A new medicinal dispenser, A bridge to the future…

1. A new medicinal dispenser, A bridge to the future…

2. Mission Statement The Automatic Pill Dispenser (APD) was envisioned, designed and created by Thomas Keating and Jared Kisler of Our Lady of Perpetual Help Catholic School in Scottsdale, Arizona. Our goal was to create a device that decreases the risk of an overdose of a prescription medication. Our mentor, Don Evans, helped us to complete this project by reviewing paper work and ideas and planning the actual device (electronically and physically). Our facilitator, Deborah Magish edited papers, made suggestions, and watched our time line.

3. The Dangers Of Overdosing

4. Problem Over the last few years deaths due to overdose of prescription drugs have greatly increased. Ninety-five percent of all unintentional poisoning related deaths are from prescription drug overdoses. Prescription drug overdoses have started to overtake cocaine and heroin overdoses as the leading cause of overdosing deaths. Any prescription drugs can be fatal if too much is taken. Our objective is to decrease the risk of overdoses from prescription medications.

5. Proposed Solutions • A digital calendar that alerts and then tells the patient the medication to take each day and at each time. • A paid phone service that calls the patient and tells them to take their medication. • An automatic pill dispenser (APD) that holds a month’s worth of medication.

6. Discussion of Possible Solutions PROPOSAL A: A digital calendar that tells the person when to take certain medication. Mounted on a wall, it gives the patient the type and amount of medication and other information such as whether or not the medication is to be taken with food. POSITIVES: Patients would not forget to take a dose of medication and if they listened, would not take too much. NEGATIVES: We felt that this did not offer enough protection from the problem we were trying to avoid as patients still had access to the entire bottle of medication. In addition, such a device would be very difficult to program.

7. Discussion of Possible Solutions PROPOSAL B:A phone service that calls the patient each time they need to take medication. POSITIVES: Patients would not forget to take a dose of medication and if they listened, would not take too much. A recording could be used. NEGATIVES: Patients still had access to the entire bottle of medication and the phone would be difficult to program. Patients would have to answer the phone a lot.

8. Discussion of Possible Solutions PROPOSAL C:An automatic pill dispenser. POSITIVES: The device would be self-contained, in the home and very convenient to use. Since the device makes a noise to alert the patient (or caregiver) it will greatly improve patient compliance in taking medications. Patients will be less likely to overdose or under dose. Instead of the patient having to go through their bottles to determine what medication is taken and when, the dispenser dispenses the proper dosages and types of medications at the proper times. The pharmacist will load the device through a “loading dock” meaning it isn’t necessary for him or her to count pills. NEGATIVES: It is a large device. It will have to be transported, intact, to the pharmacy once a month.

9. Feedback From Mentor At this point, we sent our mentor our ideas and reasoning for our final choice. This was his response. “I believe your statement and description of the problem of the rise in unintentional drug related deaths is very well phrased. It is clear that you have the problem well understood, and your selection of potential solutions to the problem spans a reasonable number of opportunities. Your selection of the Automatic Pill Dispenser (APD) seems reasonable and eminently possible.”

10. The Benefits Of Using The Automatic Pillbox Dispenser • Patient will no longer overdose or under dose themselves. • Patient no longer needs to remember complex directions. • Nursing homes will have a much easier time dispensing • pills. • Easier than answering the phone a few times a day. • Controls patient compliance more easily than a calendar that only • gives instructions.

11. Description and Overview 12’’ in height and 10’’ in diameter. Able to hold a month’s worth of medication. Programmed by the pharmacist who sets dosage amount and the time to be taken. Will make taking the proper medications in the proper dosages easier and safer.

12. Automatic Pillbox Dispenser (APD) Lid Screen View of Interior Dispensing Button

13. Feedback From Mentor “With respect to the prototype APD that you have created, without extended engineering studies and education, I would not expect to have more than a physical model that demonstrates the potential appearance of the device with some slightly extended ideas regarding its physical properties. The model you have created gives the viewer a fair idea of how it might be operated and how it would likely perform.”

14. Pharmacist's Role The pharmacist is key to making the system run efficiently and properly. He or she is the person who loads the automatic pillbox dispenser. The dispenser is docked to the medication loading device. The loading device opens the pill dispenser. The pharmacist types on a keyboard the type of medication, the dosage, and when the medication is to be taken. The pharmacist puts the medication in the loading device and the machine places the medication into small disposable capped cups. The cups are loaded onto a rack in the order in which they are to be taken. The pharmacist locks the dispenser and returns it to the patient or caregiver.

15. Pharmacist Interview Interview with Pharmacist, Mel Becvar Q: How long have you been a pharmacist? A: 5 years. Q: What made you want to be a pharmacist? A: I like to help people. Q: What is the average age group that you provide medication to? A: Very young patients and very old patients. Q: What tools do you give patients to help with compliance? A: Counseling, calendars, & weekly pillboxes. Q: Do you provide medication counseling and information to your customers? A: Yes, I do provide counseling. Q: How big of a problem is patient compliance? A: Generally speaking it is an issue, but I usually don’t see it first hand. Q: What do you do to ensure patient compliance? A: We counsel the customers, use automatic refills, calendars, and patients are called when their medication is ready.

