JP2019193797A - Medication support method - Google Patents

Abstract

To provide a medication support method that improves medication adherence by safe and sure medication by a patient of a disease requiring continuous medication, and by continuing the medication.SOLUTION: There is provided a medication support method in which a patient takes a medicine according to a medication schedule by a doctor's prescription, and which uses an instrument E with a button for transmitting information that the patient has taken a medicine to the doctor or a medical staff member each time the patient takes a medicine. The instrument with a button is mounted with a GPS, and is configured so that a patient or his or her care-giver pushes the button each time the patient takes a medicine. The doctor or the medical staff member checks whether or not a medicine is taken by receiving the information transmitted through the GPS, and if a medicine is not taken or in other emergency cases, notifies the patient or his or her care-giver.SELECTED DRAWING: Figure 4

Description

  The present invention provides a method and medication support case and system for patients with diseases requiring continuous medication safely and reliably, and in particular by using a prescription medication and a case with GPS. -It is related to a method, a medication support case, and a system for improving medication adherence by taking medication reliably and continuing.

  Conventionally, contrivances have been made to ensure medication. For example, taking medication for the purpose of helping patients or their caregivers consciously remember what they have taken, and for helping patients or their caregivers easily and surely remember what they took A confirmation support apparatus has been proposed (Patent Document 1).

In addition, patients with reduced cognitive functions, such as patients with dementia, can take prescribed medications alone to reduce the burden of caregivers' support (Patent Document 2), dementia There has been proposed a medication support holder (Patent Document 3) that assists in taking and administering medications not only to patients but also to users who are required to take regular medications.
However, there is a limit to safe and reliable medication in these devices and instruments.

  In addition, there are various problems regarding patient medication management, particularly medication management for elderly patients whose cognitive functions have declined. First, there is a “medicine adherence” problem that the patient can definitely take the medicine as instructed by the doctor. Secondly, there is a problem that the patient requests that “I have not taken it” even though I actually took the medicine. In addition, the third problem is that the patient dislikes taking the medicine and does not drink it.

  The problem of medication adherence is, for example, in elderly diabetic patients, hypoglycemia due to sudden normalization of age-related changes such as uneven diet and memory impairment and medication skipping support by family caregivers, etc., and emergency transport And socio-economic problems such as individual problems and residual drugs / polypharmacy (use of many types of drugs such as 10 to 15 kinds). For example, in the case of diabetic patients, many insulin administration subjects cannot be controlled by oral administration once a day. The presence of a risk of hypoglycemia is an important issue when focusing on diabetic patients. In addition to triggering myocardial infarction and cerebral infarction due to disturbance of consciousness, there is a risk of causing a traffic accident or driving into a social problem.

  Also, in the case of polypharmacy, medicines are prescribed by various hospitals and clinics, and it is rare that they take all internal medicines, and sometimes they do not take key drinks. In addition, medicine may be added by a doctor if it is not effective for elderly people who are not taking it. 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 hasn't taken so far, leading to hypoglycemia all at once.

  There are few ways to tell if you are taking it at this moment. For example, even if it is pointed out that a family member came back that night or not to take a medicine during the day, a patient with cognitive decline does not even remember whether or not he / she took it There are many. However, it is still memorable that I haven't taken it if I get an indication at the daytime, and I often become habitual as I take it. There are people who are unable to make such habits, but it has been desired to visualize their behavior, including whether they are impossible. In addition, centralization by regional comprehensive medical care is also desired.

  Furthermore, conventional methods for improving adherence adherence were limited to medication calendars, packaged medications, home medication guidance, etc., so doctors and pharmacists in particular know the patient's medication behavior in a timely manner, A mechanism that can give advice according to the situation was desired. There was also a need for a portable medication support case that could be managed while on the go.

JP 2002-209980 A JP 2011-031036 A Utility Model Registration No. 3201517

  It is an object of the present invention to provide a method and system for improving the medication adherence by allowing patients with diseases requiring continuous medication to safely and reliably take medication.

  As a result of earnest research to solve the above problems, the present inventor has obtained knowledge that supporting the medication using a specific medication information transmitting device can achieve the object.

  The present invention has been made on the basis of the above findings, and has achieved the object by providing the following invention.

