Your medication might start tattling on you if you skip a dose.

Scientists at MIT have developed a groundbreaking smart pill that can wirelessly report the moment it’s been swallowed, giving doctors a way to monitor whether patients are taking their prescriptions on schedule.

It may sound simple, but the stakes are high. Studies show that half of all Americans with chronic conditions don’t take their long-term medications as prescribed.

The fallout is staggering: in the US, poor adherence contributes to 125,000 potentially preventable deaths, drives 25% of hospitalizations and racks up more than $500 billion in avoidable healthcare costs each year.

People skip their medications for many reasons: high costs, fear of side effects, confusing instructions — and, for many, simple forgetfulness.

“The goal is to make sure that this helps people receive the therapy they need to help maximize their health,” Giovanni Traverso, an associate professor of medical engineering and the senior author of the study, told MIT News. 

In the past, Traverso’s lab developed capsules that can remain in the digestive tract for days or weeks, releasing medication on a set schedule. But the approach isn’t suitable for every drug.

“We’ve developed systems that can stay in the body for a long time, and we know that those systems can improve adherence, but we also recognize that for certain medications, we can’t change the pill,” he said.

“The question becomes: What else can we do to help the person and help their health care providers ensure that they’re receiving the medication?”

The answer: radio frequency (RF), a type of signal that can be easily detected from outside the body and is safe for humans.

While other scientists have tried to develop RF-enabled pills, their devices used non-degradable components that had to pass through the digestive system, increasing the risk of potential blockages.

Traverso and his colleagues solved that problem by designing a pill whose RF antenna is made from zinc and embedded in cellulose, rolled up and placed inside the medication capsule.

The capsule’s outer layer, made of gelatin coated with cellulose and either molybdenum or tungsten, blocks the RF signal until the pill reaches the stomach and begins to break down.

“We chose these materials recognizing their very favorable safety profiles and also environmental compatibility,” Traverso explained.

Once swallowed, stomach acid begins dissolving the protective coating, releasing both the drug and the device into the body. The antenna can then pick up an RF signal from an external receiver and, with the help of a tiny RF chip, send back confirmation that the pill has been ingested.

“The components are designed to break down over days using materials with well-established safety profiles, such as zinc and cellulose, which are already widely used in medicine,” said Mehmet Girayhan Sayan, MIT research scientist and lead author of the paper.

The RF chip, about 400 by 400 micrometers, is the only part of the pill that isn’t biodegradable, but tests show it passes safely through the digestive tract.

“Our goal is to avoid long-term accumulation while enabling reliable confirmation that a pill was taken, and longer-term safety will continue to be evaluated as the technology moves toward clinical use,” Sayan said.

To test the concept, the MIT team tried the capsules — called “SAFARI devices” — in five female domestic pigs, whose digestive systems are similar to humans.

After digestion, the researchers found that the coating dissolved and the devices had activated, with the RF signal successfully transmitted from their stomachs and read by an external receiver up to two feet away.

After being digested, they found that the coating dissolved and the devices activated, transmitting the RF signal from the pigs’ stomachs to an external receiver up to two feet away.

Looking ahead, the researchers envision designing a wearable device for humans that could receive the signal and relay it directly to the patient’s healthcare providers.

But don’t expect to be swallowing smart pills anytime soon.

Despite the promising early results, the devices will need extensive testing in humans to confirm their safety and effectiveness before they can be approved.

The researchers will also need to figure out how to scale up production so these carefully engineered capsules can be manufactured and used more widely.

Even if that happens, it’s unlikely that every prescription will be delivered via a SAFARI device, which will almost certainly be expensive to produce.

“We want to prioritize medications that, when non-adherence is present, could have a really detrimental effect for the individual,” Traverso said.

That could include people who have recently had organ transplants and need immunosuppressant drugs to prevent their bodies from rejecting the new organ, the researchers noted.

Other potential candidates include people with neuropsychiatric disorders, whose conditions may make it harder to take medications consistently, as well as patients with infections such as HIV or tuberculosis, where missing doses can significantly worsen disease progression.

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