MIT builds a better pillbox to prevent drug-resistant TB
Problem: Drugs to treat tuberculosis work well, but only if taken at precise intervals over many months.
Bigger problem: If they're not taken when they should be, patients can develop drug resistance, which can be lethal for them and others.
Solution? A team of MIT students and alumni has designed an inexpensive plastic pillbox to help patients keep track of their drug regimens for tuberculosis, a disease most common in the developing world. Drug regimens involve as many as seven pills taken three times a week for six to eight months.
"The box reminds patients when it's time to take their pills, so they don't have to worry about what they're supposed to take and when," said Manish Bhardwaj, a doctoral student in Electrical Engineering and Computer Science who helped develop the "uBox."
The "reminder" comes by way of small flashing lights and a buzzer timed to go off at each dosage. Each time the box opens and pills are taken, the date and time are automatically recorded. After the box is closed, it remains locked until it is time for the next treatment, preventing double-dosing.
Once a month, a visiting healthcare worker replaces the box, first inserting a tiny key in the old box to record the visit. Information from the old box, including the number of pills not tak en, is transmitted to a data center.
"The uBox will allow us to know when pills were taken out and when workers were interacting with patients," Bhardwaj said. The boxes will cost $10-$15 a piece and will be leased to government clinics and NGOs for around $2 each, he said.
In India, where Bhardwaj and his colleagues are testing the product, there are 110,000 new cases of multiple-drug resistant TB each year, according to a new World Health Organization report. Drug regimens involve as many as seven pills taken three times a week for six to eight months.
Because administering treatment programs is especially difficult in remote, rural areas, Bhardwaj and his colleagues also developed the uPhone, a special cellphone on which healthcare workers can key in patients' weight and other information.
"What the phone allows us is to find out who the sickest patients are and help doctors deliver a more targeted intervention," he said.
A field test of around 100 uPhones and 50 uBoxes will begin in May in Bihar, one of India's poorest states. After that, the MIT team hopes to expand the test. Bhardwaj also sees potential for the technology in HIV/AIDS treatment, which also involves multiple drugs and for which resistant strains are a concern.
Given high illiteracy rates in some parts of the developing world, the MIT-devised system might be useful in cicumventing complicated directions for taking medicine, said Dr. Mark Pasternack, chief of the pediatric infectious disease unit at Massachusetts General Hospital.
"Anything that lowers the difficulty of taking medication in any disease is a plus," he said.
Yet one critical factor that cannot be predicted is motivation to take the pills, Pasternack added. "The mechanical device coupled with a neighbor or family member might be the most useful."
