The present disclosure relates to an apparatus and method for automatically dispensing medications, in particular, dynamically adjusting medication regimens according to input received from a remote entity or according to a modification created by the apparatus
Medication is the first and often least invasive solution used by medical doctors for health issues today; however medications can interact with each other, in some cases reducing their effectiveness or even constituting a safety issue. Compounding this is the fact that a patient may have several doctors and specialists who do not directly coordinate treatments of the patient. A patient, or in some cases a caregiver, friend, or family member, typically must coordinate the various prescriptions and pills associated with a patient's medication regimen, for example by filling one or more “daily” pillboxes.
It is know to use a “smart” pillbox incorporating a timer, reminder lights and sounds, and ability to sense that pills have been removed from the pillbox. Some such pillboxes also record adherence, and can notify a caregiver if too much time elapses or too many doses are missed. Similarly, medication reminder apps for mobile devices are known. However, both “smart” pillboxes and mobile device apps require the patient or caregiver to prepare and enter the reminder regimen and any updates to a medication regimen.
U.S. Pat. No. 7,454,880 B1 teaches a system approach that permits medication regimens to be professionally coordinated and designed by a pharmacist, and packed into foil sealed blisters. This approach is effective in some aspects, but increases the workload on the pharmacy, and is inflexible for changes to the medication regimen. Further, this approach cannot accommodate missed dosages or pro re nata (PRN) medications. It is difficult to automate the filling and validation of blister packages in large quantities, and postage costs are increased if medications are mailed in smaller time increments.
U.S. Pat. No. 6,145,697 discloses a device for enabling a patient to have ready access to a daily dosage of medication placed in compartments at predetermined time periods. Specific dosages in the form of capsules or pills are sequentially placed in selected compartments. This approach also is inflexible for changes in the medication regimen and cannot accommodate missed dosages or PRN medications.
U.S. Patent Application Publication No. 2002/113077 discloses a medication dispensing system comprising an on-site medication dispensing unit and a central monitoring facility. The on-site medication dispensing unit holds bulk amounts of medication in a plurality of separate receptacles from which it selects a desired medication dosage according to an entered and stored prescription regimen. This approach also is inflexible for changes in the medication regimen and cannot accommodate missed dosages or PRN medications.
Medication adherence, including patient adherence to medication regimens is an important aspect of any system providing medical services. Specifically, lack of medical adherence has a negative effect on outcomes and increases costs associated with providing medical services. The lack of flexibility and adaptability noted in the approaches described above adversely impacts adherence.
According to aspects illustrated herein, there is provided a computer-based apparatus for dispensing medications, including: a dispenser; and a cassette including a plurality of compartments arranged to hold a plurality of stored medications; a first computer with a processor and a memory element configured to store computer readable instructions and first information for a plurality of medications. The first information includes a first respective dosage for each medication in the plurality of medications and a plurality of time spans, including respective points in time within each time span, for dispensing a portion of the plurality of medications, or at least one parameter for dispensing a portion of the plurality of medications on a pro re nata (PRN) basis. The processor is configured to execute the computer readable instructions to determine that the first information includes instructions to extract a first medication included in the portion of the plurality of medications from a first compartment included in the plurality of compartments. The processor is configured to execute the computer readable instructions to receive, from a second computer remote from the first computer, a first input including a first modification to the first information for the first medication or create a first modification to the first information for the first medication. The processor is configured to execute the computer readable instructions to determine that a first stored medication in the first compartment is the same as the first medication and extract, using the dispenser, a first quantity of the first stored medication from the first compartment in accordance with the first modification, or terminate extraction, by the dispenser, of the first stored medication from the first compartment in accordance with the first modification.
According to aspects illustrated herein, there is provided a computer-based system for controlling dispensing of medications, including: a service entity including a first computer with a first processor and a first memory element configured to store first computer readable instructions; and a dispensing apparatus including a cassette including a plurality of compartments arranged to hold a plurality of stored medications, a second computer including a second processor and a second memory element configured to store second computer readable instructions, and a dispenser. The first processor is configured to execute the first computer readable instructions to: receive at least one first input, including at least one prescription for at least one medication, from at least one health care provider or pharmacy entity providing the at least one medication; create information including a respective dosage for each medication included in the at least one medication and at least one time span and respective point in time within the at least one time span for dispensing at least a portion of the at least one medication, or at least one parameter for dispensing at least a portion of the at least one medication on a pro re nata (PRN) basis; and transmit the information to the second computer. The second processor is configured to execute the second computer readable instructions to extract, using the dispenser, medications stored in the plurality of compartments according to the information. The first processor is configured to execute the first computer readable instructions to: receive a second input including a change to the respective dosage, the at least one time span, or the at least one parameter; modify the information to include the second input; and transmit the modified information to the second compute. The second processor is configured to execute the second computer readable instructions to extract, using the dispenser, medications stored in the plurality of compartments according to the modified information.
