Text Messages From Doctors Help Remind Patients to Take Medication
Text messages may replace the old adage about an apple a day. A recent study has found that doctors sending texts to patients, increase the chance they'll remember to take their medication.
People forget to take their prescriptions all the time, even remembering to take vitamins is a chore. However, it'll be several months before their doctors realize they haven't been taking their meds.
Robert Glattner, MD of Forbes writes that one third of patients are non-compliant when it comes to taking their blood pressure medication. Others just forget. Regardless, doctors are trying to find a way to increase presence with their patients in between office visits, and smartphones are a great place to start.
A new study published in the journal PLOS One has found that text message reminders can help engage doctors with their patients out of the office, and remind them to take their meds. Dr. David Wald, Lead Author, Professor, and Cardiologist at Queen Mary University of London in England, explained the premise of the study:
“An important and overlooked problem in medicine is the failure to take prescribed medication. The results of this trial show that text message reminders help prevent this in a simple and effective way. More than just a reminder, the texts provided the link to identify patients who needed help.”
The study took 300 participants, divining them into two groups: one group received text message reminders to take their statin medication to treat high blood pressure and elevated cholesterol and the other group did not.
The group receiving texts would get one message every day for two weeks, asking if they'd taken their medication. Then the messages were tapered back, and sent every other day for two weeks, and again once a week for six months. If they did not reply to the text messages, the patients would receive a follow-up phone call to investigate why and answer any questions the patients had.
Out of those who received text messages, only 9 percent stop taking their medications, compared to the 25 percent who stopped completely or took less than 80 percent of it without reminders.
David Taylor, Professor Emeritus of pharmaceutical and public health policy at University College London, said of the study:
“The health implications of these results are considerable from both an economic and a health gain perspective. The method is not limited to cardiovascular disease prevention and could be used for patients on treatment for other chronic diseases.”
The marriage of technology and health care have a long journey ahead, but the potential for preventative and ongoing health care to help reduce future costs looks quite bright.
Read more at Forbes
Photo Credit: NEC Corporation of America/Flickr
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Researchers hope the technology will further our understanding of the brain, but lawmakers may not be ready for the ethical challenges.
- Researchers at the Yale School of Medicine successfully restored some functions to pig brains that had been dead for hours.
- They hope the technology will advance our understanding of the brain, potentially developing new treatments for debilitating diseases and disorders.
- The research raises many ethical questions and puts to the test our current understanding of death.
The image of an undead brain coming back to live again is the stuff of science fiction. Not just any science fiction, specifically B-grade sci fi. What instantly springs to mind is the black-and-white horrors of films like Fiend Without a Face. Bad acting. Plastic monstrosities. Visible strings. And a spinal cord that, for some reason, is also a tentacle?
But like any good science fiction, it's only a matter of time before some manner of it seeps into our reality. This week's Nature published the findings of researchers who managed to restore function to pigs' brains that were clinically dead. At least, what we once thought of as dead.
What's dead may never die, it seems
The researchers did not hail from House Greyjoy — "What is dead may never die" — but came largely from the Yale School of Medicine. They connected 32 pig brains to a system called BrainEx. BrainEx is an artificial perfusion system — that is, a system that takes over the functions normally regulated by the organ. The pigs had been killed four hours earlier at a U.S. Department of Agriculture slaughterhouse; their brains completely removed from the skulls.
BrainEx pumped an experiment solution into the brain that essentially mimic blood flow. It brought oxygen and nutrients to the tissues, giving brain cells the resources to begin many normal functions. The cells began consuming and metabolizing sugars. The brains' immune systems kicked in. Neuron samples could carry an electrical signal. Some brain cells even responded to drugs.
The researchers have managed to keep some brains alive for up to 36 hours, and currently do not know if BrainEx can have sustained the brains longer. "It is conceivable we are just preventing the inevitable, and the brain won't be able to recover," said Nenad Sestan, Yale neuroscientist and the lead researcher.
As a control, other brains received either a fake solution or no solution at all. None revived brain activity and deteriorated as normal.
The researchers hope the technology can enhance our ability to study the brain and its cellular functions. One of the main avenues of such studies would be brain disorders and diseases. This could point the way to developing new of treatments for the likes of brain injuries, Alzheimer's, Huntington's, and neurodegenerative conditions.
"This is an extraordinary and very promising breakthrough for neuroscience. It immediately offers a much better model for studying the human brain, which is extraordinarily important, given the vast amount of human suffering from diseases of the mind [and] brain," Nita Farahany, the bioethicists at the Duke University School of Law who wrote the study's commentary, told National Geographic.
An ethical gray matter
Before anyone gets an Island of Dr. Moreau vibe, it's worth noting that the brains did not approach neural activity anywhere near consciousness.
The BrainEx solution contained chemicals that prevented neurons from firing. To be extra cautious, the researchers also monitored the brains for any such activity and were prepared to administer an anesthetic should they have seen signs of consciousness.
Even so, the research signals a massive debate to come regarding medical ethics and our definition of death.
Most countries define death, clinically speaking, as the irreversible loss of brain or circulatory function. This definition was already at odds with some folk- and value-centric understandings, but where do we go if it becomes possible to reverse clinical death with artificial perfusion?
"This is wild," Jonathan Moreno, a bioethicist at the University of Pennsylvania, told the New York Times. "If ever there was an issue that merited big public deliberation on the ethics of science and medicine, this is one."
One possible consequence involves organ donations. Some European countries require emergency responders to use a process that preserves organs when they cannot resuscitate a person. They continue to pump blood throughout the body, but use a "thoracic aortic occlusion balloon" to prevent that blood from reaching the brain.
The system is already controversial because it raises concerns about what caused the patient's death. But what happens when brain death becomes readily reversible? Stuart Younger, a bioethicist at Case Western Reserve University, told Nature that if BrainEx were to become widely available, it could shrink the pool of eligible donors.
"There's a potential conflict here between the interests of potential donors — who might not even be donors — and people who are waiting for organs," he said.
It will be a while before such experiments go anywhere near human subjects. A more immediate ethical question relates to how such experiments harm animal subjects.
Ethical review boards evaluate research protocols and can reject any that causes undue pain, suffering, or distress. Since dead animals feel no pain, suffer no trauma, they are typically approved as subjects. But how do such boards make a judgement regarding the suffering of a "cellularly active" brain? The distress of a partially alive brain?
The dilemma is unprecedented.
Setting new boundaries
Another science fiction story that comes to mind when discussing this story is, of course, Frankenstein. As Farahany told National Geographic: "It is definitely has [sic] a good science-fiction element to it, and it is restoring cellular function where we previously thought impossible. But to have Frankenstein, you need some degree of consciousness, some 'there' there. [The researchers] did not recover any form of consciousness in this study, and it is still unclear if we ever could. But we are one step closer to that possibility."
She's right. The researchers undertook their research for the betterment of humanity, and we may one day reap some unimaginable medical benefits from it. The ethical questions, however, remain as unsettling as the stories they remind us of.
A space memorial company plans to launch the ashes of "Pikachu," a well-loved Tabby, into space.
- Steve Munt, Pikachu's owner, created a GoFundMe page to raise money for the mission.
- If all goes according to plan, Pikachu will be the second cat to enter space, the first being a French feline named Felicette.
- It might seem frivolous, but the cat-lovers commenting on Munt's GoFundMe page would likely disagree.
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