Background
The history of pharmacology has led to a continuous evolution of routes of administration, pharmaceutical formulations, dosage forms and dosing devices in an ongoing effort to maximize the effective benefits and relative costs of prescribed drugs. Administration of the prescription substance may be initiated in a controlled healthcare environment, for example, at a healthcare facility or by a physician at the patient's home. Early formulations may include liquid forms for parenteral (e.g., into the bloodstream) and enteral (e.g., into the gastrointestinal tract) administration, including elixirs, tonics, solutions, suspensions, syrups and final injections, Intravenous (IV) and epidural anesthesia. Early formulations can be developed, e.g., via mechanization and formulation, to produce advanced forms. Early formulations, advanced forms and further research and clinical learning, such as patient acceptance of early formulations and/or advanced forms may aid in routes of administration, pharmaceutical formulations, dosage forms and dosing devices.
As healthcare treatment shifts from limited emergency to long-term chronic disease care, a higher percentage of prescribed drug administration shifts from a controlled healthcare environment to a patient-managed environment. In a patient-managed environment, administration of liquid formulations can be difficult due to non-specific dosing instructions, outside the control of trained medical personnel. Dosing based on teaspoon and/or tablespoon measurements may be ambiguous and variable. The dosing cups may have different measurement formats and thus may cause confusion in the environment of patient management. Furthermore, the dosing cup is typically separate from the originally prescribed bottle, thus possibly resulting in erroneous administration.
Advances in mechanical manufacturing systems and pharmacological research have shifted patient-administered administration of prescription substances from liquid formulations to pills (e.g., tablets or capsules), which can extend shelf life and ease of use, accuracy of administration, and reduced manufacturing costs for patients. Thus, most oral medications in a patient-managed environment are now pills. Furthermore, there is an increasing interest in microparticulate formulations, including pellets, granules, microparticles, mini-tablets, and the like. However, patients who cannot or do not wish to swallow a tablet or capsule formulation, such as infants, elderly or disabled patients, may be given an enteral oral liquid prescription by a dosing syringe in an environment of patient management. Furthermore, parenteral liquid formulations are typically still administered in a controlled healthcare environment, as parenteral liquid formulations typically have the fastest absorption rates and have the most favorable success in the desired outcome and can improve local administration, inventory control, fraud prevention, and administration path audit capabilities.
Depending on the entity that manages drug administration, various forms of drugs may be developed to meet the desires, needs, and challenges of different entities. Although there are some exceptions based on effectiveness and toxicity, most pharmaceutical manufacturers can produce multiple pharmaceutical formulations to support different routes of administration and administration.
As consumers increasingly participate in preventive or outcome treatment programs involving drug administration in patient-controlled environments, there is an increasing demand for drug administration in patient-controlled or managed environments. For example, outpatient and/or one-day hospitalization surgical stays are increasingly common for important medical procedures, which may involve subsequent drug administration in the patient's home. In addition, as the population ages, the need for prescription management also increases. Consumers may take a variety of over-the-counter and/or prescription medications per day, with the medications typically being in the form of pills. Unfortunately, the ease of use of pills and the increasing number of consumers engaged in treatment programs for chronic patient management has resulted in misuse and poor management of many drug classes.
For example, pill forms are lightweight, portable, non-recipient specific, difficult to inventory, do not carry individual identification numbers, have a wide shelf life, and are inexpensive to produce. Thus, once outside the context of healthcare management, ingestion or use of the pill is difficult to control. Further, to achieve economies of scale in the manufacturing process, pill production is scheduled based on maximizing the output of available machines, materials, and/or ingredients rather than based on future needs. With few exceptions, the small amount of pills that are produced are wasted because they remain active for a long period of time. Pills proliferate in our society and have become a conduit for addiction and abuse.
One such patient-managed treatment that is highly susceptible to prescription abuse and poor management is opioid pain therapy. For example, according to the U.S. Food and Drug Administration (FDA), about 1 million people in the United States (US) suffer pain within a certain year. Approximately 900 to 1200 ten thousand pain patients suffer chronic or persistent pain, while the remaining pain patients develop short-term pain due to injury, disease or medical surgery. In 2014, the centers for disease control and prevention reported that the number of opioid prescriptions in the united states per year was comparable to the number of adults in the U.S. population. Although pain patients should benefit from skilled and appropriate pain management, there is a need to control abuse or addiction to opioids. FDA predecessors and physicians attempt to address the problem of opioid prevalence by balancing two complementary principles: actively managing opioid abuse and addiction while protecting the health of people experiencing acute or chronic pain. However, in areas where innovations, policies and restrictions directed to opioid abuse are implemented, pain patients may not be able to reach equilibrium. Some states have implemented additional known addict or abuser databases that must be checked by the provider before providing the prescription. However, the physician may not check the database before providing the prescription, due to the burden of using the system and/or the physician may not want to limit access to truly chronic pain patients. Other states have implemented reporting and audit trails to track physicians prescribing from the opioid family. However, to avoid the additional steps and potential of audit review, some physicians may refuse to provide pain management or short-term pain prescriptions and may refer all cases to a pain clinic.
