JP6541232B2 - Medication support case and medication adherence improvement system - Google Patents

Description

  The present invention provides a method and support case and system for safely and reliably taking a patient with a disease requiring continuous medication, and in particular, safety by using a prescription drug and a case provided with GPS. -It relates to a method, medication support case and system for reliably improving medication adherence by continuing to take medication.

  In the past, devices have been devised to ensure that medication can be taken. For example, a drug whose purpose is to support the patient or his / her caregiver to consciously remember in the mind that he or she has taken the medication, and to help the patient or his / her caregiver to remember easily and reliably that he / she took the medication. A confirmation support device has been proposed (Patent Document 1).

In addition, a medication aid device (Patent Document 2) or the like that reduces the burden of assistance such as a caregiver by enabling patients with cognitive impairment, such as patients with dementia, to take prescribed medications alone. A medication support holder (Patent Document 3) has been proposed which assists in taking and dosing medicines for patients who are required to regularly take medicines as well as patients.
However, even with these devices and instruments, there is a limit to safe and reliable medication.

  In addition, there are various problems in the patient's medication management, in particular, the patient's medication management for the elderly and patients with cognitive decline. The first point is the problem of “drug adherence” such as whether the patient can take the drug according to the instructions of the doctor. Second, there is a problem that the patient demands that he has not taken it yet although he actually took the medicine. Third, there is a problem that patients do not hate taking medicine and do not take it.

  As for the problem of medication adherence, for example, in elderly diabetic patients, hypoglycemia is caused by sudden normalization of medication skipping state due to age-related changes such as uneven diet and memory disorder and taking care of family members such as family members. There are social and economic problems such as personal problems and residual drugs / polypharmacy (using 10 to 15 kinds of various drugs). For example, in the case of a diabetic patient, there are many subjects who can not control insulin by once-daily oral administration. The risk of hypoglycemia is an important issue when focusing on diabetic patients. Impairment of consciousness may trigger myocardial infarction and cerebral infarction, and may cause a traffic accident by driving etc. or develop into social problems.

  Also, for polypharmacy problems, she is prescribed medicine from various hospitals and clinics, and she is rarely taking all internal medicines and may not have taken Kedrak. Also, if the old people who are not taking the medicine have no effect, the doctor may add medicine. And if it still doesn't work, the old man will be beaten by a doctor, and the surprised old man will take all the medicines he has not taken before, which may lead to a sudden drop in blood sugar.

  There are few ways to tell if you took it at this moment. For example, even if you indicate that your family will not come back on the night to see if they take their medicine during the day, patients with cognitive decline do not even remember whether they have taken it and insist that they have taken it. There are many. However, it is still in the memory that I did not drink by myself when I understand it at the stage of daytime, and I often think that it has ended and take it gradually. Although there are some people who can not make such habits, it is desirable to visualize their taking behavior, including whether it is impossible. In addition, centralization by regional comprehensive medical care is also desired.

  Furthermore, since methods for improving conventional medication adherence have been limited to medication calendars, packaging of medications, medication guidance at home, etc., doctors and pharmacists, in particular, know in a timely manner the patient's medication behavior, A system that can give advice depending on the situation is desired. In addition, there is also a demand for a simple portable medication support case that allows medication management outside the office.

JP 2002-209980 A JP 2011-031036 A Utility model registration 3201517 gazette

  An object of the present invention is to provide a method and a system for safely and reliably taking a patient with a disease requiring continuous taking, and for improving the medication adherence by continuing.

  As a result of earnest studies to solve the above-mentioned problems, the present inventor has found that supporting medication using a specific medication information transmitting device can achieve the above-mentioned purpose.

  The present invention has been made based on the above-mentioned findings, and achieves the object by providing the following invention.

