1.

Problem

1.1 Historical Introduction

As an individual gets older, their need for prescription drugs to treat ailments increases significantly. In
recent years, the use of prescription drugs has steadily increased. From 1998-2002, the number of
prescriptions written rose from 2.523 billion to 3.340 billion [1]. People over the age of 65 make up 35%
of the use of prescription drugs, however, they only account for 13% of the population [2]. In addition,
the elderly account for 40% of the use of nonprescription drugs [3]. The use of prescription drugs is so
prevalent among people over the age of 65 that 90% of this age group take at least one medications daily
and most take between three and four medications daily [3,4]. The amount of medication coupled with
the physical limitations associated with aging can make remembering taking all of the medications with
the proper dosage difficult. The consequences of under dosage and over dosage can be severe. A study
analyzing 131,000 deaths related to prescription drug poisoning conclude that 97% of the cases analyzed
resulted from medication errors. These errors included inappropriate dosages and medications taken
inadvertently [5]. Furthermore, with the increase of prescription drugs on the market, the percentages of
deaths related to prescription drug overdose has increased. According to a study in New Mexico, deaths
from drug overdoses rose from 1.9 deaths per 100,000 deaths in 1994 to 5.3 deaths per 100,000 deaths in
2003 [6].

To avoid the adverse effects of missing or overdosing on multiple medications, different methods have
been used to remember medication schedules. For those living in a nursing home, the caregivers are
responsible for administering the proper medication schedule. However, for seniors that choose to live
independently, no caregiver is available to remind them to take the proper medications. Many use a pill
organizer that organizes all the pills to be taken during a certain day. However, most of these organizers
are not automated and only serve as pill containers. A user can easily forget as there are no reminders
during the day. Many times relatives of seniors take on the responsibility of reminding their loved ones to
take their medicine. It can be stressful for these relatives, since they must not only keep up with their
busy schedules, but the complex medicine schedules as well. Some products exist that will alert the
senior when it is time to take their medicine, but it can be difficult for a loved one to confirm the medicine
is being taken.

1.2 Market and Competitive Product Analysis

Medication noncompliance, failure to take medication as prescribed, can be extremely dangerous.

According to the American Heart Association, 10% of all hospital admissions and 23% of all nursing
home admissions can be attributed to noncompliance [7]. For those who must take multiple types of
medication, failure to do so properly becomes much more likely. The American Heart Association says
that anywhere up to 59% of Americans fail to take their medication as prescribed when requiring multiple
types of medications [7]. Senior citizens are the primary targeted market for Automatic Prescription
Dispenser; as the elderly are the most likely demographic to have the need for multiple medications.
Senior citizens are also more apt to fail to take medications properly because “they are more prone to
visual impairment, functional disability, and cognitive dysfunction and are more likely to misunderstand
verbal instructions” [8].

The use of automated medication dispensers can aide in reducing the likelihood of taking medication
improperly. E-pill® currently has two types of automated medication dispensers available [9]. The Med-
Time XL is a small portable dispenser which does not support remote monitoring. This dispenser is
priced at $249.95. Another pill dispenser available from e-pill® is the MD.2. Unlike the Med-Time XL,
the MD.2 is large in size and is not portable. However, the MD.2 does support remote monitoring. The
MD.2 will call the caregiver whenever medication is not dispensed or the unit is low on medication. The
MD.2 sells for $749.95, plus $29.95 a month for monitoring service. The Automatic Prescription
Dispenser combines the affordability of the Med-Time XL with the advanced features of the MD.2 such
as medication instructions and monitoring. With the Automatic Prescription Dispenser the care giver will
not only be notified when medication is not dispensed, but will also be able to check the status of the
Automatic Prescription Dispenser at any time throughout the day. Furthermore, the Automatic
Prescription Dispenser is capable of supporting up to two users. This makes the Automatic Prescription
Dispenser ideal for elderly couples, who would otherwise need to purchase two separate pill dispensers.