Attempts to improve patient education, enhance labeling, limit prescription, etc. have resulted in higher costs to the healthcare provider, patient, pharmacy, and insurance company, and reduced overall patient efficiency. Ultimately, truly painful patients have difficulty obtaining opioids, while opioid abusers continue to manipulate available access despite apparent negligence in place. Policies and programs at all levels have not been successful and are insufficient to control or reduce abuse of prescribed drugs. Accordingly, there is a need for improved devices, systems, and methods for drug administration.
Detailed Description
For the purposes of promoting an understanding of the principles of the disclosure, reference will now be made to the embodiments illustrated in the drawings and specific language will be used to describe the same. It will nevertheless be understood that no limitation of the scope of the disclosure is thereby intended. Any alterations and further modifications in the described devices, systems, and methods, and any further applications of the principles of the disclosure are contemplated as would normally occur to one skilled in the art to which the disclosure relates.
Embodiments of the present disclosure provide mechanisms for administering enteral oral medications through ID-specific devices registered in a centralized management system. In an embodiment, the device includes a mouthpiece that includes a recess sized and shaped to mate with the dentition of the intended user. The mouthpiece may include position and/or pressure sensors located at various locations within the groove. The mouthpiece may include a micro-pump unit including a processor, a reservoir, an actuator, a flow channel, and an outlet valve. The reservoir may be filled with a prescription or an over-the-counter medication. The processor may be in communication with the position and/or pressure sensors and the actuator. To administer the medicament, the patient may insert the mouthpiece into the patient's mouth and close the mouth to bite into the mouthpiece. The position and/or pressure sensors may sense and measure the position of the user's dentition and the associated pressure from the bite. The processor may determine whether a match is found between the measured position and/or pressure and the expected pre-recorded data of the recipient patient. The processor may determine whether the mouthpiece is properly positioned. Upon detecting a matching and correct positioning, the processor may activate the actuator to release a precise dose of the drug through the flow channel and the outlet valve into the patient's mouth for ingestion. In embodiments, the centralized management system may track the creation and preparation of the mouthpiece, the filling of the prescription drugs, and/or the administration or distribution of the prescription drugs through various identification mechanisms.
The disclosed embodiments may provide several benefits. For example, the use of unique individual mouthpieces with embedded processors and a centralized management system may ensure that the prescribed medication is delivered to the intended recipient. Accordingly, the disclosed embodiments may avoid abuse and mismanagement of prescription drugs. Further, the disclosed embodiments may allow healthcare providers and insurance companies to better track administration of prescription medications and more accurately assess the benefits, effects, and/or outcomes of prescription medications. The disclosed embodiments may deliver precise doses of prescribed medications to patients, and may be particularly beneficial to elderly, impaired, or patients with mobility issues that may limit their ability to self-administer prescribed medications. Although the disclosed embodiments are described in the context of using dentition as a verification form for matching a prescription to an intended user, other biomarkers (fingerprints, retinal or iris scans, DNA, voice recognition, etc.) may also be applied or used in conjunction with and/or in place of dentition matching.
Fig. 1 is a top perspective view of a COPA apparatus 100 according to an embodiment of the disclosure. The COPA apparatus 100 may be used to deliver enteral oral liquids, multiparticulates, and/or other forms of medication to an intended patient or user using controlled administration. The COPA apparatus 100 is a mouthpiece that includes a top side 102 and an opposing bottom side 104. Top side 102 includes a recess 110. The recess 110 is sized and shaped to conform to the dentition of the intended user. For example, the recess 110 includes an arrangement of upper teeth for receiving an intended user. The COPA device 100 may be constructed of a biocompatible impression material or polymer.
The groove 110 includes a plurality of sensors 112 located at various locations within the groove 110. In some embodiments, the sensor 112 may be a pressure sensor or an optical position sensor. For example, the sensor 112 may be embedded at the location of contact with the user's interdental spaces, reentrant corners, and gum line. When the user closes his or her mouth around the COPA device 100 using a normal or forceful bite, the sensor 112 may determine whether the user's dentition is located within the recess 110. In some embodiments, sensors 112 may be housed on one or more flexible or flexible filament bundles embedded within grooves 110. For example, each filament bundle may be coupled between two and twenty sensors 112 or any suitable number of sensors 112. In some embodiments, the sensors 112 may be formed and distributed on a mesh structure embedded within the recess 110. The mesh structure may include any suitable number of sensors 112. The sensors 112 on the mesh structure or filament bundle may allow for a pressure distribution to be generated when a user closes his or her mouth on the COPA device 100. In an embodiment, the sensor 112 may monitor and make position and/or pressure measurements while the user closes his or her mouth. The position and/or pressure measurements may be compared to predetermined data of the user's dentition as a form of verification to identify the intended recipient of the prescription substance, as described in more detail herein.