1 . A device storage unit for storing a button-equipped device equipped with a GPS for transmitting information on the medication taken by the patient according to the medication schedule prescribed by the doctor and taking medication to the doctor or medical staff for each medication;
A medication support storage case at least comprising a medicine storage pocket for containing a medicine to which the above medication is applied;
The device storage portion is provided with an opening at a position corresponding to the button portion so that the button portion can be pressed directly in the stored state.
A device for supporting medication, wherein the device with a button is stored in the device storage unit, and a predetermined amount of medicine is stored in the medicine storage pocket at the time of use.

2 . The medication support case according to the above 1 , wherein, in use, the buttoned instrument is held so as to be positioned approximately at the center of the entire case.

3 . The medication support case according to the above 1 , wherein the case is used in a state in which the case inner side is folded in half and the periphery of the inner side of the case is bound and made longitudinal.

4 . Medication adherence improvement system, characterized by the use of medication support case according to any one of the previous SL 1-3.

  According to the present invention, it is possible to provide a method, a case, and a system for safely and reliably taking a patient with a disease requiring continuous medication and for improving the medication adherence by continuing the medication.

  In addition, the present invention is a device for ensuring medication, and in particular, it is possible for elderly diabetic patients to safely and reliably take medication without causing hypoglycemia, and to improve medication adherence by continuing it. Become.

  Moreover, according to the present invention, it becomes possible to gradually make it into habit. Even for patients who can not make such habits, they will be able to visualize their taking behavior.

  In particular, the system enables doctors and pharmacists to know in a timely manner the medications taken by the patients in charge, and to give advice according to the situation.

It is a front view which shows the medication assistance case (The state which hold | maintained the medicine and GPS inside) which concerns on one Embodiment of this invention. It is a rear view of the medication assistance case of FIG. It is a figure which shows the outer side of the state which open | released the medication assistance case of FIG. It is a figure which shows the inside surface of the state which opened the medication assistance case of FIG. It is a partially expanded view which shows the state which the medicine has been put in one of the medicine storage pockets with which the inner surface of FIG. 4 is equipped. It is the perspective view which looked the inner surface of the medication assistance case of FIG. 4 from the left surface direction. FIG. 5 is a partially enlarged view of the inner side of the medication support case of FIG. 4 in a semi-closed state. It is an enlarged view which shows the state which loosened the cover part of the instrument storage part in part, when taking out an apparatus with a drug information transmission button from the instrument storage part in the inner surface of FIG. It is an enlarged view which shows the state which opened the cover part of the instrument storage part of FIG. It is an enlarged view which shows the state which takes out an instrument from the instrument storage part of FIG. 8 in the arrow direction. It is an enlarged view which shows the state which took out the instrument completely from the instrument storage part of FIG. It is an enlarged view which shows the state which opened the mouth of the outer side storage part with which the medication assistance case of FIG. 2 is equipped. It is a perspective view showing an example of a device with a medication information transmission button (equipped with GPS) used for a medication support case, a medication support method and a medication adherence system according to an embodiment of the present invention.

Hereinafter, the present invention will be described in detail based on its preferred embodiments.
According to the medication support method as one embodiment of the present invention, the patient takes the drug according to the prescription according to the prescription of the doctor, and transmits information on the medication to the doctor or medical staff (nurse, pharmacist, etc.) for each medication. Using a button-equipped device (GPS device) equipped with a GPS for the purpose, and configured such that the button is pressed by the patient or the carer of the patient each time the patient takes a medication, and the doctor or medical staff The medication is confirmed by receiving information transmitted via GPS, and in the case of non-medication or in case of other emergency, the patient or a carer of the patient is contacted.

  In particular, it is desirable to use a case (medication support case) containing a prescribed amount of medicine together with an apparatus with a drug administration information transmission button in order to have effectiveness even when going out, etc. By using such a medication support case, it is possible to provide the GPS-equipped device with a function that allows the drug to be carried.

