 |
Claims  |
|
|
I claim:
1. A medication-dispensing system comprising prescribing data storage means
having a memory for storing prescription information, prescribing data
entry means for encoding prescription information on the prescribing data
storage means, and medication-dispensing means responsive to information
stored in the prescribing data storage means including display means for
displaying instructions regarding medication referred to in the
information stored in the prescribing data storage means, medication
container means for storing and dispensing medication, alerting means for
alerting a user of a scheduled medication time in response to medication
regimen information received by the dispensing means, dispense means for
terminating operation of the alerting means and indicating the scheduled
medication and confirming entry means requiring actuation by a user to
indicate compliance with medication instructions and to terminate
operation of the dispense means.
2. A medication-dispensing system comprising prescribing data storage means
having a memory for storing prescription information, prescribing data
entry means for encoding prescription information in the prescribing data
storage means, and medication-dispensing means responsive to information
stored in the prescribing data storage means including display means for
displaying instructions regarding medication referred to in the
information stored in the prescribing data storage means, medication
container means for storing and dispensing medication in response to
medication regimen information received by the dispensing means and
confirming entry means requiring actuation by a user to indicate
compliance with medication instructions, wherein the container means
comprises a normally closed container which is released to permit access
to medication and wherein the dispenser will not permit closing of the
container in the absence of actuation of the confirming entry means.
3. A medication dispenser according to claim 2 including alarm means
actuated in response to an attempt to close the container in the absence
of actuation of the confirming entry means.
4. A medication dispenser according to claim 2 including means for
preventing further operation of the dispenser in the absence of a
confirming entry after the container has been released and means for
recording confirming entries.
5. A medication-dispensing system according to claim 2 wherein the
container is a drawer which includes a plurality of compartments for
storing medication and including indicator means for indicating one of the
plurality of compartments for use by a user in accordance with
instructions displayed on the display means.
6. A medication-dispensing system according to claim 2 wherein the storage
and dispensing means includes a second container and wherein one container
contains medication to be taken on a prescribed schedule and the second
container contains medication to be taken on demand.
7. A medication-dispensing system according to claim 1 wherein the
medication storage and dispensing means comprises at least one container
with a plurality of compartments and load means responsive to actuation by
a user to display instructions regarding loading of medication into
selected compartments in the storage and dispensing means.
8. A medication dispenser according to claim 1 wherein the alerting means
includes alarm means for indicating the time for taking of medication and
further including release means for releasing a storage and dispensing
means to permit dispensing of medication in response to the alarm.
9. A medication-dispensing system according to claim 1 wherein the
medication-dispensing means includes internal memory means for storing
information and keyboard means permitting a user to enter information into
the memory means.
10. A medication-dispensing system according to claim 1 wherein the
prescribing data entry means is responsive to information contained in a
medication information storage means and in a patient information storage
means and includes display means for displaying medication information and
patient information and keyboard means for entering and displaying
prescription information and for storing prescription information on the
prescribing data storage means.
11. A medication-dispensing system according to claim 1 including
dispensing data storage means having a memory for storing dispensing data
and dispensing data encoding means for encoding dispensing data into the
dispensing data storage means and wherein the medication-dispensing means
is responsive to information stored in the dispensing data storage means.
12. A medication-dispensing system according to claim 1 wherein the storage
and dispensing means has a plurality of compartments for different
medications and each compartment has a separate cover.
13. A medication dispenser according to claim 1 wherein the container means
comprises a plurality of compartments, each having a slidable cover to
permit access to medication contained therein.
14. A medication dispenser according to claim 1 wherein the container means
comprises a plurality of compartments, each having a hinged cover to
permit access to medication contained therein.
15. A medication dispenser according to claim 14 wherein the hinged cover
has a first hinge permitting the entire cover to be opened and a second
hinge permitting only an end portion of the cover to be opened to permit
medication to be removed from the compartment.
16. A medication dispenser according to claim 14 including detector means
for detecting the cover in the closed position.
17. A medication dispenser according to claim 14 wherein the cover is
normally retained in the closed position and including release means for
releasing the cover to permit access to medication in the compartment.
18. A medication dispenser according to claim 1 wherein the medication
container means comprises a plurality of compartments, each having a
bottom surface which slopes upwardly toward one end to facilitate removal
of medication therefrom.
19. A medication dispenser comprising medication container means, data
storage means removably connected to the dispenser for providing
medication information to the dispenser, display means for displaying
medication information including instructions regarding medication,
control means responsive to the data storage means for controlling the
display means to display instructions for use of medication in the
medication container means, confirming entry means for actuation by a user
to indicate compliance with instructions presented on the display means,
and alarm means for generating an alarm signal upon closing of the
medication container means prior to actuation of the confirming entry
means.
20. A medication dispenser according to claim 19 wherein the removably
connected data storage means comprises prescribing data storage means
arranged to receive prescribing data at a remote location.
21. A medication dispenser according to claim 19 wherein the removably
connected data storage means comprises dispensing data storage means
arranged to receive dispensing data at a remote location.
22. A medication dispenser according to claim 19 including alarm means
responsive to the control means at the selected times when medication is
made accessible to the user.
23. A medication dispenser according to claim 19 including internal memory
means for storing information in the dispenser and keyboard means
permitting a user to enter information into the internal memory means.