The COPA apparatus 100 further includes a sealed prescription dispensing unit 120. The sealed recipe dispensing unit 120 may be located at the top center of the COPA apparatus 100. The sealed prescription dispensing unit 120 may include a sealed sleeve 124 and a plurality of access ports 122 extending into the prescription dispensing unit 120 from a top side of the sealed sleeve 124. The access port 122 can be configured to receive a prescription substance. For example, a clinician or pharmacy technician may fill the prescription substance into the prescription dispensing unit 120 via the access port. The prescription substance may include various forms of preparations, such as liquids and/or multiparticulates. The prescription dispensing unit 120 may include other components, such as a processor, chambers, flow channels, actuators (e.g., micro-pumps), and outlet valves, as described in more detail herein.
The COPA apparatus 100 may provide patient identification via patient dental impressions in the recess 110. For example, each individual has a unique dental impression. While there may be certain patterns of age and alignment of tooth types at which certain teeth may erupt, mature and be replaced by permanent teeth, the placement, size, angle, distance, and resulting bite between certain points in the patient's mouth may be different for different patients. In addition, damaged teeth, missing teeth, filled teeth, covered teeth, and restorations such as crowns, bridges, partial dentures, and complete dentures further identify the nature or uniqueness of the oral cavity of different individuals. Thus, the use of the COPA device 100 with dentition imprints may effectively identify a particular individual. The COPA apparatus 100 may provide further patient identification functionality via various patient verification mechanisms implemented by a processor coupled to a mouthpiece (e.g., embedded within the sealed prescription dispensing unit 120), as described in more detail herein.
The COPA apparatus 100 also provides controlled prescription administration functionality via a sealed prescription dispensing unit 120. For example, the processor may be in communication with the sensor 112 and configured to determine whether the COPA device 100 is properly positioned within the mouth of the intended user. Upon detecting the correct position, the processor may control components within the sealed prescription dispensing unit 120 to release or deliver a precise dose of the prescription substance into the mouth of the intended user, as described in more detail herein.
Fig. 2 is a bottom perspective view of a COPA apparatus 100 according to an embodiment of the disclosure. The bottom side 104 includes a recess 210, the recess 210 being sized and shaped to conform to the dentition of the intended user, e.g., the lower teeth. The recess 210 is embedded with a plurality of sensors 212 similar to the sensors 112. The sensor 212 may be coupled to a flexible or pliable bundle or mesh structure of filaments. The prescription dispensing unit 120 includes a plurality of outlet valves 222 on the bottom side 104 in which the prescription substances may be released. Although the COPA apparatus 100 is shown with a top recess 110 printed with the upper teeth of the intended user and a bottom recess 210 printed with the lower teeth of the intended user, the COPA apparatus 100 may include a single recess 110 or a single recess 210 that provides a substantially similar function.
Fig. 3 is a perspective view of a COPA apparatus 100 according to an embodiment of the disclosure. Fig. 3 illustrates the COPA apparatus 100 with an upper portion of the sealing sleeve 124 (shown in fig. 1) removed to provide a more detailed view of the prescription dispensing unit 120. As shown, the prescription dispensing unit 120 includes a micro pump unit 300. The inlet port 122 may be in communication with the micro pump unit 300 to allow filling of the prescription substance into the micro pump unit 300.
Fig. 4 is a perspective view of the COPA device 100 positioned for docking at a docking station 400, according to an embodiment of the present disclosure. Fig. 5 is a perspective view of the COPA device 100 docked at a docking station 400 according to an embodiment of the present disclosure. The COPA device 100 may be located in a docking station 400 for storage, charging, and/or communication over a communication network. The docking station 400 may include a docking compartment 410, a wireless transceiver 420, a charging assembly 430, a plurality of indicators 440, and a COPA device sensing assembly 450. The wireless transceiver 420, charging assembly 430, indicator 440, and sensing assembly 450 may be arranged on the docking station 400 as shown or in any suitable configuration.
Docking compartment 410 may be sized and shaped to accommodate COPA device 100. The wireless transceiver 420 may be configured to transmit and receive data when the COPA device 100 is docked to the docking station 400 via a patient-specific wireless network, as described in more detail herein. The charging component 430 may include a tactile charging component (e.g., for charging a battery) and may be configured to charge the COPA device 100 when the COPA device 100 is docked at the docking station 400. For example, the operation of the processor, the actuator, and the release of the prescription substance operate based on electrical power. The COPA device sensing component 450 may be configured to detect whether the COPA device 100 is properly docked. For example, the bottom side 104 of the COPA device 100 may also include a docking station sensing assembly, wherein alignment between the COPA device 100 and the docking station 400 may be detected via the COPA device sensing assembly 450 and the docking station sensing assembly. After detecting the alignment, the charging component 430 may begin charging the COPA device 100. Further, the COPA apparatus 100 may upload prescription administration activities to the COPA management system via the wireless transceiver 420, as described in more detail herein. The indicator 440 may include a Light Emitting Diode (LED). The indicator 440 may be configured to indicate whether the COPA device 100 is properly positioned within the docking compartment 410 for charging and wireless communication. The indicator 440 may also be configured to indicate a charging status (e.g., power on/off) of the COPA device 100 and/or wireless transmission and/or reception activity of the wireless transceiver 420.