According to aspects illustrated herein, there is provided a computer-based method for dispensing medications, including: storing in a memory element for a first computer for a dispensing apparatus computer readable instructions and first information for a plurality of medications, the first information including a first respective dosage for each medication in the plurality of medications and a plurality of time spans, including respective points in time within each time span, for dispensing a portion of the plurality of medications, or at least one parameter for dispensing a portion of the plurality of medications on a pro re nata (PRN) basis; executing, using a processor for the first computer, the computer readable instructions to determine that the first information includes instructions to extract a first medication, included in the portion of the plurality of medications, from a first compartment included in a plurality of compartments for a cassette for the dispensing apparatus, the plurality of compartments arranged to hold a plurality of stored medications; executing, using the processor, the computer readable instructions to: receive, from a second computer remote from the first computer, a first input including a first modification to the first information for the first medication, or create a first modification to the first information for the first medication; and executing, using the processor, the computer readable instructions to: determine that a first stored medication in the first compartment is the same as the first medication; and extract, using a dispenser for the dispensing apparatus, a first quantity of the first stored medication from the first compartment in accordance with the first modification, or terminate extraction, by the dispenser, of the first stored medication from the first compartment in accordance with the first modification.
According to aspects illustrated herein, there is provided a computer-based method for controlling dispensing of medications, including: storing first computer readable instructions in a first memory element for a first computer for a service entity; storing second computer readable instructions in a second memory element for a second computer for a dispensing apparatus; executing, using a first processor for the first computer, the first computer readable instructions to: receive at least one first input, including at least one prescription for at least one medication, from at least one health care provider or pharmacy entity providing the at least one medication, create information including: a respective dosage for each medication included in the at least one medication and at least one time span and respective point in time within the at least one time span for dispensing at least a portion of the at least one medication, or at least one parameter for dispensing at least a portion of the at least one medication on a pro re nata (PRN) basis, and transmit the information to the second computer; executing, using a second processor for the second computer, the second computer readable instructions to extract, using a dispenser for the dispensing apparatus, medications stored in a plurality of compartments for a cassette for the dispensing apparatus according to the information; executing, using the first processor, the first computer readable instructions to: receive a second input including a change to the respective dosage, the at least one time span, or the at least one parameter, modify the information to include the second input and transmit the modified information to the second computer; and executing, using the second processor, the second computer readable instructions to extract, using a dispenser for the dispensing apparatus, medications stored in the plurality of compartments according to the modified information.
Various embodiments are disclosed, by way of example only, with reference to the accompanying schematic drawings in which corresponding reference symbols indicate corresponding parts, in which:
Moreover, although any methods, devices or materials similar or equivalent to those described herein can be used in the practice or testing of these embodiments, some embodiments of methods, devices, and materials are now described.
Processor 108 is configured to execute computer readable instructions 112 to determine information 114 includes instructions 132 to extract medication 116A included in portion P1 from compartment 128A included in compartments 128. Hereinafter, it is understood that the term “processor 108 is configured to” is the same as “processor 108 is configured to execute computer readable instructions 112 to”. Processor 108 is configured to: receive, from computer 134, remote from computer 106, input 136 including modification 138 to information 114; or create modification 138. Processor 108 is configured to determine that stored medication 130A in compartment 128A is the same as medication 116A and extract, using the dispenser, quantity 140 of medication 130A from compartment 128A in accordance with modification 138, or terminate extraction, by the dispenser, of medication 130A from compartment 128A in accordance with modification 138. In an example embodiment, computer 134 is operated by service entity 141. A service entity is further described below.
Medications 128 are in the form of pills or capsules. In an example embodiment, dispenser 102 is configured to extract pills or capsules one at a time, using any means known in the art, as necessary to fulfill a particular dosage 118.
