
Digitally Tracking Patients With Schizophrenia: The Future Is Here
What does the evidence tell us about digital sensors for treatment adherence in patients with schizophrenia and other psychiatric disorders?
Dr Torous is a Clinical Fellow in Psychiatry at Harvard Medical School and Senior Resident at the Harvard Longwood Psychiatry Residency Training Program in Boston. He is the Digital Psychiatry Editor for Psychiatric Times. Twitter:
The FDA
Some have questioned whether an ingestible medication that sends digital signals regarding adherence is appropriate for use in disorders like schizophrenia. Concerns that Abilify MyCite may increase paranoia and delusions have been raised. However, while concern for patient welfare is well intentioned, it may be more appropriate to consider what the evidence reveals about technology use and schizophrenia.
Two years ago, our team worked with the
Coincidently, we worked with a patient with schizophrenia who
Rather, it is encouraging to see the introduction of new tools and innovations for psychiatric disorders. Schizophrenia and related disorders impact ~1.5% of the population, and in the US, the
For the appropriate patients, it is possible to imagine how this digital pill could help them with medication, monitor progress, and share results their family and psychiatrists. And if the Abilify MyCite system detects when a patient has stopped taking the medication, that may be a window to have a conversation about adverse effects or other issues. A quick discussion here could prevent a relapse that can be stressful to patients and their families as well as expensive to the health care system. Of course, some patients may not want to use such a system and could easily take off the wearable patch.
That said, we all must be careful in this new world of digital psychiatry. Looking at the mobile app space, the lack of consumer privacy protections for apps that record personal health information like medications and even sensor data (such as real-time location) is
There are real privacy risks today-right now Abilify MyCite is taking the right steps to mitigate potential harm through regulation and research. Like any new medication, Abilify MyCite will only become well adopted if it can demonstrate that it is effective in the real world. While its ability to track ingestion is novel and raises concerns, it also presents an opportunity to improve outcomes for patients with schizophrenia and related disorders.
Disclosures:
Dr Torous is a Clinical Fellow in Psychiatry at Harvard Medical School and Senior Resident at the Harvard Longwood Psychiatry Residency Training Program in Boston. He is the Digital Psychiatry Editor for Psychiatric Times. Twitter:
References:
1. US Food and Drug Administration. FDA approves pill with sensor that digitally tracks if patients have ingested their medication. November 13, 2017.
2. Gay K, Torous J, Joseph A, Pandya A, Duckworth K.
3. Torous J, Firth J, Mueller N, Onnela JP, Baker JT.
4.Torous J, Roux S.
5. Marcus SC, Olfson M.
6. FBI. Consumer Notice: Internet-Connected Toys Could Present Privacy and Contact Concerns for Children. July 17, 2017.
7. Torous J, Roberts LW. Needed innovation in digital health and smartphone applications for mental health: transparency and trust. JAMA Psychiatry. 2017;;74:437-438.
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