Elderly Medication Adherence Monitoring with the Internet of Things X. Toh, H. X. Tan, H. Liang and H. P. Tan Singapore Management University, Singapore Institute for High Performance Computing, A*STAR, Singapore
1,000,000 800,000 Elderly Aged Above 65 Years Old 900,000 100,000 80,000 Elderly Living Alone 83,000 600,000 60,000 400,000 440,000 40,000 35,000 200,000 220,000 20,000 0 0 2000 2015 2030 2012 2030 National Population And Talent Division, Singapore Elderly Medication Adherence Monitoring with the IoT 2
Enabling Ageing-In-Place through Technology (e.g. sensor-enabled homes) Supported by the Singapore Ministry of National Development (MND) and National Research Foundation (NRF) under L2NIC Award No. L2NICCFP1-2013-5. Elderly Medication Adherence Monitoring with the IoT 3
Importance of Monitoring Medication Adherence Medication non-adherence leads to: Health issues and reduced effectiveness of treatment Vulnerability to adverse complications Increased healthcare expenditure, morbidity and mortality Elderly Medication Adherence Monitoring with the IoT 4
Limitations of Existing Products Expensive with recurring costs Existing medication habits of elderly Cannot be customized to consumption habits Non-interoperable with other sensing devices Non-integrated with personalized care model Elderly Medication Adherence Monitoring with the IoT 5
A Solution for Inferring Medication Adherence Medication box that can be personalized Unobtrusive and non-instrusive Allows real-time monitoring, for reactive intervention by caregivers Allows longitudinal monitoring, for pre-emptive intervention by caregivers Currently, the only way to accurately detect medication adherence is through image-based solutions or ingestible medicine. Elderly Medication Adherence Monitoring with the IoT 6
Medication Box Prototype Hardware components MedBox MedBox (Normally Closed) Reed Switch Arduino Fio (microcontroller) Xbee radio (IEEE 802.15.4) LiPo battery Elderly Medication Adherence Monitoring with the IoT 7
Packet Transmission Schedule in MedBox Sensor Reed switch breaks contact with magnet, board is powered on Multiple pkt txn for redundancy and reliability Sleep period Continued to txn Reed to switch makes conserve indicate energy that contact box is with magnet, not closed board is powered off Elderly Medication Adherence Monitoring with the IoT 8
Medication Box Gateway Receive pkts from sensor(s) Publish data to backend through MQTT Hardware components Beaglebone Black Xbee radio (IEEE 802.15.4) 3G dongle + SIM card Elderly Medication Adherence Monitoring with the IoT 9
Monitoring and Analysis Density-Based Spatial Clustering of Applications with Noise (DBSCAN) to cluster medication intake timings Distance function :: cyclic difference between any two medication intake timings = 1 hr :: maximum distance between two medication intake timings that can be considered to be in the same cluster MinPts = 5 :: minimum number of points in cluster ( -neighborhood) Descriptive statistics to deduce regularity of inferred medication intake frequency Elderly Medication Adherence Monitoring with the IoT 10
System Architecture *Anycast routing is used for reliability and robustness, as well as to decrease cost. Elderly Medication Adherence Monitoring with the IoT 11
Elderly Care Model Survey Data (With Periodic Updates) Sensor Data Long Term Monitoring & Data Analysis Medical Reconciliation and Intervention by Care-Givers Irregular Medication Intake Elderly Categorization Regular Medication Intake Non-Adhering Adhering Elderly Medication Adherence Monitoring with the IoT 12
Participant Profile 3 to 8 chronic illnesses 4 to 10 types of medication Daily intake frequency between 1 to 3 69 to 81 years old 10 elderly Elderly Medication Adherence Monitoring with the IoT 13
Inferred Medication Intake Frequency Elderly 1090 Elderly Medication Adherence Monitoring with the IoT 14
Inferred Medication Intake Frequency Elderly 1070 hospitalization outdoor activities on Sundays Elderly Medication Adherence Monitoring with the IoT 15
Medication Intake Timings Elderly 1060 Elderly Medication Adherence Monitoring with the IoT 16
Ground Truth Evaluation Two-Week Medication Diary Elderly Medication Adherence Monitoring with the IoT 17
Discussion and Insights Elderly are concerned about electrical consumption of mainspowered gateway Elderly with active lifestyles tend to upset daily medication routine Only medication consumption can be inferred Dosage and type of medication cannot be monitored Single-compartment Triple-compartment Elderly Medication Adherence Monitoring with the IoT 18
Increase duration and scale of study to derive both longitudinal and transversal insights in medication adherence Work more closely with caregivers and medical professionals to better provide holistic care model Elderly Medication Adherence Monitoring with the IoT 19
Thoughts? Hwee-Xian TAN hxtan@smu.edu.sg SMU-TCS icity Lab, Singapore Elderly Medication Adherence Monitoring with the IoT 20