Globally, >47M individuals live with dementia, with new incidence of 7.7M annually.
Medication mismanagement is one of the most common and concerning risk factors in people
with dementia (PwD), as it leads to undertreatment, emergency room visits, hospital
admissions/readmissions, and serious adverse events. 3M older U.S. adults are admitted to
nursing homes due to drug-related adherence problems with costs >$14B/year. Furthermore,
30% of hospital admissions of older adults are drug related with 11% attributed to
medication non-adherence and 17% to adverse drug reactions. While Alzheimer's disease
(AD) & type 2 diabetes mellitus (DM) individually have considerable morbidity &
mortality, they often occur together, worsening adverse outcomes, quality of life, & care
costs. This is especially true as the AD/DM combination creates a complex balancing act
of med management & symptom monitoring in older populations. While the goal is to keep
older adults with dementia at home as long as possible, these challenges lead to untold
personal & family suffering, as well as billions in potentially avoidable healthcare
costs annually. The HiDO-ALZ platform will solve these challenges by automating
medication administration for PwD to eliminate mismanagement, decrease caregiver burden,
reduce healthcare utilization, and facilitate PwD to age in place. HiDO is being
developed as an automated, AI driven medication dispensing and direct observation
platform to optimize adherence. The device integrates medication dispensing, dose
administration time, medication synchronization, & pair of front-facing cameras to
validate the right meds, right route, right time, right dosage to the right patient
(5R's). Cameras record every dose using facial recognition & provide real -time
medication consumption recordings. Through cloud connectivity, providers & caregivers
have access to video observation logs, dose administration time, adherence trends, &
longitudinal adherence via web dashboard. Patients & caregivers can easily setup complex
medication protocols in minutes using a smartphone app. The device then alerts patients
and dispenses up to 7 different types of meds simultaneously, with up to 90 days of
medication. Connected data sources including remote blood pressure and weight
measurements, as well as electronic health record lab results and videoconferencing
integrate in a single dashboard. The project will build on successful Phase I, in which
the medication dispensing unit was updated with modifications for dementia, passed all
bench testing, and was successfully validated in pilot usability with dementia subjects.
Phase II will expand the foundation with four Aims: 1) Enhance device with remote sensors
for diabetes management, expanded data integration, and video conferencing, 2) Test
enhanced platform for usability in dementia subjects, 3) Transition the design to formal
manufacturing process to ensure system meets performance standards and regulatory
requirements & produce pre-production devices for testing, & 4) Conduct in-home clinical
trial to demonstrate adherence and efficacy.