1. A medication support method using a button-equipped device for sending information that a patient took a medication according to a medication schedule prescribed by a doctor and that the medication was taken to a doctor or medical staff for each medication,
The instrument with a button is equipped with GPS, and each time the patient takes a medicine, the button is pressed by the patient or a caregiver thereof,
The doctor or the medical staff confirms the medication by receiving the information transmitted via the GPS, and informs the patient or a caregiver thereof when the medication is not taken or in other emergency cases. A medication support method characterized by:

2. 2. The medication support method according to 1 above, wherein a case containing a predetermined amount of medicine is used together with the device with the medication information transmission button.

3. A device storage unit for storing a device with a button equipped with a GPS for sending information that a patient has taken according to a medication schedule according to a doctor's prescription, and for each medication taken to a doctor or medical staff,
A medicine support storage case comprising at least a medicine storage pocket for containing a medicine to be a subject of the medicine,
The instrument storage part is provided with an opening at a position corresponding to the button part so that the button part can be pressed directly in the stored state,
The medication support case, wherein the device with a button is stored in the device storage portion and a predetermined amount of medicine is stored in the medicine storage pocket when used.

4). 4. The medication support case according to 3 above, wherein the device with buttons is held so as to be positioned at a substantially central portion of the entire case when in use.

5. 5. The medication support case according to 3 or 4 above, wherein the medication support case is used in a state where it is folded in half around the central portion inside the case and bound around the inner side surface of the case to make it vertically long.

6). 3. A medication adherence improvement system using the medication support method according to 1 or 2 or the medication support case according to any one of 3 to 5.

  ADVANTAGE OF THE INVENTION According to this invention, the patient of the disease which requires a continuous medication can take a medicine safely and reliably, and the method, case, and system which improve a medication adherence by continuing can be provided.

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

  Further, according to the present invention, it becomes possible to make a habit as soon as it is taken. Even for patients who are unable to make such habits, they can visualize their behavior.

  In particular, doctors and pharmacists will be able to ascertain the patient's medication behavior in a timely manner and provide advice according to the situation.

It is a front view which shows the medication assistance case (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 support case of FIG. It is a figure which shows the outer side surface of the state which opened the medication assistance case of FIG. It is a figure which shows the inner surface of the state which opened the medication assistance case of FIG. It is a partially expanded view which shows the state in which the medicine is put into one of the medicine storage pockets with which the inner surface of FIG. 4 is equipped. It is the perspective view which looked at the inner surface of the medication assistance case of FIG. 4 from the left side surface direction. FIG. 5 is a partially enlarged view of an inner surface of the medication support case of FIG. 4 in a semi-closed state. It is an enlarged view which shows the state which loosened a part of cover part of an instrument storage part, when taking out an instrument with a medication 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 accommodating 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 opening | mouth of the outer side storage part with which the medication assistance case of FIG. 2 is equipped. It is a perspective view which shows an example of the medication information transmission button-equipped device (GPS deployment) used for the medication support case, medication support method, and medication adherence system concerning one embodiment of the present invention.

Hereinafter, the present invention will be described in detail based on preferred embodiments thereof.
The medication support method as one embodiment according to the present invention is based on a medication schedule according to a doctor's prescription, and sends information on the medication taken to a doctor or medical staff (nurse, pharmacist, etc.) for each medication. A device with a button (GPS device) equipped with a GPS for performing the operation is configured so that each time a patient takes a drug, the button is pressed by the patient or a caregiver thereof. Confirmation of medication by receiving information transmitted via GPS, and in case of not taking medication or in other urgent cases, contact the patient or their caregiver.

  In particular, it is desirable to use a case (medication support case) in which a predetermined amount of medicine is stored together with a device with a medication information transmission button in order to be effective even when going outside. By using such a medication support case, it is possible to provide a GPS-equipped device with a function that allows the drug to be carried around.

In the medication support method according to an embodiment of the present invention, the effect of the usefulness and the possibility of secondary use was determined based on the following points.
(1) Simple operation using the existing GPS system (2) Improvement of adherence, formation of habits backed by behavioral science (3) Operation in regional comprehensive medical care

  As shown in FIGS. 1 and 2, the medication support case 10 according to the present embodiment is composed of a leather-made medication support portable basket, and the medicine and GPS are stored inside when the patient goes out. And is used in a state where it is bound with Velcro (registered trademark, the same applies hereinafter) [detachable stopper member] 3. Several magic tapes 3 are provided around the medication support case 10 so that the inner side surface of the case for storing the medicine and GPS can be opened and closed.