In some embodiments, the docking station 400 provides a closed loop control system that can sense and detect the presence of the COPA apparatus 100 at various stages of use and/or storage and provide corresponding feedback and/or alerts to the user, caregiver, physician, and/or pharmacy. For example, the indicator 440 may be configured to indicate that the COPA device 100 is near the docking station 400, is properly docked within the docking station 400, is improperly docked within the docking station 400, is charging, is fully charged, is transmitting data, is operating properly, is operating improperly, and/or other status indications. In some embodiments, the docking station 400 may include a sound generating component (e.g., a speaker) that may generate various tones and/or vibrations to indicate the current state, including proximity or docking of the COPA device 100, charging activity, and/or communication activity. In some embodiments, the docking station 400 may communicate with a computing device such as a smartphone, tablet, or computer (e.g., via the wireless transceiver 420 or via a wired connection), and may send feedback and/or alerts (and a log of prescription administration activities obtained from the COPA device 100) to the COPA smartphone or tablet application.
The COPA device 100 may be placed in a docking station 400 between administrations for storage, charging, and/or communication as needed (e.g., multiple times per day, daily, nightly, weekly, etc.). The charging and/or power requirements of the COPA apparatus 100 (including the prescription dispensing unit 120) may be minimal, as the operations associated with dispensing a medication may typically span a short duration (e.g., 1 minute or less). In addition to charging and wireless communication, the docking station 400 may help prevent the COPA device 100 from being lost, misplaced or damaged. For example, the docking station 400 may also include a locking mechanism to provide an additional protocol for matching the COPA device 100 with the intended user. In an embodiment, the docking station 400 may include a fingerprint or optical scanning component configured to unlock or release the COPA device 100 based on fingerprint verification or any other biometric marker against the fingerprint of the intended user.
To prevent an unintended user from successfully matching and unlocking the COPA device 100 for subsequent release of a recipe, the processor within the recipe dispensing unit 120 may also be configured to limit the activation time for releasing the recipe in conjunction with a locking mechanism. For example, the charged COPA device 100 may be inserted into the mouth of a patient for drug delivery or release at a designated time. When the administration of the drug is not time-specific, control of the drug release time may begin after the initial use. For example, the processor may be configured to record the time of initial use and control subsequent release based on the elapsed duration or interval between prescribed medications. The processor may be configured to release the drug at a specified time or for a specified duration of time for subsequent delivery.
Fig. 6 is a perspective view of the COPA apparatus 100 and a micro-pump unit 300 positioned for coupling, according to an embodiment of the disclosure. The micro pump unit 300 is the core of the prescription dispensing unit 120. The micro pump unit 300 includes a processor 310, a reservoir 320, an actuator 330, and a plurality of outlet valves 340. The processor 310 is configured to control the micro-pump unit 300 and record activities associated with the COPA device 100, such as medicament delivery time and amount, charging time, and/or wireless communication activities. Reservoir 320 is configured to hold a prescription substance, e.g., as a substance formulated for delivery via micro pump unit 300. The actuator 330 is configured to push or deliver a precise dose of the prescribed substance upon activation. An outlet valve 340 is located at the bottom of the micro pump unit 300 and is configured to release the prescription substance for ingestion. A more detailed view of the micro pump cell 300 is shown in fig. 7 and 8, and the interaction between the components of the micro pump cell 300 is described in more detail below. The micro-pump unit 300 may be prepackaged with the prescription by various mechanisms, as described in more detail herein. As shown, the COPA apparatus 100 may include a compartment 114, the compartment 114 being sized and shaped to receive the micro-pump cell 300. For example, a prepackaged micro pump unit 300 may be positioned within the compartment 114 and covered by the sealing sleeve 124 (shown in fig. 1) to form a sealed prescription dispensing unit 120.
Fig. 7 provides a detailed view of the internal components of the micro pump cell 300 and the interaction between the internal components, in accordance with an embodiment of the present disclosure. In this regard, fig. 7 is a cross-sectional view of a COPA apparatus 100 according to an embodiment of the present disclosure. The cross-sectional view is taken along line 101 of fig. 1. Although fig. 7 shows one of the sensors 112 positioned on the flexible or pliable filament 116, the sensors 112 may be positioned on a mesh structure as described above. The micro-pump unit 300 is located within the compartment 114 (shown in fig. 4) of the COPA device 100. The micro-pump unit 300 may also include a charging component 360 (e.g., a battery) and a memory 370 (shown in fig. 8). The charging assembly 360 may be in communication with the processor 310 and the actuator 330. When the COPA device 100 is docked at the docking station 400 as shown in fig. 4, the charging assembly 360 may be coupled to the charging assembly 430 of the docking station 400 and configured to charge the COPA device 100 (e.g., the processor 310 and the actuator 330) via battery charging or wireless charging. Memory 370 may include volatile and non-volatile memory of any suitable memory type, including Random Access Memory (RAM), Read Only Memory (ROM), Programmable Read Only Memory (PROM), Erasable Programmable Read Only Memory (EPROM), Electrically Erasable Programmable Read Only Memory (EEPROM), Dynamic Random Access Memory (DRAM), Static Random Access Memory (SRAM), and combinations thereof.