In an example embodiment, input 136 includes information 142 provided by health care provider 144, pharmacy entity 146 that supplied medication 116A, or governmental agency 148 regulating manufacture or distribution of medication 116A. In an example embodiment, medication 116A is a prescription medication and health care provider 144 wrote a prescription for medication 116A. Thus, apparatus 100 dynamically adapts information 114 (including the regimen for medication 116A) to accommodate changes to the information/regimen made by the health care provider or pharmacy entity. For example, the health care provider may receive lab results that necessitate a change to dosage 118 or time span 122 for medication 116A. Apparatus 100 receives the change via input 136 and automatically updates information 114 and the dispensing of medication 116A without requiring the patient or care giver to make any adjustment to apparatus 100 themselves. In the case of input 136 from agency 148, input 136 could include a warning to modify a dosage or to avoid taking medication 116A with another medication 116, and apparatus 100 automatically makes the required adjustment without requiring the patient or care giver to make any adjustment to apparatus 100 themselves.
In an example embodiment, information 114 includes instructions 150 to extract dosage 118A of medication 116A at time span 122A included in time spans 122. Modification 138 identifies time span 152 with point in time 154, and the processor is configured to extract, using the dispenser and within time span 152: quantity 140 of medication 130A from compartment 128A; or quantity 155, different from quantity 140, of medication 130A from compartment 128A. In an example embodiment, time span 152 is included in time spans 122. Thus, apparatus 100 automatically and dynamically accommodates changes in the schedule for taking a medication.
In an example embodiment, the processor is configured to block, using the dispenser, extraction of medication 116A within time span 122A. Thus, apparatus 100 automatically and dynamically prevents extraction of a medication within a particular time frame as required by modification 138. In an example embodiment, time span 152 precedes time span 122A in a chronological sequence; or time span 152 follows time span 122A in a chronological sequence. In an example embodiment, input 136 includes time span 152 or the processor is configured to calculate time span 152. In an example embodiment, input 136 includes quantity 155 or the processor is configured to calculate quantity 155.
In an example embodiment, the processor is configured to create data 156 regarding medications 116 or 130. Processor 108 is configured to generate modification 138 according to data 156 or the processor is configured to transmit data 156 to computer 134. In the latter case, computer 134 is configured to create input 136 in response to data 156. In an example embodiment, data 156 is a log recording extraction of medications 130 from apparatus 100, for example, recording when particular medications 116 have been extracted and the respective dosages of the medications extracted. In an example embodiment, data 156 includes information 158 regarding compliance with dosages 118, time spans 122, or the at least one parameter 126.
For example, if a patient fails to take medication 116A according to time span 122 for the medication, apparatus 100 or computer 134 automatically determines if adjustments to information 114 are needed (for any or all medications 116) and automatically generates the adjustment (modification 138). In turn, apparatus 100 automatically implements the adjustment. For example, in response to a request for a PRN medication, apparatus 100 or computer 134 reviews log information included in data 156 for the requested medication and determines if the request is compliant with information 114, for example, is the request far enough in time from a previous extraction of the medication. If the request is compliant, apparatus 100 dispenses the requested medication according to information 114 and modification 138.
In an example embodiment, information 114 includes instructions 160 to extract dosage 118B of medication 116A at time span 122B included in time spans 122. Modification 138 identifies dosage 162 of medication 116A, and the processor is configured to extract, using the dispenser, dosage 162 of medication 130A from compartment 128A within time span 122B. In an example embodiment, input 136 includes dosage 162. In an example embodiment, the processor is configured to calculate dosage 162. Thus, apparatus 100 accommodates concurrent changes to dosages and scheduling for a medication.
In an example embodiment, the processor is configured to determine that information 114 includes instructions 164 to extract, using the dispenser, dosage 118C of medication 116A at time span 122C: included in time spans 122. The processor is configured to make determination 166 that medication 130A: has not been extracted from the cassette by the dispenser within time span 122C; or has been extracted from cassette 104 by the dispenser within time span 122C and not removed from the dispenser within predetermined time period 168. In an example embodiment, the processor is configured to create modification 138 in response to determination 166. In an example embodiment, the processor is configures to transmit determination 166 to computer 134 and computer 134 is configured to create modification 138 using determination 166.
