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Brigham & Women's Hospital Opioid Adherence Digital Pill Pilot

Rationale / Objectives

Opioid pain reliever prescribing in the ED setting has increased over the past decade. The aim of this pilot project was to validate digital pill technology and investigate opioid adherence among patients discharged from the emergency department with fracture pain.

Project/Program Description & Major Achievements

26 patients were involved in the project. Adherence was monitored remotely through eTectRx’s platform, and the researchers conducted brief patient interviews at the end of the 7-day study period. The participating patients ingested a median of six of their 21 pills, with the majority taken within the first three days. 

Lessons Learned

Currently, eTectRx’s pills are only available for institutional review board-approved research and are unavailable for sale in the U.S., however, the results demonstrate potential as a tool to combat abuse and improve prescription practices.

People / Organizations Involved

Further Description

The 26 patients involved in this study had no previous experience with opioids who were discharged from an emergency department with acute fracture pain were approached to participate in the pilot project. A total of 15 patients (10 refused participation and one was unable to complete the study) were provided with 21, 5mg oxycodone digital pills (standard capsules that contain an embedded wireless ingestible sensor). Chemicals in the stomach activate the sensor, which emits a radio frequency that can be captured by a wearable reader.  A corresponding app sends these readings to a cloud-based platform, where the care team can view time-stamped dose adherence data for their patients. While there was variability in ingestion patterns, the findings indicate that self-administration will stop well before the supply runs out.

Brigham and Women’s Health Care – the parent corporation for Brigham and Women’s Hospital, Brigham and Women’s Faulkner Hospital and the Brigham and Women’s Physician Organization – includes 150 outpatient practices with over 1,200 physicians.

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Major Achievements

 

Metric Result Details
Accuracy rate

 84% 

*a total of 112 ingestion events, compared to 134 ingestions based on pill count 
Average # of pills ingested 6 out of 21 pills given
% of dose ingested within the first 3 days 82%  
% of patients taking opioids at one week 86% *represents 6 patients who required operative repair