  In addition, in this embodiment, the bag of leather products is used, but the material of the medication support case is not limited to this, and various materials can be used as long as the effects of the present invention can be achieved. Moreover, as long as a medicine and GPS can be hold | maintained inside, it is not necessary to be a bag and it can be set as various storage tools.

Further, the shoulder support S is usually attached to the medication support case 10 at a predetermined position, and the burden of carrying can be reduced by hanging on the shoulder of a patient or a caregiver thereof.
The term “caregiver” as used herein includes a wide range of persons who cooperate in patient compliance support in addition to those who actually perform patient care.

  As shown in FIG. 2, a vertically long outer storage portion 11 is provided on the back surface of the medication support case 10 according to the present embodiment for storing things necessary for carrying such as a prescription and medical instructions. The outer storage portion 11 is made of a resin having a transparent surface so that the inside can be seen. When a document or the like is put into the outer storage unit 11, a vertically long storage port can be widened 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 is removed and opened in the medication support case 10 in the state shown in FIGS. 1 and 2, 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 units 1 and 2 for storing GPS, medicine, and the like on the inner surface 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 surface of the case, whereby the above-described vertically long state ( (See FIGS. 1 and 2).

  On the inner surface of the medication support case 10, there is provided a device storage unit 1 for storing a device E with a button equipped with GPS. The device E is for sending information that the patient has taken the medicine according to the medication schedule prescribed by the doctor and that the medicine has been taken to the doctor or medical staff for each medication. The instrument storage portion 1 is provided with an opening 1h at a position corresponding to the button portion so that the button portion can be pressed directly in the stored state. Due to the presence of the opening 1h, forgetting to press the button can be prevented.

  In addition, a medicine storage pocket 2 is provided on the inner surface of the medication support case 10 for containing a medicine M to be taken. 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 the medicine. For example, when there are medicines to be taken after each meal (or before meals), they can be stored separately in the medicine storage pockets 2a, 2b, 2c. In this way, accidental medication can be prevented.

  In the medication support case 10, when the patient goes out, etc., the device E with buttons is stored in the device storage portion 1, and a predetermined amount of the drug M is stored in the drug storage pockets 2a, 2b, 2c. Used. As described above, by storing the medicine M and the device E equipped with GPS in one case 10, it is possible to easily provide information to a doctor or the like when taking the medicine. As a result, patients with diseases that require continuous medication can be safely and reliably taken, and medication adherence can be improved by continuing. Furthermore, taking can gradually become a habit, and taking action can be visualized.

  In the medication support case 10, the position and arrangement of the device storage unit 1 and the drug storage pocket 2 (2 a, 2 b, 2 c) are not particularly limited, but at the time of use (specifically, the drug M, the device E, and others as necessary) When storing a manual or the like and binding and carrying the case, it is preferable that the button-equipped device E (GPS device) is held so as to be positioned at a substantially central portion of the entire case. That is, when installed like the position of the instrument storage unit 1 shown in FIG. 4 (right middle), the morning medicine in the left medicine storage pocket 2 (2a), the day medicine in the middle (2b), and the evening medicine By dividing the medicine into the lower stage (2c), since there is relatively little medicine in the daytime, the balance of the thickness of the entire case is improved even if the thickness of the device E is taken into consideration, and it is easy to use. In addition, you may make the position of the instrument storage part 1 and the medicine storage pocket 2 reverse right and left. In addition, when taking other than morning and evening (for example, before going to bed), the medicine for going to bed can be stored using a storage unit other than the medicine storage pocket 2.

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

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

  Moreover, as shown in FIG. 6, the 1st inner lower storage part 6 is provided under the instrument storage part 1 side in the inner surface of the medication assistance case 10, and the 2nd under the medicine storage pocket 2 side is provided. The inner lower storage part 7 is provided. These inner lower storage parts 6 and 7 can easily store a relatively long and relatively large document or the like, and can be provided with spare medicines that are not used most recently.

  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 portion C of the opened inner surface, and finally folded in half through a semi-closed state. It stops with each surrounding magic tape 3 so that it may become. In this way, it is folded in half and used in a vertically long state. In such a state, it becomes easy to take out the medicine when taking the medicine, and it becomes possible to press the button of the instrument immediately after taking the medicine.