In the method for supporting medication according to one embodiment of the present invention, the effect determination on the usefulness and the possibility of secondary use is performed based on the following points.
(1) Simple operation using existing GPS system (2) Improvement of adherence, formation of habitation backed by behavioral science (3) Operation in regional comprehensive medical care

  As shown in FIG. 1 and FIG. 2, the medication support case 10 according to the present embodiment has a main structure made of a leather and is a portable support for medication support, and when the patient goes out, the medicine and the GPS are internally contained. And held in place with Velcro (registered trademark, the same applies hereinafter) [removable stop member] 3. Several Velcro tapes 3 are provided around the medication support case 10 so that the inside surface of the case for storing the medicine and the GPS can be opened and closed.

  In the present embodiment, although the bag of the leather product is used, the material of the medication support case is not limited thereto, and various materials can be used as long as the effects of the present invention can be achieved. Also, as long as the medicine and the GPS can be held internally, it is not necessary to be a bag, and various containers can be provided.

Also, in the medication support case 10, a shoulder belt S is usually attached at a predetermined position, and the burden on carrying can be reduced by hanging it on the shoulder of a patient or a caregiver thereof.
In addition, "carers etc." mentioned here shall widely include those who cooperate with patient's medication support etc. other than those who actually care for patients.

  As shown in FIG. 2, on the back of the medication support case 10 according to the present embodiment, a vertically long outer storage portion 11 is provided in which things such as prescriptions and medical manuals necessary for carrying are placed. The outer storage portion 11 is made of a resin whose surface is transparent so that the inside can be seen. When placing a document or the like in the outer storage section 11, the vertically-long storage port can be expanded to easily store a relatively large document or the like from the lateral direction (the direction of the arrow) (see FIG. 12).

  When the magic tape 3 in the medication support case 10 shown in FIGS. 1 and 2 is removed and opened, the outer side shown in FIG. 3 and the inner side shown in FIG. 4 appear. As shown in FIG. 4, the medication support case 10 according to the present embodiment is provided with various storage sections 1, 2 and the like for storing GPS, medicines and the like on the inner side thereof.

  The medication support case 10 according to the present embodiment is folded in half around the case inner central portion C of FIG. 4 and bound on the left and right with the velcro 3 existing around the inner side of the case. It can be carried and the like as FIGS. 1 and 2).

  The inner surface of the medication support case 10 is provided with an instrument storage unit 1 for storing a buttoned instrument E on which a GPS is mounted. The device E is for the patient to take the medicine according to the prescription schedule prescribed by the doctor, and to transmit information on the medicine or doctor's staff that the medicine was taken. The instrument storage unit 1 is provided with an opening 1 h at a position corresponding to the button portion so that the button portion can be directly pressed in the stored state. By the presence of the opening 1 h, it is possible to prevent the button from being forgotten.

  Further, on the inner side of the medication support case 10, a medicine storage pocket 2 for containing a medicine M to be taken is provided. The medicine storage pocket 2 is provided with three pockets 2a, 2b and 2c so that the medicine storage pocket 2 can be classified according to the type of medicine and the time of taking medicine. For example, if there are medicines to be taken after (or before) each meal in the morning, afternoon and evening, they can be stored separately in the medicine storage pockets 2a, 2b, 2c. In this way, accidental medication can be prevented.

  When the patient goes out, the medication support case 10 stores the buttoned device E in the device storage portion 1 and stores a predetermined amount of medicine M in the medicine storage pockets 2a, 2b and 2c. Used. As described above, by storing the medicine M and the device E on which the GPS is mounted in one case 10, it is possible to easily provide information to a doctor or the like in taking a drug. As a result, patients with diseases requiring continuous medication can be taken safely and reliably, and by continuing, medication adherence can also be improved. Furthermore, it can become habit habitation gradually, and it becomes possible to visualize taking behavior.