1.3 Concise Problem Statement

The current pill dispensers on the market are highly divided by price. The low end MD.2
contains no monitoring capability, while the high end has some monitoring, but costs $500 more,
plus a monthly fee. The Automated Pill Dispenser will bring the monitoring features to a design
that is much more affordable.

The Automatic Prescription Dispenser serves as a pill organizer with smart, automatic pill dispensing
ability. The Automatic Prescription Dispenser is designed to address the needs of the elderly. The
Automated Prescription Dispenser allows a relative or friend of the elder in need of care to fill the
dispenser with multiple medications and create a medication schedule via scheduling and monitoring
software. An alert indicates when medication is ready to be taken. The Automatic Prescription Dispenser
is made to be extremely user friendly for senior users. The senior user will push a button to dispense the
medication and notify the monitoring software that the medication has been dispensed. If the medication
has not been dispensed after a certain amount of time, the relative or friend of the elderly user is notified.
Another problem that elders face is that many have poor eyesight. This can lead to trouble reading the
small medication instructions on the pill container. The Automatic Prescription Dispenser offers a large
well-lit display to make reading medication instructions easier for the elderly user.

1.4 Implications

The Automatic Prescription Dispenser provides piece of mind to loved ones worried about their aging
relatives. No longer do they have to worry about reminding their elderly parents to take their medication.
By using the scheduling software, they are assured the medications are taken on time, and not accidentally
taken twice.

The Automatic Prescription Dispenser also aids in saving lives. A recent survey of hospital patients
showed 11% were hospitalized due to medication non-adherence [10]. One study shows up to 45% of the
elderly population do not take their medication as prescribed. The study cites “forgetfulness, avoidance
of troublesome adverse effects, cognitive decline, physical inability to self-administer medicines,
economic limitations and intentional under dosage” as possible reasons of non-adherence. By adding
some high-end features such as monitoring to the lower-cost models, the automated pill dispenser may
also take a significant portion of both the high end and low end market shares.
[1] Cohen, J.S., MD, “Prescription Drug Use in America: The Startling Numbers and Their
Implications,” MedicationSense.com. 2003.
http://www.medicationsense.com/articles/july_sept_03/prescript_drug_use.html

[2] Metlay, J. P., MD, PhD, Cohen, A, PhD, Polsky, D, PhD, Kimmel, S., E., MD, MSCE, Koppel, R,
PhD, and Hennessy, S., PharmD, PhD, “Medication Safety in Older Adults: Home-Based Practice
Patterns,” Journal of American Geriatrics Society, vol. 53, pp 976-982, 2005.

[3] Fulton, M.M., “Polypharmacy in the elderly: A literature review,” Journal of the American Academy
of Nurse Practitioners, vol. 17 issue 4, pp.123-132, 2005.

[4] Geller, A.M. and Zenick, H., “Aging and the Environment: A Research Framework,”Environmental
Health Perspectives, vol. 113 number 9, pp. 1257-1262, 2005.

[5] “New USCD Research Shows Deadly Drug Mistakes Spike at the Start of Each Month, Suggests
Pharmacy Errors,” Science Daily. 2005.
http://www.sciencedaily.com/releases/2005/01/050106111344.htm

[6] Preidt, R., “Fatal ODs on Rx Meds a Growing Problem,” MedicineNet.com. 2006.
http://www.medicinenet.com/script/main/art.asp?articlekey=61140

[7] “Statistics You Need to Know” (2007, Jan. 24). American Heart Association. [Online]. Available:
http://www.americanheart.org/presenter.jhtml?identifier=107

[8] Ratra, G. “Drug Therapy and the Elderly,” Careguide@Home. 2007.

http://www.careguideathome.com/modules.php?op=modload&name=CG_Resources&file=article&sid=1
493

[9] e-pill Medication Reminders. (2007, Jan. 24). e-pill®. [Online]. Available:
http://www.epill.com/

[10] MacLaughlin, E.J., Raehl, C. L., Treadway, A. K., Sterling, T., L., Zoller, D. P., and Bond, C., A.,
“Assessing medication adherence in the elderly which tools to use in clinical practice?” Drugs and Aging,
vol. 22, pp 231-255, 2005.