The processor 310 may be in communication with the sensor 112, for example, via a wire 710 and the actuator 330. The actuator 330 may be in communication with the reservoir 320 and the outlet valve 340 via a flow channel 350. The reservoir 320 may be in communication with the inlet port 122 (shown in fig. 1) and the flow channel 350.
The reservoir 320 may include one or more chambers 322, for example, one, two, three, four, five, six, or any suitable number of chambers 322. The chamber 322 may be configured to hold a prescription substance 720. In this regard, the number and size of the chambers 322 may be selected based on the number of prescription substances, the type(s) of prescription substances, and/or the dosage to be used. The cavity 322 may be any size that still allows the device to be positioned within the mouth of a patient. In some cases, the chambers 322 communicate with corresponding chambers or channels formed in the COPA apparatus 100 to allow for increased storage volume for the prescription substance(s). The chamber 322 may be in communication with the inlet port 122. In some embodiments, each chamber 322 communicates with one of the access ports 122 through an access cannula 730.
The clinician or pharmacy technician may fill or refill the prescription substance 720 via the access port 122. Prescription substance 720 may include a liquid formulation, a powder formulation, a multiparticulate formulation, or any other suitable formulation. In some embodiments, all of the chambers 322 are filled with a liquid formulation. In some other embodiments, one chamber 322 may be filled with a liquid formulation and the other chamber 322 may be filled with a powder or multiparticulate formulation. The prescription substances 720 in different cavities 322 may be released simultaneously to form a particular formulation or at different times to prevent certain active ingredients in the prescription substances 720 from reacting with each other. In this regard, each chamber 322 may contain a different prescription substance 720 for the intended user.
The actuator 330 may be a micro-pump adapted to deliver a drug formulation. The actuator 330 may be activated or triggered by the processor 310 to cause the prescription substance 720 to flow through the flow channel 350 and out of the cannula 740 and be released via the outlet valve 340. The actuator 330 may be activated one or more times to release a precise dose of the prescribed substance 720. The flow channel 350 may be constructed from a suitable tube material. The outlet valve 340 may be any suitable flow control valve, for example, having a flexible membrane, configured to prevent the prescription substance 720 from leaking into the user's mouth or to flow the prescription substance back into the COPA device 100 from the user's mouth.
The processor 310 may be any suitable microcontroller or microprocessor configured to perform the functions described herein, including functions such as performing patient identification and verification, performing position sensing and/or pressure detection (e.g., in conjunction with the sensor 112), instructing the actuator 330 to release a dose of the prescribed substance 720, controlling the opening of the outlet valve 340, controlling the operation of the components of the micro-pump unit 300 according to the medicament instructions of the intended user, storing dispensing data, and the like. The medicament instructions may include at least a dose and a time for dispensing the substance to an intended user. The medicament instructions may be stored in the memory 370.
In operation, the COPA apparatus 100 may be inserted into the mouth of a user. The user may close his or her mouth around the COPA device 100 and bite into the COPA device 100, which may trigger the sensor 112 to perform a position and/or pressure measurement. The processor 310 may determine whether the COPA device 100 is properly positioned in the user's mouth based on the measurements from the sensor 112. In some embodiments, when creating the COPA apparatus 100, position and/or pressure data of the user's mouth may be recorded and stored in the memory 370. The processor 310 may compare the current location and/or pressure measurements to the raw location and/or pressure data to determine whether there is a match between the current user of the COPA apparatus 100 and the intended user of the COPA apparatus 100. The processor 310 may also compare the current position and/or pressure measurements to the raw position and/or pressure data to determine whether the COPA apparatus 100 is properly positioned within the oral cavity of the intended user.
When the user is verified as the intended user and the COPA device 100 is properly positioned within the oral cavity of the intended user, the processor 310 may send an activation instruction to the actuator 330 and open the outlet valve 340 to administer one or more prescription substances 720 stored in the micro-pump unit 300 in accordance with the medicament instructions of the intended user. Activation of the actuator 330 and opening of the outlet valve 340 may be based on a medicament instruction or prescription stored in the memory 370 when the prescription substance 720 is filled.
In some embodiments, the COPA apparatus 100 may include one or more indicators that may provide feedback and/or alerts to a user when the COPA apparatus 100 is in use. The indicator(s) may include a vibration component, a sound generation component (e.g., a speaker), and/or a visual indicator component. For example, the vibration component may vibrate the COPA device 100 in different pulse patterns to indicate different states of the COPA device (e.g., one vibration indicating initiation of correct user authentication and assignment, two vibrations indicating completion of assignment, a patterned or repeated vibration indicating an error of the COPA device, etc.). Similarly, the sound generation component may generate various tones and/or patterns to indicate different states of the COPA device. Likewise, the visual indicator assembly may include one or more LEDs that display different colors and/or patterns to indicate different states of the COPA device. The current state of the COPA device 100 may be determined based on feedback from the processor 310, the sensors 112 or 212 (e.g., correct or incorrect positioning of the COPA device 100), sensors for monitoring substance dispensing (e.g., volume and/or flow sensors), the docking station 400, and/or other sensors or monitoring devices associated with the COPA device 100 and/or the docking station 400 for determining the state of the COPA device 100.