  In the medication support case 10, the position and arrangement of the device storage unit 1 and the drug storage pocket 2 (2a, 2b, 2c) are not particularly limited, but at the time of use (specifically, the drug M, the device E, and others as needed) It is preferable that the buttoned instrument E (GPS device) be held at a substantially central portion of the entire case when storing a manual etc. and binding and carrying the case). That is, when the device storage unit 1 shown in FIG. 4 is installed at the position (middle right side), the morning medicine in the left medicine storage pocket 2 is upper (2a), midday medicine is middle (2b), and evening By dividing the medicine into the lower part (2c), since the medicine for daytime is relatively small, even if the thickness of the device E is taken into consideration, the thickness balance of the whole case is improved and it becomes easy to use. The positions of the tool storage unit 1 and the medicine storage pocket 2 may be reversed. If it is necessary to take a dose other than morning, evening, and evening (for example, before bedtime, etc.), it is also possible to use a storage unit other than the drug storage pocket 2 to store a pre-sleep medicine or the like.

  The medication support case 10 is provided with a first card case 4 whose inside can not be seen from the outside, and a second card case 5 whose inside is made of a transparent resin. These card slots 4 and 5 can be used for storing ID cards, medical examination tickets and the like. However, these are not essential, and other storage units can be provided as needed.

  FIG. 5 is an example showing a state immediately before using a drug. As shown in FIG. 5, the medicine is stored in the medicine storage pocket 2 a provided on the inner side of the medication support case 10. When the same medicine is used, a plurality of medicines M can be stapled on a mount (not shown), and one medicine can be removed each time it is used. In particular, it is preferable to put a mount in the medicine storage pocket 2a and put out the medicine to be used on the front of the medicine storage pocket 2a, from the viewpoint of easy removal of the medicine.

  In addition, as shown in FIG. 6, the first inner lower storage portion 6 is provided under the device storage portion 1 side on the inner side surface of the medication support case 10, and the second inside under the medicine storage pocket 2 side. An inner lower storage section 7 is provided. These inner lower storage sections 6, 7 can easily store a vertically long, relatively large document or the like, and can also be equipped with a spare drug which is not used immediately.

  As shown in FIG. 7, the medication support case 10 containing necessary items is closed in the direction of the arrow centering on the central part C of the open inner side, and is finally folded in half through the semi-closed state. It is stopped by each velcro 3 around so that it may become. In this way, it is used in a state of being vertically folded. In this state, it becomes easy to take out the medicine when taking a drug, and it is possible to press the button of the device immediately after taking the drug.

  Since it is not necessary to take out the device E with the medication information transmission button for a certain period after storing it, the device storage portion 1 has a lid portion 1i for holding the device E after storage so as not to be removed. When the medication support case 10 is used, the apparatus E is normally held in the back of the apparatus E in the apparatus storage unit 1 by sandwiching the apparatus E with the lid 1i. When it is necessary to charge the appliance E, the lid 1i is opened to take out the appliance E.

  As shown in FIG. 8, when taking out the device E with the medication information transmission button from the device storage portion 1 in the inner side surface of the case 10, first loosen the lid portion 1i of the device storage portion from the state of inserting it into the back. Remove. Next, as shown in FIG. 9, the lid 1i is opened, and the appliance E is taken out in the direction of the arrow from the opening of the appliance storage unit 1. And as shown in FIG. 10, the instrument E can be completely taken out from the instrument storage 1 in the direction of the arrow. FIG. 11 shows a state in which the device E has been completely removed from the device storage portion 1.

  FIG. 13 shows an apparatus 80 with a medication information transmission button (manufactured by NTT DoCoMo, Inc.) which is an example of the apparatus E with a medication information transmission button used in the present embodiment. As shown in FIG. 13, the device 80 with a drug administration information transmission button is provided with a large button 81 at the center of the front so as to be simple (without voice) and easy to use and understand. The device 80 is used by the patient wearing the body usually by means of a hanging strap or the like so that the device 80 can be used anytime and anywhere. In addition, the device 80 can be used as a more useful tool by attaching a medicine. The appliance 80 is preferable because the duration of the power supply is rechargeable once a week, and matches the home condition. Furthermore, the cost is also advantageous.

  A button 81 (hereinafter also referred to as a "GPS button") provided on the device 80 according to the present embodiment is taken by the patient according to a medication schedule prescribed by a doctor in charge of the patient, and the doctor or medical staff It is a button for transmitting information of taking medication to (nurse, pharmacist, etc.).

