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Can't remember your meds? A necklace is in the works for you

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Maysam Ghovanloo and Xueliang Huo display MagneTrace necklace (Gary Meek)

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Maysam Ghovanloo and Xueliang Huo display MagneTrace necklace (Gary Meek)

Sharon Brangman, a doctor of geriatric medicine in Syracuse, N.Y., is accustomed to forgetful patients. Once, a patient mistakenly took multiple doses of his heart medication and slowed his heart rate to a life-threatening level. He had to be hospitalized and have a temporary pacemaker installed. “He could have very well died,” said Brangman, chief of geriatrics at Upstate Medical University.

Brangman estimates at least 60 percent of her patients have taken their medication incorrectly at least once.

Nationally, one in three adults who are prescribed drugs to take regularly say they frequently do not follow their treatment plans, according to a Harris Interactive survey. Nearly two-thirds of the adults who were prescribed drugs in 2004 said they just forgot to take their medication.

Now engineers at Georgia Institute of Technology are developing a sensor-equipped necklace to help patients take their medication on time. The product is called MagneTrace and it uses magnetic sensors embedded in pills to detect when a pill is ingested. The tiny sensors pass through the patient's digestive system.

If a pill is not taken at the correct time, the necklace is designed to send a signal to a smart phone, which then alerts the patient. If that prompt is ignored, the phone contacts a doctor or caregiver. The necklace and the software for the phone have already been created but the developers have not yet transferred the software to the phone.

“It will have an immense effect on the health care system if a system like this one helps patients comply with their medication,” said Maysam Ghovanloo, the developer and assistant professor at Georgia Tech’s School of Electrical and Computer Engineering. Pharmacy experts estimate that the problem costs the health care system at least $100 billion annually in expenses such as hospital visits, surgeries and new prescriptions.

The necklace, which has at least one year of testing before it is ready to be approved by the Food and Drug Administration and marketed for general use, is not a cure-all. It will not help patients who don’t take their medicine for reasons other than forgetfulness. And some doctors worry that placing magnetic tracers in pills to trigger the necklace could be dangerous.

The developers will soon begin testing the necklace on animals. The device is built around a dog collar for now, but Ghovanloo said it can easily be refashioned for humans.

But it will take more than a necklace for the device to work; pharmaceutical companies will need to produce pills with a magnetic tracer in them. Critics say the cost of those tracers could outweigh potential savings from the necklace.

The product would also do little for people who do not take their medication because it’s too expensive or for a myriad of reasons other than forgetfulness. “Their assumption is that all this forgetfulness is because people just forget, and that’s just not the case,” said Bruce Berger, head of the department of pharmacy care systems at Auburn University. “Being reminded to take a drug you’re not really sure you need, it costs too much, or it has side effects you’re not tolerating is not going to make you take it more.”

The necklace may also be inconvenient for some patients. “You’re asking someone who may or may not be compliant to now wear a necklace and make sure that necklace is on when they take their medication,” said Jack Fincham, a professor at University of Missouri School of Pharmacy. “Many people, not only females but males, would balk at wearing something day in and day out.”

Nancy Dortzbach, a professional caregiver from Lakeport, N.Y., said she’s had patients with crippling Alzheimer’s or dementia who are too senile to benefit from the necklace. Her current patient, an elderly woman, once took all her pills out of a cabinet and tossed them about her home. When Dortzbach asked what happened, the patient said she could not remember.

But Dortzbach said the necklace would help patients who have limited impairments and memory loss. “People work all their lives, save their money and have to give it all away to caregivers,” Dortzbach said. “There’s a lot of people around the world that wouldn’t need a caregiver if they had that device to remind them to take their medicine.”

Brangman, the doctor of geriatric medicine, said some of her patients already have difficulty using the Life Alert necklace, which features a button elderly people can push in an emergency. “I have patients who forget to push the button or even wear the little device.”

Brangman, who has many patients who take multiple medications, is concerned that swallowing too many magnets could harm patients taking multiple medicines. Ghovanloo said the product tests will address that issue.

“We need to make sure that these magnets stay apart so that they don’t form a blockage in the stomach,” Ghovanloo said. “The coating that we have around this tracer is to make sure that the magnets stay apart.”

One of the downsides of the current design is that it cannot differentiate between two different types of medications. When Ghovanloo was asked to develop the product by a company he said did not want to be named, he proposed placing an identification chip in every pill similar to the systems used in access cards at universities and businesses. That plan, which could discriminate between pills, was deemed too expensive, he said.

Ghovanloo said the necklace could have other uses. Pharmaceutical companies could use it in drug trials to make sure participants follow their drug regimens.

Or pet owners could employ it to make sure their animals are getting the treatments the need. Dogs, for example, may swallow a pill and then vomit in a hidden place that their owners don’t know about. “If the dog is using this collar, you will see that the tracer has passed again because it can detect the passage of the tracer in either direction,” Ghovanloo said. “So that can tell you whether the dog is cheating you or not.”

E-mail: aln2115@columbia.edu