Medication Adherence Improvement with Abilify Computer Chip?

Medication Adherence Improvement with Abilify Computer Chip?

Last week, the Food and Drug Administration (FDA) approved the use of a computer chip inside of aripiprazole (Abilify) pills. This computer chip is designed to indicate whether the person has taken his or her medication or not. The theory (and marketing push) is that this computer chip will improve treatment adherence (compliance). It will “ensure” people are taking their medications as prescribed. But will a computer chip inside of an antipsychotic really improve medication adherence?

The Computer Chip Inside of Aripiprazole (Abilify)

According to Prakash Masand, MD, the details on the computer chip inside aripiprazole can be described as:

. . . medication embedded with an ingestible sensor, [includes] a wearable sensor (being attached on left costal area on patient’s body), and software applications (mobile computing devices). After ingestion of the medication, the sensor embedded in medication is automatically activated in stomach and then a signal containing adherence-related information is transmitted to a secure cloud-based server via communication between the wearable sensor and the mobile application.

In other words, we are asking patients to wear a sensor on their body and ingest computer chips that talk to it and then to the cloud.

Who wants to sign up first?

Who Is Supposed to Use This Medication-Adherence Computer Chip?

As this sensor is being placed in aripiprazole (Abilify), an antipsychotic that is primarily indicated for schizophrenia (although it is commonly used for bipolar disorder treatment as well), what we’re really asking is people with schizophrenia to ingest computer chips.

Now, on the surface (at least, to a drug company), this might make sense. Medication adherence in schizophrenia (and, indeed, bipolar) is a major issue and keeps people from getting and staying well. I totally get this. And so some drug company thought a way to improve medication adherence would be to officially track whether medications had been taken via a sensor.

Okay, I see their logic.

But did no one in the marketing group have a minute of common sense? I mean, really, would these marketers want to wear a sensor all day every day so that their medication could talk to it via computer chip? Or did they think people with schizophrenia or other mental illnesses would do it simply because they’re “crazy.” Yeah, I figure it’s probably the latter.

Issues with Medication Adherence and an Ability Computer Chip

The new aripiprazole (Abilify) computer chip is supposed to improve medication adherence. But what do patients think? Will a computer sensor actually work?I figure people with schizophrenia or bipolar disorder are treated as “lesser-than” because they have a serious mental illness. After all, we can’t be trusted to take our medications, so surely we deserve to be wired up to a computer.

There are major, major issues with this “solution.”

  • Schizophrenia typically contains pronounced paranoia. These are the people who are worried that the government is spying on them (often). There is no way to convince them more heavily that they are correct than by wiring up their bodies and medication.
  • Computer chips in medication are of course, horrendously expensive. Aripiprazole (Abilify) is an expensive medication to begin with, and certainly embedding a computer chip in every one ups the price dramatically. Good for drug companies, bad for patients.
  • People with schizophrenia (and often bipolar) are typically on social assistance that may not even cover aripiprazole, period, let alone some version of it with an embedded microchip.
  • I don’t want to be tracked by a computer and I don’t think the average person wants to be either.

Using a Computer Chip in Medication for Serious Mental Illness Is Insulting

Actually, I find this medication adherence/compliance via aripiprazole (Abilify) computer chip thing to be very insulting. It feels like a paternal, unreasonably-powered force is not just watching over me but watching in me. I would never, ever agree to such a thing. And that’s coming from someone who never misses a medication dose.

I can’t say this would help no one. There must be situations in which this would be helpful to the patient. This would, after all, give doctors more information about what is happening for their patients and would give families peace of mind about their loved ones. I get that.

Helping People Adhere to Medication Treatment Isn’t About a Microchip

But in general, this is bullshit, seriously. This will not improve medication adherence to antipsychotics en masse.

And you know why? Because this doesn’t address the major reason people don’t take their medications: side effects. I don’t know how much research and development money it took to develop this new technology, but I can say that money would have been much better spent looking for an antipsychotic that doesn’t cause life-altering side effects. All this money could have been spent to actually help people rather than put them under a microscope.

[Treatment adherence, of course, is much more complicated than what I’ve briefly explained and an excellent discussion of medication adherence and this new development can be seen here.]

Microchips in Antipsychotics Won’t Improve Medication Adherence or Help Sick People

Honestly, the whole thing makes me mad. It’s not about helping sick people, it’s about helping doctors. It’s not about alleviating the pain of serious mental illness, it’s about further dehumanizing people with schizophrenia and bipolar disorder. (No, it’s not dehumanizing if you agree to it, but how many people are going to willingly sign up for this intimate sensor? I suspect a whole lot of sly manipulation will be needed in order to get people to agree.)

I’ll tell you what: as soon as you make cardiology patients and diabetics have microchips in their pills, I’ll contemplate it. Until then, I’ll consider it primarily discriminatory.

I have no problem with people who wish to use this technology for themselves with informed consent, I just worry this will be a tiny proportion of people and I just don’t think sick humans should be reduced to medication sensors.

Image by 심현주 (Own work) [CC BY-SA 3.0], via Wikimedia Commons.

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About Natasha Tracy

Natasha Tracy is an award-winning writer, speaker and consultant from the Pacific Northwest. She has been living with bipolar disorder for 18 years and has written more than 1000 articles on the subject.

Natasha’s New Book

Find more of Natasha’s work in her new book: Lost Marbles: Insights into My Life with Depression & Bipolar. Media inquiries can be emailed here.

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