  Since the appliance storage unit 1 does not need to take out the appliance E with the medication information transmission button for a certain period of time after storage, the device storage unit 1 has a lid 1i for sandwiching the appliance E after storage to prevent it from being removed. When the medication support case 10 is used, it is usually left in a state where the device E is inserted into the back of the device E in the device storage unit 1 so that the device E is sandwiched between the lids 1i. When it is necessary to charge the instrument E, the lid 1i is opened to take out the instrument E.

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

  FIG. 13 shows a device 80 with medication information transmission button (manufactured by NTT Docomo), which is an example of the device E with medication information transmission button used in the present embodiment. As shown in FIG. 13, the medication information transmission button-equipped device 80 is provided with a large button 81 in the center of the front so that it is simple (no audio) and easy to use and understand. The instrument 80 is usually used by a patient by attaching it to the body with a hanging strap so that it can be used anytime and anywhere. Moreover, it can utilize as a more useful tool by attaching the instrument 80 with a medicine holder. The appliance 80 is preferably a rechargeable battery that lasts once a week, and is suitable for home use. Further, it is advantageous in terms of cost.

  A button 81 (hereinafter also referred to as “GPS button”) provided on the instrument 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 a doctor or medical staff for each medication. It is a button for transmitting information on taking medicine to (nurse, pharmacist, etc.).

  The instrument 80 is equipped with a GPS, and whenever the patient takes a drug, the patient or his caregiver presses the button 81 to transmit information (hereinafter also referred to as “GPS information”) via the GPS. The Then, the doctor or medical staff in charge receives the information to confirm the medication, and in the case of not taking the medication or in other urgent cases, the patient or their caregiver is contacted. Thereby, a doctor etc. can check for every patient's taking. Moreover, it can be utilized as a more useful tool by providing rules such as hypoglycemia.

Using this instrument 80, the following was specifically performed.
(Target)
The subjects were 24 diabetic patients over 75 years old who could press the GPS button for each medication (77 ± 7.8 years old, 9 women, HbA1c = 7.4 ± 0.5%).
Confirmation of medication from GPS information, and if not taking medication or in case of emergency, contact the patient / family by phone. About 8 weeks after the intervention, a questionnaire survey (self-filled) was conducted on the person, family and staff.
Pre-intervention cognitive function tests: HDS-R (21.6 ± 0.5), MMSE (22.2 ± 0.9)

The person in charge in the hospital is a pharmacist (daytime medication check) and a doctor (nighttime medication and emergency response). At night, the office supervisor and doctor (because medical judgment is necessary) will do it.
The drug setting depends on the target patient, but for a person living alone, the drug is set together with charging of the device 10 with a medication information transmission button equipped with GPS once a week by a visiting nurse or day service.

(result)
Eight patients skipped over 10% of the number of doses. The frequency decreased with continued intervention. It is shown below in order of the number of multiple answers in verification of effect determination.
(1) The operation is simple and not confusing. Long time operation is possible. There is no patient cost burden.
(2) It is easy to form a habit because of intervention on the spot. You can see life patterns. Appropriate intervention in the location display.
(3) Acupuncture search with the cooperation of public institutions, the handling of single patients, and safety confirmation by family members.
In addition, although there are issues such as privacy, it was thought that the family was taking as an example of not taking it as well as improving adherence, but obtaining the living information such as the target patient riding in the car without telling the family It was also useful.

(Discussion)
Patients who are eligible for regional comprehensive medical fees are required to grasp and centrally manage all outpatient medical institutions and prescription drugs. For this purpose, the operation of the medication support method according to the present embodiment is consistent from the viewpoint of grasping and managing prescription drugs. And by always carrying the medication information transmission button-equipped device in the medication support method according to the present embodiment, it can be expected that it can be used for warning and searching when the subject's cognitive function declines.

  According to the present invention, the internal behavior of a patient can be visualized and confirmed or pointed out by a doctor or medical staff on the spot. In particular, flexible operation is possible, for example, a blood glucose level reporting emergency button can be used. In addition, customizing medication and confirming the patient's location can be performed. Furthermore, the patient's location information can be used at a low cost, which is useful for searching and living. It can also be used in various occupations.

  Moreover, according to this invention, the medication adherence improvement system which uses the medication support method or medication support case mentioned above can be provided.

