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Smart Systems

The WHO defines adherence to medical regimens as the degree to which a patient’s behaviour (eg adoption of recommended lifestyle changes, following a diet, taking medication) deviates from the recommendations of their healthcare provider. Nonadherence to regimens – in particular, to pharmacotherapy – can result in increased mortality and morbidity, hospital admission rates and costs of treatment, all of which may have a profound personal and societal impact (1,2). While adherence varies depending on complex personal and social characteristics of the patient, the question of whether medication ingestion can be objectively confirmed and quantified persists – especially when a patient wishes to conceal nonadherence.

Successful adherence to a prescription drug regimen, requiring precise timing and complete dose ingestion and/or avoidance of dose escalation, is often essential for adequate therapy. Risks are increased in some medications by under-use or poorly timed use. Examples of this include completion of anti-tuberculosis agents to achieve consistent cure (3); anti-gout medications, in which gaps in coverage result in severe acute episodes often requiring expensive hospitalisations (4); and anti-hypertensive medications, which may have symptoms inhibiting compliance, but are necessary to reduce cardiovascular risks over decades and improve wellbeing (5). On the other hand, nonadherence to drug regimens through over-use, including accidental or purposeful overdoses or drug escalation, are profoundly dangerous and costly at the personal and societal levels where pain medications – particularly opiates – are concerned (6).

The possibilities for drug formulations and drug devices for improving adherence issues in a broad array of disease states are protean. Already, impact has been made through long novel delivery systems, such as longacting weekly formulations, transdermal patches and extended-release orally disintegrating tablets (7). Hope is increasing for more sophisticated devices that can further alleviate the manifold issues of encouraging and monitoring adherence to drug regimens.

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Dr Neil D Theise MD is a physician-scientist at a leading New York City Medical school, US. He is an internationally recognised authority on liver diseases and adult stem cell biology. Neil engages in clinical practice, basic science and clinical research on diverse topics. He has been Lead Scientist at Pop Test and Palisades Therapeutics companies since their founding.

Dr Razvan Ene PhD is an expert in electronics and telecommunications. He completed his management studies at Motorola University, US, where he also lectured on risk management. In the printed circuit boards industry, Razvan was R&D Director of DDi’s ES division in US. He is now Chief Operating Officer at Elco Group.

Dr Mark A Prendergast received his training in neuroscience at the University of Nebraska, US, in 1994 and received postdoctoral training as a fellow in the Departments of Pharmacology at the Medical College of Georgia, US, and University of Kentucky, US, from 1994-1999. In 2014, he was awarded the title of University Research Professor by the University of Kentucky, US, in recognition of his years of research productivity in studying neuropharmacology of substance abuse. This work includes examining novel pharmacological approaches for the treatment of alcohol use, methamphetamine abuse, nicotine dependence and opiate intake.

The World Intellectual Property Organization has named Randice Altschul one of the world’s most notable inventors – the only woman ever so named. Randi is the Chief Exectutive Officer of the Pop Test and Palisades Therapeutics companies. She is an entrepreneur/ inventor of new products and author of new books and properties. Randi is also highly skilled at innovative adaptation of high technology for commercialisation. She created the disposable cell phone, the credit card phone, the programmable debit card, the paper laptop and other new products and properties, which range from games and game shows to high-tech electronics and everything in between, including food, gifts and, of late, medical devices and therapeutics. 
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Dr Neil D Theise
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Dr Razvan Ene
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Dr Mark A Prendergast
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Randice Altschul
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