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
Steve Connor is the Science Editor of The Independent. He has won many awards for his journalism, including five-times winner of the prestigious British science writers’ award; the David Perlman Award of the American Geophysical Union; twice commended as specialist journalist of the year in the UK Press Awards; UK health journalist of the year and a special merit award of the European School of Oncology for his investigative journalism. He has a degree in zoology from the University of Oxford and has a special interest in genetics and medical science, human evolution and origins, climate change and the environment.
Friday 17 February 2012
Medical treatment is about to go wireless. New advances in microelectronics have enabled doctors to contemplate the day when they will be able to 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 heathcare 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 yesterday 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.
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.
"You could literally have a pharmacy on a chip. You can do remote-control delivery and you can deliver multiple drugs," said Professor 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," Professor 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 and released yesterday at the AAAS meeting found that microchip worked as expected and the women showed signs of improved bone formation and reduced risk of fractures.
"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.
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, in order 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.
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