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

  In particular, when using the medication support case described above, it is possible to carry the medication in an appropriate state with a device with a medication information transmission button (GPS device), and the act of “pressing after drinking” improves the medication behavior adherence be able to. The habit of carrying the GPS device is enhanced by carrying the medicine, and the habit of carrying the GPS device can be made even if there is a slight decline in cognitive function. In addition, the application of the present invention is premised on the person who can press the button, but even if it is a patient who cannot do this custom (a single patient who cannot live alone), a family member, a third party, etc. The present invention can be applied by the caregiver using the medication support case to receive assistance.

  In addition, the present invention is designed for local use / single life support, but it is possible to contact multiple places by e-mail, make mobile available when searching for traps, etc. For example, providing an additional function to the instrument 80 makes the tool even more useful.

As described above, the present invention has been described based on the above-described embodiment, but other modifications can be appropriately made.
In the present invention, improvement in medication adherence has been described by taking a diabetic patient as an example. However, the present invention is not limited to the above-described embodiment, and various patients can be targeted.

  As described in detail, the present invention solves the problem of adherence for patients and the problem of polypharmacy for therapists (doctors or medical staff), and grasps of therapists by the family (caregivers, etc.) and the behavior of the patients. It can solve all the problems from the three aspects of mismatch resolution.

  That is, according to the present invention, it can be understood that a patient (particularly a patient with dementia) has taken the medicine at this moment. The therapist can improve the symptom by taking an appropriate amount of the medicine without giving the patient an additional dose of medicine more than necessary, and does not cause the patient's hypoglycemia or the like due to the sudden taking of the medicine. In addition, even if the family thinks that the patient is taking medicine appropriately (appropriate amount), the range of behavior of the patient is limited to an extent that can be understood (for example, a patient with dementia is riding in a car secretly to the family) However, this problem is also solved by the present invention.

  Conventionally, there is only a method for grasping the patient's use by visiting nursing and helpers, etc. based on the medicine calendar, the presence / absence / remaining amount of the medicine, etc., and it can be understood after a while from the time when the original medicine should be taken Often. Doctors and medical staff (therapists) now want to know if the patient has taken medicine at this stage, when and where they are taking it, and what action they are taking. Yes, the case according to the present invention is made possible as a method and system to understand it. It has also been demonstrated that the present family found that the patient's family believed that the patient was taking and was not actually taken. In addition, for example, when the button of the appliance in the case according to the present invention is pushed twice when something happens, it is possible to grasp a mental state such as anxiety at night of a patient that the family could not know.

  By adopting the case according to the present invention, it has been possible to almost surely make it difficult to know whether or not a patient has taken a medicine. In particular, a button-equipped device provided in the center with a relatively large button installed in the above-described case according to the embodiment of the present invention is a condition that a button is pressed when a patient drinks, and a simple method in terms of behavioral science. Adopted and surely able to take action. If even such a behavior is not possible, the problem of the patient can be understood at that stage, and this can lead to the next development in which more intense care is required.

  The GPS-equipped instrument with a button used in the case according to the present invention usually requires charging of the battery for one hour per week. For this reason, if visiting nursing, day service, etc. are applied once a week, the battery of the instrument with a button can be charged at that time, and the case of the present invention can be used continuously.

  INDUSTRIAL APPLICABILITY The present invention has industrial applicability as a method, a case, and a system in which a patient with a disease requiring continuous medication can safely and surely take medication and improve medication adherence by continuing medication.

10: Medication support case 1: Device storage 1h: Opening 1i: Lid 2,2a, 2b, 2c: Medicine storage pocket 3: Velcro 4: First card slot 5: Second card slot 6: No. One inner lower storage part 7: Second inner lower storage part 11: Outer storage part 80: Apparatus with medication information transmission button 81: Button

Claims (2)

A medication support method using a button-equipped device for sending information that a patient took a medication according to a medication schedule prescribed by a doctor and that the medication was taken to a doctor or medical staff for each medication,
The instrument with buttons is equipped with GPS, and each time the patient takes a medicine, the button is pressed by the patient or its caregiver,
The doctor or the medical staff confirms the medication by receiving the information transmitted via the GPS, and in the case of not taking the medication or other emergency, contact the patient or the caregiver thereof. A medication support method characterized by:   The medication support method according to claim 1, wherein a case containing a predetermined amount of medicine is used together with the device with the medication information transmission button.

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