In an example embodiment, dispenser 102 includes user interface 167. The processor is configured to provide sensory output 168 via the user interface to alert the patient or care giver that it is time to receive a medication or medications 116 from apparatus 100. In an example embodiment, the processor is configured to receive input 169 from the user interface to trigger extraction of a medication or medications according to information 114. In an example embodiment, input 169 includes biometric data 170, and the processor is configured to confirm that biometric data 170 is for a patient for whom medications 116 are intended or an agent authorized to obtain medications 116 from the dispenser for the patient, and in response to confirming biometric data 170, extract, using the dispenser, quantity 140 of medication 130A from compartment 128A in accordance with modification 138.
In an example embodiment, for a PRN medication, user interface 167 displays a menu listing available PRN medications and the patient or care giver is able to select a medication from the menu and request the medication. As noted above, apparatus 100 or computer 134 reviews the request.
In an example embodiment, information 114 includes instructions 172 to extract, using the dispenser, dosage 118D of medication 116A at time span 122D included in time spans 122. The processor is configured to make determination 174 that an input requesting extraction of medication 116A has not been received by the dispenser within time span 178 before or after time span 122D. In an example embodiment, the processor is configured to create modification 138 in response to determination 174. In an example embodiment, the processor is configured to transmit determination 174 to computer 134 and computer 134 is configured to create modification 134 using determination 174. Thus apparatus automatically and dynamically adjusts for missed dosages of a medication and enables the time period for detecting such missed dosages to be set.
In an example embodiment, the at least one parameter 126 includes parameter 126A specifying time span 180 between extractions of medication 116A, or parameter 126B specifying a cumulative amount 182 of medication 116A extracted within time period 184. Modification 138 includes a change to parameter 126A and/or parameter 126B. For example, changes to parameter 126A or 126B can be made by a health care provider according to results of lab tests or a physical examination or to account for pharmacokinetic affects related to addition of a new medication to a patient's medication regimen or a change in dosage of an existing medication in the medication regimen.
In an example embodiment, information 114 includes dosage 118E for medication 116B in medications 116 and time span 122E, included in time spans 122, for dispensing medication 116B. The processor is configured to make determination 186 that dosage 118E has not been extracted within time span 122E and has been extracted at point in time 188 outside of time span 122E. That is, a medication has been extracted at a time outside of compliance with a regimen for the medication. In an example embodiment, the processor is configured to make determination 189 that cumulative amount 190 of PRN medication 116B has been extracted within time span 191. Thus, apparatus 100 tracks cumulative dosages of the PRN medication. In an example embodiment, the processor is configured to create modification 138 in response to determination 189. In an example embodiment, the processor is configures to transmit determination 189 to computer 134 and computer 134 is configured to create modification 138 using determination 189.
In an example embodiment, the processor is configured to determine that information 114 includes instructions 192 to extract, using the dispenser: dosage 118F of medication 116A within time span 122F included in time spans 122; or medication 116A in compliance with the at least one parameter 126. The processor is configured to determine that stored medication 130B in compartment 128B included in compartments 128 is the same as medication 116C included in medications 116. The processor is configured to extract, using the dispenser: dosage 118G of stored medication 130B from compartment 128B within time span 122G included in time spans 122; or stored medication 130B in compliance with parameter 126.
Modification 138 includes a change to dosage 118F, or time span 122F, or parameter 126. The processor is configured to modify, according to modification 138: dosage 118G, time span 122G, or parameter 126 with respect to medication 116C. Apparatus 100 accounts for “cascading” impacts on information 114 due to modification 138. For example, if modification 138 changes the dosage or dosage schedule of medication 116A, apparatus 100 or computer 134 determines that the changes require changes to the dosage or dosage schedule for medication 116C. Apparatus 100 then modifies information 114 for medication 116C accordingly and implements the modified information 114 for medication 116C. Thus, apparatus 100 adjusts for one medication due to non-compliance for another medication or due to a cumulative dosage of another medication. Stated otherwise, apparatus 100 monitors and adjusts for interaction between medications.
In an example embodiment, information 114 includes identity 193 of a patient for whom medication 116A is prescribed. The processor is configured to: receive, from the user interface, input 194 including data 195 regarding parameter 196 related to health of the patient; and create, in response to input 194, modification 138; or transmit data 195 to computer 134. In an example embodiment, computer 134 is configured to create modification 138 using data 195. For example, the patient, the care giver for the patient, or a health care provider at the location of apparatus 100 can input data such as blood pressure readings, blood sugar levels etc. In general, any health-related data known in the art can be inputted. Apparatus 100 also can interface directly with devices obtaining data 195 from the patient. Thus, apparatus 100 can modify information 114 immediately, automatically, and dynamically according to real time conditions.