  GPS is mounted on the device 80, and each time the patient takes a drug, information (hereinafter also referred to as "GPS information") is transmitted via the GPS when the patient or his / her caregiver presses the button 81. Ru. Then, the doctor or medical staff in charge confirms receipt of the information, and the patient or the carer of the patient is contacted in the case of not taking medication or in the case of other emergency. Thereby, a doctor or the like can check each time a patient takes it. In addition, it can be used as a more useful tool by establishing rules such as hypoglycemia.

It implemented concretely below using this instrument 80.
(Target)
The subjects were 24 patients over the age of 75 who were able to press the GPS button after taking each drug (77 ± 7.8 years, 9 women, HbA1c = 7.4 ± 0.5%).
Make medication confirmation from GPS information and contact the patient / family member by phone when not taking medication or in case of emergency. A questionnaire survey (self-administered type) was conducted on the person, family members and staff around 8 weeks after the intervention.
Pre-intervention cognitive function test: HDS-R (21.6 ± 0.5), MMSE (22.2 ± 0.9)

The personnel in the hospital are a pharmacist (daytime medication check) and a doctor (nighttime medication and emergency response). At night, the office watch and the doctor (because medical judgment is necessary) will do.
The medicine set depends on the target patient, but for a single person, the visiting nurse or the day service sets the medicine together with the charging of the device 10 with the medication information transmission button equipped with GPS once a week.

(result)
Eight patients skipped over 10% of the dosing frequency. The frequency decreased as the intervention continued. In the verification of the effect judgment, it is shown below in the order of multiple answers.
(1) Operation is simple and does not get lost. Can operate for a long time. There is no burden on patient costs.
(2) Because it intervenes on the spot, it is easy to form a habit. You can see life patterns. Proper intervention in the display of places.
(3) 徘徊 search by cooperation of public organizations, correspondence of single living patients, safety confirmation by family.
In addition, there is a problem such as privacy, but I thought that I was taking it as a case not only taking improvement as well as adherence improvement but my family was taking it as a case, but the target patient was riding in a car without family and obtaining living information Was also useful.

(Discussion)
Patients who are eligible for regional comprehensive medical services are required to understand and centrally manage all visiting medical institutions and prescription drugs for the patients. To this end, the operation of the medication support method according to the present embodiment is consistent with the aspect of grasping and managing prescription drugs. Then, by carrying the device with the medication information transmission button in the medication support method according to the present embodiment at all times, it can be expected that it can be used for warning and searching when a subject person's cognitive function declines.

  According to the present invention, the oral behavior of a patient can be visualized, and confirmation or indication can be made by a doctor or medical staff on the spot. In particular, flexible operation is possible, such as the use of a blood sugar level reporting emergency button. In addition, you can make it customary to take medicines and check the patient's location. In addition, the location information of the patient can be used at low cost, and it can be used for searching and living. In addition, it can be used by many types of workers.

  Further, according to the present invention, it is possible to provide a medication adherence improvement system using the medication support method or the medication support case described above.

  Thus, the present invention is a simple method, case or system, so that it can be started immediately without hesitation for the patient and can also be corrected immediately. And it can be expected to be a tool that can be used by anyone, anywhere, anytime.

  In particular, when using the medication support case described above, the drug can be carried around in an appropriate state with a device with a drug information transmission button (GPS device), and the action of "press and then drink" improves medication medication adherence. be able to. And by taking medicine around, the habit of carrying around the GPS device is enhanced, and even if there is mild cognitive decline, the habit of carrying around the GPS device becomes possible. In addition, although the application of the present invention is premised on a person who can press a button, it is a patient who can not live in this habit (a patient who lives alone and can not live alone), a family, a third party, etc. The present invention can be applied when the care giver of the patient receives the assistance using the medication support case.

  In addition, the present invention is for local response only in the area, but it is possible to contact a plurality of places by e-mail, to enable the mobile to be available when searching for wrinkles, etc., and also to make a buzzer By providing an additional function to the device 80, such as, it becomes an even more useful tool.