Fig. 8 is a schematic diagram of a micro pump cell 300 according to an embodiment of the present disclosure. Fig. 8 provides a more detailed view of the micro-pump unit 300 and the interaction with the sensor 112 and the docking station 400. As shown, the micro-pump unit 300 may also include a wireless transceiver 380. Wireless transceiver 380 may implement any suitable wireless communication protocol. The wireless transceiver 380 may wirelessly communicate with the docking station 400, for example, to upload recorded activities or to download revised or new medication instructions, as described in more detail herein. Additionally, the wireless transceiver 380 may communicate wirelessly with other wireless communication devices, including communication devices of the intended user (e.g., computers, tablets, smart phones, etc.). In this regard, the processor of the micro-pump unit 300 may be configured to initiate an alert or alert to the user (e.g., based on the timing of the medicament instruction) by triggering the communication device of the intended user to issue such an alert or alert (e.g., by activating an audible and/or visual indicator). Similarly, the processor of the micro-pump unit 300 and/or docking station 400 may be configured to initiate an alarm or reminder by communicating with the medical provider's communication device. For example, the micro-pump unit 300 and/or docking station may alert a healthcare provider based on failed attempts to dispense a substance according to a medication order (e.g., the patient does not take a medication as prescribed) and/or to authenticate the intended user (e.g., indicating that someone other than the intended user is attempting to access the medication or that the intended user is experiencing difficulty using the device).
Fig. 9 is a schematic diagram of a system 900 according to an embodiment of the present disclosure. The system 900 includes the COPA device 100, a docking station 400, a doctor 910, a pharmacy 920, a patient/authorized caregiver portal 930, and a central management system 950 in communication with each other via a network 940. Network 940 may include one or more wireless access networks and/or one or more wired networks that may be connected to a backbone network or the internet. Network 940 may include network encryption and security policies for protecting patient privacy. Network 940 may include cloud storage for data storage and retrieval across network 940 based on encryption and security policies. The doctor 910 may be a registered doctor of the prescription management system. The pharmacy 920 may be an approved pharmacy and/or COPA equipment (e.g., mouthpiece) manufacturer. The COPA manufacturer may be an individual or tissue trained to pre-cure a standardized dental impression (e.g., COPA apparatus 100) that captures different individual elements of the dentition of the intended recipient. The system 900 may provide a recognition system for tracking prescription administration and management paths to prevent misuse and mismanagement.
At a high level, the doctor 910 may prescribe a medication to the patient, and the pharmacy 920 may create a mouthpiece for the patient and fill the mouthpiece according to the prescription(s) provided by the doctor 910. The pharmacy 920 may program the micro-pump unit of the mouthpiece to deliver a precise dose of the prescribed medication and/or medication intake time. In this regard, the medication instructions for the patient may be stored in the memory of the micro pump unit. The patient may insert the mouthpiece into the patient's mouth and, upon verifying that the user is the intended recipient, the micro-pump unit will dispense the prescribed medication in a programmed manner. When the mouthpiece is not in use, the patient may dock the mouthpiece at the docking station. The docking station may charge the mouthpiece and/or communicate with the doctor 910 and/or pharmacy 920 via a wireless and/or wired connection. The doctor 910 and/or pharmacy 920 may monitor and retrieve information associated with dispensing the prescribed medication from the docking station 400. The physician 910 can provide instructions to adjust the medication instructions based on the monitoring and/or retrieval information and/or based on an assessment of the patient's progress. The pharmacy 920 may send instructions to the docking station 400 to adjust the medication instructions stored in the memory of the micro-pump unit based on commands from the physician 910. For example, when the mouthpiece is docked at the docking station, the medicament instructions stored in the memory may be updated or reprogrammed accordingly. Alternatively, the medication instructions stored in the memory may be updated or reprogrammed at the pharmacy 920. Similarly, the physician 910 can prescribe a new drug based on the monitoring and/or retrieval information and/or based on an assessment of the patient's progress. The pharmacy 920 may refill the micro-pump unit 300 accordingly.
The patient/authorized caregiver portal 930 may be stored on a computer server or in cloud storage on the network 940. The management system 950 may be hosted on the network 940. The management system 950 may include a master database that stores information associated with the patient and all COPA activities. For example, the management system 950 may allow a doctor (e.g., doctor 910), an assembly or administration technician, a pharmacist (e.g., pharmacy 920), and any healthcare personnel participating in the COPA process to access at least some portion of the master database, e.g., based on a login. In embodiments, different people may have different login profiles, and access to the master database may be based on the login profiles. In some embodiments, the patient/authorized caregiver portal 930 may be hosted on the management system 950 and may have some access to the master database. The patient information may include an identification of the patient, a health history, a prescription history, an identification of the processor 310 within the COPA device 100, an identification of the docking station 400 to which the COPA device 100 is charged, and the like. The identification of the patient may include a Social Security Number (SSN) or other unique identifier of the patient. The prescription history may include an identification of the doctor (e.g., doctor 910) who dispensed the medication to the patient, an identification of the pharmacy (e.g., pharmacy 920) in which the prescription medication was filled or refilled, an identification of the prescription medication, and an identification of the processor 310 within the micro-pump unit 300 in which the medication was filled. Prescription history may also be stored and managed by the management system 950. The identification of the physician may include a National Provider Identifier (NPI) of the physician. NPIS is the unique identification number of the physician covered by the health insurance currency and accountability act (HIPPA). The identification of the pharmacy may include an impression technician Identifier (ID), an assembly technician ID, and a registered pharmacy ID. The impression technician ID identifies the technician who created the COPA device 100 for the patient. The assembly technician ID identifies the technician who is assembling or filling the prescription drug into the micro-pump unit 300 of the COPA apparatus 100. The pharmacy ID identifies the pharmacy where the prescription medication is filled. The prescription drug identification may include a medicament ID identifying each prescription substance or formulation filled into the micro-pump unit 300 of the COPA apparatus 100.
