It’s easy to write dispassionately about the importance of patient compliance and the role of packaging. But it’s a different story when you become a participant in a Beta test of a new product and find yourself on the front lines of a new compliance-prompting package.
My 13-year-old son Casey has Down Syndrome and some of his behaviors are on the autism spectrum. He takes two different meds twice daily, one dose of each in the morning and a different dose of each at night. The two drugs are Abilify and Chlonodine.
He cannot be responsible for his own compliance, so that task falls to his mother and father—or someday a sibling or caretaker. Interestingly, I’m proud to say we rarely miss a dose. So compliance is not the issue. Our problem is more complex—more often than not if there is a medication error it is that Casey gets double-dosed!
Because we are running around our hectic household like everyone else these days, I might give Casey his meds and leave for work, and my wife then thinks he missed and gives him his meds again. Or my wife will give Casey his nighttime dose then leave for her book group meeting. When I actually put him to bed later, I will give him his medicine again. Or at least we are inconvenienced having to contact each other and ask if he got his meds already. Abilify, in particular, is an anti-psychotic drug, and a double dose can cause a very off-day.
Could the compliance-promoting package, Vitality’s GlowCaps, which won an innovation award from the Healthcare Compliance Packaging Council, actually help us?
The Vitality GlowCaps people wanted me to put their new product to work, with the understanding I would write whatever I wanted to regarding our experience. I did not approach this article trying to understand how their system works. I did not call Vitality with questions. I wanted only to report from a layperson’s perspective what our experience was using the product.
A few days after signing up for the program I was alerted by e-mail that my package was on its way and I received a password to my account on my.vitality.net.
The box arrived a few days later where it sat on our kitchen countertop while life took us in a different direction—a funeral for a business partner, and Homecoming for our 16-year old daughter. A few days later I received a phone call from Vitality asking if I got the package? Did I have any questions?
I ignored it for yet another week after which I was gently prodded by a person on the phone to open the package and log onto the Web site. I have to admit these gentle but persistent reminders are probably the reason why I opened the box or it still might be sitting there. So no package itself is going to solve the compliance question—live human interaction was key here.
I logged on (simple) and set dose times for both GlowCap bottles at 7 a.m. and 7 p.m. It was easy to interface with Vitality’s Web site. Choices were simple and self-explanatory.
I’m not sure an elderly or infirm person could figure it out by themselves, as my wife wondered aloud, but a caregiver or family member certainly could. And it seems Vitality would be helpful here as well.
The account on the Web allows a choice of cell phone, text, or e-mail messages to be generated automatically. I decided on an e-mail to my phone to tell me when a dose has been missed, and my wife would get a text with the same alert. So if we are out to dinner and a caretaker forgets, we can call home and remind them to give Casey his night time meds.
So I opened the box to find two GlowCap pill bottles and a plug-in nightlight that doubles as wireless network communications. Not much else, but I discovered I did not need much else.
First we plugged in the nightlight, which glows a nice steady blue until dose time. With some shades of Big Brother, the minute we plugged in the nightlight, I got an e-mail saying welcome to Vitality network. Our house is wired to Vitality!
When dose time arrives, the nightlight starts pulsating orange. And the caps—if they are within 100 feet of the nightlight, start blinking, letting us know a dose is due. So the nightlight is no longer blue, but a throbbing orange, and the caps of Casey’s pill bottles are blinking. Clearly it’s medicine time. If we delay another hour, the caps start chirping as well, so to the visual cue a sound cue is added. (Not sure my Mom, who is hard of hearing, would ever hear the chirp).
So if I come downstairs at 7:30 in the morning and the nightlight is blue, I know Casey has already received his dose from his mother and all is well with Vitality network. If I still see a pulsating orange nightlight and caps blinking, I can administer Casey’s medicine since I know it has not been done yet.
The minute the pill bottle is opened and closed, there is an audible signal—one from the bottle, and an answering tone from the nightlight. Once the second one is opened and closed, the pulsating orange light turns blue and the caps return to their normal, non-blinking state. That action is logged into the Vitality network, which sends an e-mail after a week with our compliance report. We’re at 100%!
Two interesting side notes: first, when the light starts to pulsate and the caps blink, Casey now comes to get us to tell us “medicine.” Second, last Friday night we were at a neighbors and our daughter called to say the medicine “thingy” was blinking and what should she do? Instead of waiting for us to get home and giving Casey his dose late, our daughter gave it to him on time.
So after a few weeks can I say Vitality GlowCaps solved our particular compliance problem of over-dosing? Absolutely! While the system may not have been designed to do so, I’m pleased to say with confidence that we no longer worry about the medication mix-up.