As mentioned above, although this invention was demonstrated based on embodiment mentioned above, it can be suitably changed as this in addition to this.
Although the present invention has been described by taking a diabetic patient as an example for the improvement of medication adherence, the present invention is not limited to the embodiment described above, and various patients can be targeted.

  The present invention, as described in detail, solves the problem of adherence for the patient and the problem of polypharmacy for the therapist (doctor or medical staff), and allows the family (caregiver etc) to understand the patient's behavior and the patient's behavior. It is something that can solve all the problems from the three aspects of eliminating the mismatch.

  That is, according to the present invention, it can be understood that the patient (particularly a dementia patient) has taken the drug at this moment. In addition, the therapist can improve the symptoms by taking an appropriate amount of the drug without unnecessarily administering the drug to the patient, and it will not cause the patient's hypoglycemia etc. due to the sudden drug taking. Also, even if the family thinks that the patient absolutely takes the medicine properly (appropriate amount), the patient's range of action is limited to an understandable range (for example, a patient with a dementia ride in the car without knowing the family) However, such problems can be solved by the present invention.

  Conventionally, there has been no alternative but to determine the presence or absence of patients taking medication calendars by means of home-visit nursing care or helpers etc., the presence or absence of drugs, and the remaining amount. It is often As a doctor or medical staff (on the side of the therapist), I really want to know whether the patient has taken the medicine at this stage, where and when he is taking it, what kind of action is taking place, etc. Yes, the case according to the present invention is made possible as a method, system that makes it clear. It has also been demonstrated by the present invention that the patient's family was not actually taking what they believed in the patient's taking. In addition, for example, when the button of the device in the case according to the present invention is pressed twice when there is something, for example, it was also possible to grasp nighttime anxiety and the like mental state of the patient whom the family could not know.

  By adopting the case according to the present invention, it has almost certainly been possible to determine whether it has been difficult to determine whether a patient has taken a drug in the past. In particular, a buttoned instrument provided with one relatively large button in the center according to an embodiment of the present invention according to the above-mentioned case provides a condition that the patient presses the button after drinking, and a behaviorally simple method It is adopted and can certainly make it easy to take action. Furthermore, if you can not even do this kind of behavior, you will be able to identify the patient's problems at that stage, which can lead to the next development of needing more intensive care.

  The GPS-equipped buttoned instrument used in the case according to the present invention usually requires one hour of battery charging per week. For this reason, if home-care or day service etc. is assigned once a week, the battery of the buttoned instrument can be charged at that time, and the case of the present invention can be used continuously.

  The present invention has industrial applicability as a method, a case, and a system for safely and reliably taking a patient with a disease requiring continuous medication, and also improving medication adherence by continuing the medication.

10: medication support case 1: appliance storage unit 1h: aperture 1i: lid 2, 2a, 2b, 2c: medicine storage pocket 3: magic tape 4: first card holder 5: second card holder 6: second First inner lower storage section 7: second inner lower storage section 11: outer storage section 80: device with medication information transmission button 81: button

Claims (4)

A device storage unit for storing a button-equipped device equipped with a GPS for transmitting information on the medication taken by the patient according to the medication schedule prescribed by the doctor and taking medication to the doctor or medical staff for each medication;
A medication support storage case at least comprising a medicine storage pocket for containing a medicine to which the above medication is applied;
The device storage portion is provided with an opening at a position corresponding to the button portion so that the button portion can be pressed directly in the stored state.
A device for supporting medication, wherein the device with a button is stored in the device storage unit, and a predetermined amount of medicine is stored in the medicine storage pocket at the time of use. In use, the button with the instrument is held so as to be positioned at a substantially central portion of the entire case, claim 1 medication support case according. The medication support case according to claim 1 , wherein the medication support case is used in a state where it is folded in half around a central portion inside the case and bound around the inner side of the case to form a longitudinal shape. Medication adherence improvement system, characterized by the use of medication support case according to any one of 請 Motomeko 1-3.

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