In an embodiment, the physician 910 can examine the patient and determine whether replacement therapy is likely to be helpful to the patient. When the physician 910 determines that the patient requires a particular drug, for example, according to a pharmaceutical formulation guideline based on the COPA administration option, the physician may prescribe the patient. The doctor 910 may electronically transmit the prescription to the pharmacy 920 via the network 940, for example, according to HIPPA data protection standards and an Electronic Medical Record (EMR) format.
At the COPA manufacturer, an impression technician may take an impression of the mouth and teeth of a prospective patient to create a mold for the COPA apparatus 100, for example, according to COPA guidelines and instructions. The mold may include a sealing sleeve similar to sealing sleeve 124. For example, an impression technician may use a tray filled with a bio-friendly polymer to create an impression of the patient's dentition. Creation of a mold for the COPA apparatus 100 may be accomplished by a COPA-approved dentist, hygienist, and/or other trained professional (e.g., COPA apparatus assembly technician).
An assembly technician may prepare the prepackaged micro-pump unit 300. Each micro-pump cell 300 may be identified based on the ID of the processor 310 embedded within the micro-pump cell. The assembly technician may record the ID of the micro-pump unit 300 in the management system 950. For example, the assembly technician may enter an ID into the management system 950, query a COPA device ID database of the management system 950 that stores and tracks the ID of the COPA device (e.g., COPA device 100), and create a new record of the COPA device 100 created for the patient. An assembly technician may, for example, wirelessly activate processor 310 within micro-pump unit 300. Activation may include programming the processor 310 according to commands received from the physician 910. The programming may include a patient's medication instructions (e.g., dosage and medication timing for each prescribed medication). As described above, different chambers 322 may be filled with different formulations. Thus, the programming may include the order of release, specific release times and/or release durations, and/or intervals between releases of the different formulations. For example, some formulations may be programmed for Immediate Release (IR) and some for Extended Release (ER).
After activating the micro pump cell 300 or the processor 310, the assembly technician may place the activated micro pump cell 300 in the top center of the mold where the sealing sleeve is located. The micro-pump unit 300 may be positioned such that the entry cannula 730 extends outside the sealing sleeve through the entry port 122 and the exit cannula 740 extends through the base of the mold. An assembly technician may place a filament or mesh sensor 112 into the groove 110 of the COPA device 100. The assembly technician may attach a hose from an air compressor to the inlet port 122 on the top of the mold so that pressurized air may be pumped into the micro-pump unit 300 through the inlet cannula 730 to ensure that the flow channel 350 is not compressed during filling of the mold. The assembly technician may pump the liquid polymer into the mold and solidify the liquid polymer. After the liquid polymer solidifies, the COPA apparatus 100 is complete.
After the COPA apparatus 100 is completed, the COPA apparatus 100 may be transferred to a pharmacy 920. At the pharmacy 920, a pharmacy staff member (e.g., a COPA implementation technician) may place the COPA apparatus 100 on a base or other structure configured to allow access to the micro-pump unit 300 for filling. The base may be covered with a sterile sleeve each time before the COPA device is placed on the base. The pharmacy staff may retrieve the record for the COPA apparatus 100 from the COPA management system 950, for example, via the network 940, based on the ID of the processor 310 within the COPA apparatus 100. The pharmacy staff may purchase a medication (e.g., vial, pouch, bottle, etc.) from the drug manufacturer based on the medication specified in the order received from the doctor 910. The pharmacy staff may update the record of the COPA device 100. The pharmacy staff may activate or open the control valve at the access port 122 to inject or deposit a dispensed prescription (e.g., prescription substance 720) into the one or more chambers 322 of the reservoir 320 via the access port 122. After filling is complete, the pharmacy staff may close the control valve. The pharmacy staff may repeat the same process to fill the other chambers 322 in the reservoir 320. The release of the formulated prescription is then based on the matching of the teeth of the intended recipient and the COPA device 100 as described above. It should be noted that in some embodiments, the pharmacy 920 and the COPA manufacturer may be the same entity.
