Can Digital Pills Help Monitor Opioid Use?

Understanding how patients use opioids could be key to understanding the opioid crisis. Researchers have a new tool for tracking the pills.

Despite the ubiquity of opioid painkillers, medicine still isn’t certain of how the drugs are used once a patient leaves the clinic and fills their prescription. This, according to a new study from Brigham and Women’s Hospital, “leads to variable and overly generous opioid prescribing practices, resulting in a surplus of opioids,” which can then lead to abuse and addiction.

Researchers today have a new tool to enhance their understanding of opioid use, however: digital pills. The pills contain unique radiofrequency emitters. When triggered by digestive chemicals, they transmit signals to an externally-worn adhesive patch. The patch is linked to a reader that logs the ingestion data, allowing clinicians to monitor when the pills are taken.

Peter R. Chai, MD, MMS, was lead author of the new Brigham and Women’s Hospital report, published recently in Anesthesia & Analgesia. He said the work was both a study of how patients used opioids and also of how well digital pill technology can monitor that use.

His team employed the eTectRx ID-Cap system to monitor 15 patients following treatment for acute fractures. Each patient was prescribed a course of 21 digital oxycodone pills, linked to the eTrectRx system. They found that patients only ingested 6 of the 21 pills they were given, on average, and most ceased taking the oxycodone after 3 days.

“The right kind of patient probably takes less opioids for acute fracture pain than we expect,” Chai told Healthcare Analytics News™ in an interview. “It’s not the perfect population to generalize to everybody, but in the very least we’re starting to have some evidence that we probably are giving out too many opioids.”

Digital pill commercialization has so far been limited. Last week, the FDA approved the first variety, a sensor-enabled version of the antipsychotic Abilify. Often prescribed for schizophrenia, bipolar disorder, and major depressive disorder, the tech-enabled version of the drug is intended to ensure adherence.

Chai thinks digital opioids could have the opposite effect. “With a medication like opioids, knowing that you’re being watched potentially is a good thing,” he said.

Digital pills could become more common as the accompanying systems shrink, according to Chai. When his team began the research more than a year before publication, the signal reader was cumbersome. By the time they had completed the work, they had been refined down to the size of an ID card. “Our hope is that the iterative technology improvements will eventually get rid of the reader, and the pill could transmit directly to a smartwatch or cell phone in the future,” he said.

Chai assured Healthcare Analytics News that digital pills don’t represent a substantial privacy risk. The stored data are simply pill identification codes linked to times of ingestion. In the event that a reader was stolen or the signal was hacked, no identifiable personal health information would be lost.