16. Pharmaceutical Representative Interview Interview with Pharmaceutical Representative, John Keating Q: Working with Sepracor, what are your responsibilities? A: Calling on doctor’s offices and educating them on the products I represent. Q: What products does Sepracor market? A: Sepracor markets different medications that are aimed at two areas of the body, the central nervous system (Lunesta for insomnia) and the respiratory system (Xopenex for asthma, Brovana, and Omnaris.) Q: Who do you call on in Phoenix? A: A variety of physician specialists in a fixed geographic area that center around four valley hospitals. Q: What do you like about your job? A: Providing information that helps a doctor know how to use Sepracor’s medication to help their patients. Q: Do you ever receive constructive criticism? A: Yes I ask physicians for feedback to better be able to talk with their peers.

17. Role of Caregiver If the patient is unable to safely operate the automatic pillbox dispenser, the caregiver is responsible for operating the dispenser and giving the medication to the patient. The caregiver can receive an audible alert or wear a bracelet that gives an audible alert when it is time to take their medication. The dispenser has a screen that displays special information such as taking medication with or without food. The caregiver has an important role in a nursing home, or when the patient is unable to take the medication themselves at home. If the patient is able to take the medication themselves, they will not need a caregiver.

18. How The Patient Receives Medication From Start To Finish The patient will receive their pillbox (APD) from the pharmacist after their medication is loaded and the dispensing directions are programmed. When it is time to take the medication, an audible sound alerts the patient with a sound transmitted from the pillbox. The patient will press a small button on the pillbox to dispense the medication and display special information such as taking medication with or without food. After a month of medication is used, the patient or caregiver will return the pillbox to the pharmacist to be refilled.

19. Class Presentation Our 8th grade class and teacher were shown the preceding slides and told about the APD. Our classmates were asked if they had any questions and we spent about 20 minutes answering questions. At the end of the question and answer period, we gave them the survey that follows. We analyzed the survey and, based upon their responses, feel we need to make some changes to the Automatic Pill Dispenser.

20. Survey Results • The automatic pillbox dispenser is designed to prevent certain types of accidents. What accidents? Students said it should prevent overdosing and under dosing. • What advantages do you see in this device? Most students said it reminds people to take their medication and using the device would mean fewer deaths due to taking the wrong dose. • What are the disadvantages of this device? Most said that it was too big, it might not be safe for children, and there was no way to take medication if the patient was away from home without taking APD with them. • Would you personally use the APD? A little more than half of the students said yes and the rest said no. • Who do you think this device would most benefit? Most students said this would benefit the elderly.

21. Survey Results (cont.) 6.How much medication do you think the APD should hold? Most students chose a one month supply. 7. How should the machine identify the user? Students were offered a numeric code, password or finger print identification. Most students chose fingerprint ID. 8. Do you feel the APD should be operated by electricity, battery or both? Most students chose that it be powered by both. 9. If this device were sold, how much would you pay? Most students in our class would pay $200-$300 for the APD. 10. If you were going to use this, where would you place it in your home? Some students said they would place the APD in either the kitchen or the bathroom.

22. Feedback After our presentation and survey, we decided we needed to make two changes: • The device needs to be made child proof by making it only dispense the medicine if a fingerprint match is made. • The device needs to dispense medication early if the patient needs to take it when away from home.

23. Jared Kisler 8th grade student at OLPH catholic school 14 years old Favorite subjects are math and science Enjoys playing golf and baseball Participates in Math Counts as a mathlete Thomas Keating 8th grade student at OLPH catholic school 14 years old Favorite subjects are social studies and science Enjoys playing lacrosse and soccer Team Profile

24. Bibliography Becvar, Mel. Walgreen pharmacist. Personal interview. 3 Feb. 2009. Drug Overdose. Altha Roberts Edgren, author. Dec. 2002. Gale Encyclopedia of Medicine. 3 Feb. 2009 <http://www.healthatoz.com/Atoz/common/standard/ transform.jsp?requestURl=/healthatoz/Atozency/drug_overdose.jsp>. Evans, Don. Mentor. Personal interview. 16 Dec. 2008. Keating, John. Pharmaceutical representative. Personal interview. 18 Dec. 2008. Prescription Drugs Blamed for Rising Overdose Deaths. 22 Feb. 2008. Join Together. 3 Feb. 2009 <http://www.jointogether.org/news/headlines/inthenews/2008/ prescription-drugs-blamed- for.html>

25. Biography Of Mentor Don Evans • Radio Announcer for NBC. • Actor in a Repertory Theatre. • Korean War Army service. • Electronics Repair Company. • General Contractor building residences. • Lawrence Berkeley Laboratory, as Engineer and Senior Scientist. • Consultant on Safety of Mass Transit Systems, world wide. • General Manager for a Swiss based Electronic Controls company. • Cofounder and Director of Engineering for a Silicon Valley startup company. • Awarded several patents for technical advancements in several fields. • Degrees in Mechanical and Electrical Engineering, Computer Sciences and Psychology. • Author of many technical papers and technical magazine articles.

26. Index