The initial ID created for the COPA device 100 (e.g., of the processor 310) may be a permanent ID of the COPA device 100. The information associated with the filled prescription may be associated with the ID of the COPA apparatus 100 and recorded in the management system 950 and/or an internal tracking system of the pharmacy 920. Thus, the COPA apparatus 100 is fully traceable by creating and preparing a path. Further, a mold used to manufacture the COPA apparatus 100 may be assigned a mold ID, and may be stored in the management system 950 in association with the ID of the processor 310. The protocol for using the stored mold may be recorded and a record of subsequent mouthpieces may be associatively stored in the management system 950. Thus, abuse or fraud may be tracked via the management system 950.
The pharmacy staff may pair the COPA device 100 with the docking station 400. The pharmacy staff may record the ID of the docking station 400 in association with the COPA device 100 in the management system 950. The wireless transceiver 420 of the docking station 400 may be recorded and registered in the management system 950 for remote access to the processor 310 embedded in the COPA device 100. For example, the pharmacy staff may adjust the dose of filled prescription drug based on the instructions or the instructions of the prescribing physician 910 by accessing the processor 310 via the wireless transceiver 420 without the patient returning the mouthpiece to the pharmacy 920 before depleting the active ingredient(s). The adjustments may allow, for example, a limited number of revisions to the amount of drug delivered per release, the time of release, the suspension of one or more chambers 322.
The patient may pick up the COPA device 100 and docking station 400 from the pharmacy 920, and pharmacy staff may provide instructions to the patient for use. The patient may insert the COPA device 100 into the patient's mouth and close the mouth to bite the COPA device 100 so that the prescription dispensing unit 120 or the micro-pump unit 300 may release the prescription drug for ingestion. The patient may clean the COPA device 100 after use and dock the COPA device 100 at the docking station 400.
The patient and/or authorized caregiver may access the online COPA account hosted on the management system 950, for example, via the network 940. The wireless transceiver 420 may detect and transmit data such as activity recorded by the mouthpiece (e.g., the dispensed dose and timing of each medication) to the management system 950. The patient may view a record of the drugs loaded into each chamber 322 of the COPA apparatus 100. The patient may view a record of the administration path of the drug filled in the COPA device 100, including the initial prescription and any subsequent revisions. The patient may view a record of the expected depletion timeline in order for the patient to pick up a second pre-filled COPA device (e.g., COPA device 100) and drop a depleted COPA device when the treatment is a repeat treatment.
In an embodiment, the refill process of the COPA device 100 may use a similar strategy as today's drug refill strategy. The COPA apparatus 100 may be used for extended treatment planning. The prescribing physician 910 can adjust and revise the prescription based on the treatment results observed from the patient. The doctor 910 can electronically transmit the revised prescription to the pharmacy 920. The pharmacy staff or the fulfillment technician may wirelessly send revised instructions to the processor 310 via the wireless transceiver 420 of the docking station 400. The management system 950 may store a complete record of all revisions. When the intended recipient runs out of COPA on schedule or as revised, the COPA apparatus 100 may be returned to the pharmacy 920 for refilling, for example, as instructed by the prescribing physician 910. The pharmacy staff may flush saline solution into the COPA device 100 through the access port 122, into the sealed prescription dispensing unit 120 and out the outlet valve 222. After flushing the COPA apparatus 100, the pharmacy staff may refill the COPA apparatus 100 based on instructions received from the doctor 910 and may update the records in the management system 950. For example, if the prescription is written to make three refills, the record will indicate the three-medicament ID and the previous-medicament ID associated with the ID of the processor 310 of the COPA apparatus 100. By recording all information associated with the COPA device 100, patient and medication information in the management system 950 can be retrieved at any time, including when a patient changes providers or pharmacies during a treatment plan.
In an embodiment, when the COPA apparatus 100 is no longer needed, e.g., at the end of a treatment plan or a change in a treatment plan, the COPA apparatus 100 may be deactivated and the management system 950 may be updated to indicate the deactivation of the COPA apparatus 100. In some embodiments, when the deactivation time of the COPA apparatus 100 is within a certain time limit (e.g., X months), the assembly technician may reuse the original imprint to build a new COPA apparatus 100. The ID of the processor 310 within the new COPA device 100 may be stored in the management system 950 in association with the old ID of the old COPA device 100. In an embodiment, the creation and preparation processes described above may be repeated when the COPA device 100 requires recasting due to actual changes in the recipient's dentition. Information associated with the new mold may be stored on the management system 950 in association with the patient and the prescription medication. By tracking all COPA devices 100 associated with a particular patient or a particular prescription, an unintended user is less likely to gain access to the prescription medication or provide erroneous information of abuse or prescription substances for the intended user.
The following table lists the reference numbers and corresponding reference names:
table 1-reference numerals and corresponding reference names.
Those skilled in the art will appreciate that the above-described apparatus, systems, and methods may be modified in various ways. Therefore, those of ordinary skill in the art will appreciate that the embodiments encompassed by the present disclosure are not limited to the specific exemplary embodiments described above. In this regard, while illustrative embodiments have been shown and described, a wide range of modifications, changes, and substitutions is contemplated in the foregoing disclosure. It will be appreciated that such variations may be made to the foregoing without departing from the scope of the present disclosure. Accordingly, the appended claims are to be construed broadly and in a manner consistent with the present disclosure, as appropriate.