In an example embodiment, information 114, for each patient includes: respective dosage 118H for respective medication 116D in medications 116; and respective time span 118H included time spans 122 for dispensing respective medication 116D; or at least one respective parameter 126 for dispensing respective medication 116D on a PRN basis. The processor is configured to determine that information 114 includes instructions 196 to extract each respective medication 116D from respective compartment 128C included compartments 128. The processor is configured to receive inputs 197 including identification information 198; confirm that identification information 198 is one of the patients. The processor is configured to extract, using the dispenser, respective quantity 199 of respective medication 116D for the patient from respective compartment 128C in accordance with modification 138, or terminate extraction, by the dispenser, of the respective quantity 199 of respective medication 116D for the patient from respective compartment 128C in accordance with modification 138.
In an example embodiment, each compartment 161 includes a port 163 that is an opening in lid 165 of the cassette. The lid is attached to the body and is rotatable about central axis 155 using actuator 167, which can be any actuator known in the art. The lid also can be a molded plastic part and port 163 an aperture corresponding to the size and shape of one compartment 161. Thus, when lid 165 is rotated to align port/aperture 163 with a compartment, all the medications in the compartment fall out of the compartment by gravitational force into dispensing port 169. Cassette 104 can be shipped so that port/aperture 163 is locked into position corresponding to an empty reserve compartment, for example by anti-rotation feature 171. When the cassette is installed in dispensing device 102 and has been confirmed as being a correct cassette, the locking of the lid is removed and at the appropriate time, actuator 167 rotates the lid to align with the appropriate compartment 161.
In an example embodiment, dispenser 102 includes lid drive gear shaft 173, lid 165 includes hub 175, and body 151 includes hub 177. Hubs 175 and 177 enable relative rotation of the lid and body 151.
Thus, apparatus 100 can provide and control medications for a plurality of patients. This aspect of apparatus 100 is particularly advantageous for a clinic, health care provider office, hospital, or other facility providing health care services. All the functions described above for a single patient are applicable to each patient for the case in which information 114, medications 116, and medications 128 pertain to a plurality of patients.
Processor 135 is configured to execute computer readable instructions 139 to: receive at least one input 202, including at least one prescription 204 for at least one medication 116, from at least one health care provider 144 or pharmacy entity 146 providing the at least one medication. Processor 135 is configured to execute computer readable instructions 139 to create information 114 including: respective dosage 118 for each medication 116 included in the at least one medication 116 and at least one respective time span 122 and respective point in time 124 within the at least one respective time span 118 for dispensing respective portion P1; or at least one respective parameter 126 for dispensing respective portion P2 on a PRN basis.
Processor 206 is configured to execute computer readable instructions 139 to transmit information 114 to computer 106. Processor 108 is configured to execute the computer readable instructions 112 to extract, using dispenser 102, medications 130 stored in compartments 128 according to information 114. Processor 135 is configured to execute computer readable instructions 139 to: receive input 206 including change 208 to a respective dosage 118, a respective time span 122, or respective parameter 126; modify information 114 to generate modification 138 including input 206; and transmit modification 138 to computer 106. Processor 108 is configured to execute the computer readable instructions 112 to extract, using the dispenser, medications 130 stored in compartments 128 according to modification 138.
The discussion of apparatus 100 in
Apparatus 100 and system 200 retain the advantages of professional regimen design, and add the flexibility to accommodate changes in the regimen or deviation of a patient from the regimen. Apparatus 100 and system 200 also provide interaction checking and dosage control for pro re nata (PRN) medications.
The extraction mechanism of dispenser 102 and cassette 104 can be any dispenser mechanism and cassette known in the art. Cassette 104 can be supplied with medications 128 using any means known in the art. In an example embodiment, apparatus 100 includes any printer known in the art configured to generate a print of instructional data transmitted by processor 106 or computer 134 to the printer.
It will be appreciated that various of the above-disclosed and other features and functions, or alternatives thereof, may be desirably combined into many other different systems or applications. Various presently unforeseen or unanticipated alternatives, modifications, variations, or improvements therein may be subsequently made by those skilled in the art which are also intended to be encompassed by the following claims.