Advances in medical technology over the years have played a factor in people living longer and healthier lives. Irrespective of these advances, a number of health problems such as hypertension, arthritis, myasthenia gravis, heart conditions and the like persist. Treatment of these health problems often requires that a patient comply with a relatively complex medication regimen by which the patient must take certain dosages of certain medications at various times throughout the day.
Seniors and the chronically ill are particularly vulnerable to the misuse of prescription drugs, especially where a number of different drugs are to be taken throughout the day and night or where one drug is to be taken at precise time intervals. For example, in an attempt to comply with a prescribed medication regimen in which various drugs are to be taken at different points of time throughout the day, a patient may apportion out the daily prescription and quantities of medication, and then take all of this medication in one dose at a particular time. Similarly, patients have been known to increase the dosage of drugs that are taken without obtaining approval of their physician based upon the mistaken belief that if one dose is good, then two must be better.
Non-compliance with medication regimens in this fashion can cause serious health problems and lead to permanent institutionalization which could be avoided if the prescribed regimen were followed more precisely. For example, prescription drug mishaps, in which noncompliance is a major factor, result in significantly increased medical costs and between three to five percent of all hospital admissions are directly related to an adverse drug reaction caused by mismedication.
Various medication dispensing systems and controls have been used to combat the patient non-compliance problem. For example, U.S. Pat. No. 5,412,372 to Parkhurst et al. describes a portable drug dispenser which uses a blister pack of pills having a two-dimensional array of drugs. In use, the blister pack is interconnected with a monitoring unit. The drugs are dispensed from the two-dimensional array by a user physically breaking the blister package and then removing the pill. The control unit detects the breakage of the blister package and internally records the time of breakage as an indication of the time the pills were consumed. In addition, the control unit provides audible and visual alarms to alert a user of the need to take the medication.
U.S. Pat. Nos. 5,267,174 and 5,329,459 to Kaufman et al. disclose medication dispensing systems that are interactive with the needs of the patient. These systems may dispense medications of a first or second variety. In both systems, timers restrict access to either medication based upon the risks associated with each medication. Physiological monitoring facilities are provided along with communication facilities to allow health care professionals at remote locations to assess risks and authorize the dispensation of medications.
U.S. Pat. No. 5,072,430 discloses a device for indicating a need to take a prescribed doses of medication that are stored in a blister package. The device monitors and then electronically stores the identity of the blister package that is broken. The device is particularly suited for use in trials of new drugs and medicaments.
U.S. Pat. No. 5,047,948 to Turner discloses a pill dispenser that includes features for special medication and for emergency help. Pills are dispensed from rotating spiral actuators and timers provide a minimum time interval between which medication may be taken.
U.S. Pat. No. 5,020,037 to Raven discloses an alarm pill box which contains a single pill compartment. A display alerts a user at a preprogrammed time to take the medication. Raven contains no provisions for dispensing pills or for remotely ordering refills and, significantly, no control mechanism is used to prevent overmedication by a patient.
U.S. Pat. No. 5.,014,875 to McLaughlin et al. discloses a security and dispensing device for drugs and medical supplies. Access to various compartments is allowed only through the entry of appropriate identification codes. Patient drug prescriptions may be entered remotely by a pharmacy for display on a monitor associated with the security and dispensing device. A nurse or other facility employee retrieves drugs for delivery to patients based upon entry of a personal identification code and/or patient information.
U.S. Pat. No. 4,911,327 to Shepherd et al. discloses a pill dispenser that individually dispenses pills at predetermined times. An audio and visual alert is activated at the predesignated times. The dispenser has features to alert a nurse if the pill is not taken and to call a pharmacy when the unit is empty. The unit can be remotely programmed and uses a reloadable carousel to dispense pills.
U.S. Pat. No. 4.847,764 to Halvorson describes a computer-based remotely located drug dispensing station for use in a hospital. The drugs are packaged in individual units are and delivered to a nurse by the dispensing station for distribution. A computer associated with the dispensing station notifies the nurse of a need for medication which the nurse then delivers to the patient. When the station is empty, the computer automatically orders more medication from an interconnected pharmacy.
U.S. Pat. No. 4,748,600 to Urquhart discloses a pill dispenser that is interactive with the needs of a patient. Pills are dispensed from a carousel based upon the patient's requests and the risks associated with the particular drug used. When a pill is not taken, a communications link requests help.
U.S. Pat. No. 4.733,362 to Haraguchi discloses a drug dispensing apparatus which utilizes a packaging sheet or paper for accommodating individual drug doses in separate packets. The patient's name, times for taking the drug doses, and other pertinent information is printed on the packets.
U.S. Pat. No. 4,695,954 to Rose et al. discloses a programmable drug dispenser having a prescribed dose of medication contained within a number of individual compartments. A programmable controller of the dispenser unlocks an access door to each compartment at an appropriate instant and sounds an alert for a patient to ingest the medication. The system includes a monitor through which medical personnel can obtain a video display or printed record of the prescription information and patient compliance information which is stored within a memory device. A modem is included for transmitting the data stored within the memory device to a central location.
U.S. Pat. No. 4,616,316 to Hanpeter et al. discloses a medication compliance monitoring system comprising a blister pack having an array of medications which is detachably connected to an electronic memory circuit. The memory circuit detects and stores the time when the blister pack is ruptured over an extended period of time and can be hard-wire connected to a microcomputer to process the data and provide a display of compliance information.
The Baxter.RTM. ATC 212 Automated Medication Dispensing System is an apparatus by which patient medication orders can be dispensed in flexible strips of labelled packages. Each strip comprises a number of individual packages of medication that are separated by perforations. Relevant information such as patient name, medication name, time and date of medication administration and the like is printed on the face of each package in text as well as barcode. This system is particularly suited for large-scale applications and other institutional uses, but is not amenable for use in the home health care environment.