X. Toh, H. X. Tan, H. Liang and H. P. Tan

Singapore Management University, Singapore

Institute for High Performance Computing, A*STAR, Singapore

Elderly Medication Adherence Monitoring with the Internet of Things

220,000

440,000

900,000

0

200,000

400,000

600,000

800,000

1,000,000

Elderly Aged Above 65 Years Old

2000 2015 2030

35,000

83,000

0

20,000

40,000

60,000

80,000

100,000

Elderly Living Alone

2012 2030

National Population And Talent Division, Singapore

Elderly Medication Adherence Monitoring with the IoT 2

Enabling Ageing-In-Place through Technology

Elderly Medication Adherence Monitoring with the IoT 3

(e.g. sensor-enabled homes)

Supported by the Singapore Ministry of National Development (MND) and National Research Foundation

(NRF) under L2NIC Award No. L2NICCFP1-2013-5.

Medication non-adherence leads to:

Importance of Monitoring Medication Adherence

Health issues and reduced effectiveness of treatment

Vulnerability to adverse complications

Increased healthcare expenditure, morbidity and mortality

Elderly Medication Adherence Monitoring with the IoT 4

Expensive with recurring costs

Cannot be customized to

consumption habits

Non-interoperable with other sensing devices

Non-integrated with personalized care model

Limitations of Existing Products

Elderly Medication Adherence Monitoring with the IoT 5

Existing medication habits of elderly

A Solution for Inferring Medication Adherence

Elderly Medication Adherence Monitoring with the IoT 6

Currently, the only way to accurately detect medication adherence is through image-based solutions or ingestible medicine.

Medication box that can be personalized

Unobtrusive and non-instrusive

Allows real-time monitoring, for reactive intervention by caregivers

Allows longitudinal monitoring, for pre-emptive intervention by caregivers

Hardware components MedBox MedBox

Medication Box Prototype

(Normally Closed) Reed SwitchArduino Fio (microcontroller)Xbee radio (IEEE 802.15.4)LiPo battery

Elderly Medication Adherence Monitoring with the IoT 7

Packet Transmission Schedule in MedBox Sensor

Reed switch breaks contact with magnet, board is powered on

Multiple pkt txn for redundancy and reliability

Sleep period to conserve energy

Continued txn to indicate that box is

not closed

Reed switch makes contact with magnet, board is powered off

Elderly Medication Adherence Monitoring with the IoT 8

Hardware components

Medication Box Gateway

Beaglebone BlackXbee radio (IEEE 802.15.4)3G dongle + SIM card

Receive pktsfrom sensor(s)

Publish data to backend

through MQTT

Elderly Medication Adherence Monitoring with the IoT 9

Density-Based Spatial Clustering of Applications with Noise (DBSCAN) to cluster medication intake timings

Distance function :: cyclic difference between any two medication intake timings

= 1 hr :: maximum distance between two medication intake timings that can be considered to be in the same cluster

MinPts = 5 :: minimum number of points in cluster (-neighborhood)

Descriptive statistics to deduce regularity of inferred medication intake frequency

Monitoring and Analysis

Elderly Medication Adherence Monitoring with the IoT 10

System Architecture

Elderly Medication Adherence Monitoring with the IoT 11

*Anycast routing is used for reliability and robustness, as well as to decrease cost.

Elderly Care Model

Survey Data

(With Periodic

Updates)

Sensor Data

Long Term

Monitoring &

Data Analysis

Elderly

Categorization

AdheringNon-Adhering

Irregular Medication Intake Regular Medication Intake

Medical

Reconciliation

and Intervention

by Care-Givers

Elderly Medication Adherence Monitoring with the IoT 12

10 elderly

69 to 81 years old

3 to 8 chronic illnesses

4 to 10 types of

medication

Daily intake frequency between 1

to 3

Participant Profile

Elderly Medication Adherence Monitoring with the IoT 13

Inferred Medication Intake Frequency

Elderly Medication Adherence Monitoring with the IoT 14

Elderly 1090

Inferred Medication Intake Frequency

Elderly Medication Adherence Monitoring with the IoT 15

Elderly 1070

hospitalization

outdoor activities on Sundays

Medication Intake Timings

Elderly Medication Adherence Monitoring with the IoT 16

Elderly 1060

Ground Truth Evaluation

Elderly Medication Adherence Monitoring with the IoT 17

Two-Week Medication Diary

Elderly are concerned about electrical consumption of mains-powered gateway

Elderly with active lifestyles tend to upset daily medication routine

Only medication consumption can be inferred

Dosage and type of medication cannot be monitored

Discussion and Insights

Elderly Medication Adherence Monitoring with the IoT 18

Single-compartment Triple-compartment

Increase duration and scale of study to derive both longitudinal and transversal insights in medication adherence

Work more closely with caregivers and medical professionals to better provide holistic care model

Elderly Medication Adherence Monitoring with the IoT 19

Thoughts?

Elderly Medication Adherence Monitoring with the IoT 20

Hwee-Xian TANhxtan@smu.edu.sg

SMU-TCS iCity Lab, Singapore