both physicia and pharmacist-recorded information and may also receive and store information entered by the patient.
- the folding cover 70 has two hinges 82 and 83 arranged to permit either the entire cover or only a front segment 84 to be pivoted away from the corresponding compartment.
- the double-hinged cover can be arranged to that it is released only at the time medi ⁇ cation is to be dispensed.
- the double-hinged cover may be open- able by the user at any time and such opening is sensed by a switch engaging the front segment 84.
- the screen may read “Confirm to Continue” and, after confirmation, the screen may read “Close Cover to Continue” and an alarm will be set off if an attempt is made to continue without closing the cover.
- the display will read "Please Confirm” and further operation of the system will be prevented until the confirming entry has been made.
- the display 73 may simply be a symbol display for preformed characters and symbols whereas, for a medium- or higher-priced unit, the display 73 may be an alpha-numeric display and the keys 74 may include an alpha-numeric keypad or a separate keypad may be plugged into the unit.
- Higher-priced configurations may include a silicon microchip with a serial interface in the card 76 rather than magnetic storage and each such chip may have a laser-written unique electronically-read ⁇ able code number for positive identification.
- the functions of several of the keys de- scribed in connection with the embodiment of Fig. 1 may be combined into a single key.
- the Select and Scroll functions may be combined into one key and the Demand Override and Dispense functions combined into an ⁇ other key, and the Yes/Enter and Confirm functions may be combined into one key.
- Other function combinations for the same key are also possible.
Abstract
Description
Claims
Priority Applications (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
JP6506472A JPH06511183A (en) | 1992-08-19 | 1993-08-16 | programmable drug delivery system |
EP93920113A EP0612420A4 (en) | 1992-08-19 | 1993-08-16 | Programmable medication dispensing system. |
Applications Claiming Priority (4)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US93207292A | 1992-08-19 | 1992-08-19 | |
US07/932,072 | 1992-08-19 | ||
US08/092,352 US5408443A (en) | 1992-08-19 | 1993-07-15 | Programmable medication dispensing system |
US08/092,352 | 1993-07-15 |
Publications (1)
Publication Number | Publication Date |
---|---|
WO1994004966A1 true WO1994004966A1 (en) | 1994-03-03 |
Family
ID=26785577
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/US1993/007710 WO1994004966A1 (en) | 1992-08-19 | 1993-08-16 | Programmable medication dispensing system |
Country Status (6)
Country | Link |
---|---|
US (1) | US5408443A (en) |
EP (1) | EP0612420A4 (en) |
JP (1) | JPH06511183A (en) |
CA (1) | CA2121126A1 (en) |
MX (1) | MX9304656A (en) |
WO (1) | WO1994004966A1 (en) |
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FR2753087A1 (en) * | 1996-09-09 | 1998-03-13 | Biostat | MODULAR POCKET MEDICINE DISPENSER |
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CN106999351A (en) * | 2014-09-12 | 2017-08-01 | 伯克顿迪金森公司 | Ancillary drug is filled and managed |
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US11278660B2 (en) | 2015-11-30 | 2022-03-22 | Sanofi-Aventis Deutschland Gmbh | Packaging assembly with mounting attachment |
US11951274B2 (en) | 2015-11-30 | 2024-04-09 | Sanofi-Aventis Deutschland Gmbh | Packaging assembly |
US11369732B2 (en) | 2017-02-24 | 2022-06-28 | Sanofi | Packaging assembly |
US11565034B2 (en) | 2017-02-24 | 2023-01-31 | Sanofi | Packaging assembly |
US11724021B2 (en) | 2017-02-24 | 2023-08-15 | Sanofi | Packaging assembly |
US11944777B2 (en) | 2017-02-24 | 2024-04-02 | Sanofi | Packaging assembly |
US11213458B2 (en) | 2017-03-20 | 2022-01-04 | Access Business Group International Llc | System and method for monitoring intake compliance |
US10874591B2 (en) | 2017-03-20 | 2020-12-29 | Access Businss Group International LLC | System and method for monitoring intake compliance |
Also Published As
Publication number | Publication date |
---|---|
US5408443A (en) | 1995-04-18 |
CA2121126A1 (en) | 1994-03-03 |
MX9304656A (en) | 1994-03-31 |
JPH06511183A (en) | 1994-12-15 |
EP0612420A4 (en) | 1994-12-14 |
EP0612420A1 (en) | 1994-08-31 |
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