24. A medication dispenser according to claim 19 wherein the medication
container means includes a slidable drawer having a plurality of
compartments which may be released at the selected times to permit access
to one or more of the compartments and indicator means for indicating the
compartment containing medication for use at the selected time.
25. A medication dispenser according to claim 19 wherein the medication
container means comprises at least two drawers which are selectively
releasable and wherein one of the drawers may be released at selected
times in accordance with a medication regimen and another drawer is
selectively releasable by the user to permit access to medication to be
taken on demand.
26. A medication dispenser according to claim 19 including remote
communication means permitting communication with the dispenser from a
remote information source.
27. A medication dispenser according to claim 19 including remote locator
means for causing the dispenser to produce a locating signal.
28. A medication dispenser according to claim 21 wherein the dispensing
data storage means includes means for limiting the number of times the
dispensing data stored in the storage means may be reused.
29. A medication dispenser according to claim 19 wherein the container
means comprises a plurality of compartments, each having a hinged cover to
permit access to medication contained therein.
30. A medication dispenser according to claim 29 wherein the hinged cover
has a first hinge permitting the entire cover to be opened and a second
hinge permitting only an end portion of the cover to be opened to permit
medication to be removed from the compartment.
31. A medication-dispensing system comprising medication data storage means
having a memory for storing medication information, display means for
displaying information regarding medication stored in the medication data
storage means, medication container means for storing and dispensing
medication, dispense means for opening the medication container means,
confirming entry means requiring actuation by a user to indicate taking of
medication contained in the container means, and reminder means to remind
the user to close the medication container means. |
|
 |
|
 |
Claims |
|
|
|
Description |
|
|
BACKGROUND OF THE INVENTION
This invention relates to medicine-dispensing devices and, more
particularly, to a programmable medicine-dispensing system.
Heretofore, a variety of medicine-dispensing devices have been proposed. In
the patent to Rose et al., U.S. Pat. No. 4,695,954, for example, a
medication-dispensing system is provided in which prescription information
is encoded into a memory card by a programming device located at a
pharmacy in accordance with a physician's instructions. The memory card is
inserted by the patient into a dispenser which automatically releases the
appropriate medication at the required times and provides a corresponding
alarm and visual indication on a screen. The dispenser includes sensors
which detect the removal of medication from a delivery compartment to
record compliance by the patient, but failure of the patient to remove the
medication will not prevent the dispenser from continuing its programmed
operation but instead may send an alarm to a remote location. This system
is intended for use by a patient at a facility where supervising personnel
can observe monitors and take corrective action promptly, but is not
portable or useful in an environment where the patient must follow a
regimen without close supervision by others.
The patent to Urquhart et al. U.S. Pat. No. 4,725,997 discloses a
dispensing device for pharmaceutical preparations which is programmed with
information concerning a dosing regimen and permits the user to deviate
within limits from the regimen and monitors the deviations while
preventing dispensing outside the predetermined limits. The dispensing
device has a data communication interface for communicating with a
physician or pharmacist and includes a display screen on which
instructions and inquiries may be displayed.
The Mcintosh et al. U.S. Pat. No. 4,088,056 discloses a programmed
medication clock having a plurality of separate compartments for different
types of medication along with a separate indicator and acknowledgment
switch adjacent to each compartment to indicate the compartment from which
medication is to be taken and to acknowledge taking of the medication by
the user. The Lloyd et al. U.S. Pat. No. 5,099,463 shows a medication
alarm device with separate holders for removable medication containers and
corresponding indicator lights to designate a container from which
medication is to be taken.
In the Schollmeyer et al. U.S. Pat. No. 4,504,153, a cap for a medication
container includes a programmable prompting device which is programmed in
accordance with the physician's prescription instructions to automatically
prompt a patient to take medication at prescribed times. The prompting
device is programmed by plugging it into a pharmacist's programming
station which is connected to a computer for supplying programming
instructions in accordance with the physician's prescription.
The Bender U.S. Pat. No. 3,871,551 discloses a pill dispenser usable by a
patient with no supervision. According to that patent, a manually-advanced
pill dispenser is provided for periodic delivery of medication at timed
intervals and failure to remove a pill from the dispenser at the required
time will prevent further advance of the dispensing system. The patents to
Carlson, U.S. Pat. No. 4,223,801; Wirtschafter et al., U.S. Pat. No.
4,588,303; McLaughlin, U.S. Pat. No. 4,717,042; Cole et al., U.S. Pat. No.
4,731,765; and Shepherd et al., U.S. Pat. No. 4,911,327, similarly
disclose dispensing arrangements in which removal of medication at the
appropriate time is detected.
The Shepherd et al. patent also discloses a refill alarm, as does the Kehr
et al. U.S. Pat. No. 4,768,176, and the latter patent also discloses an
arrangement for dispensing prescribed drugs at variable times in
accordance with the patient's activities. None of the prior art, however,
provides a programmable medicine dispenser in which a separable data
storage unit may be programmed by a physician or a pharmacist to provide
specific instructions with respect to each drug to be taken and which also
requires the patient to properly confirm that he has followed the
instructions or which releases a drawer containing medications and
provides a visual indication of the location of medication to be taken.
SUMMARY OF THE INVENTION
Accordingly, it is an object of the present invention to provide a
programmable medicine-dispensing system which overcomes the
above-mentioned disadvantages of the prior art.
Another object of the invention is to provide a programmable
medicine-dispensing system which is appropriate for a patient who is not
under immediate supervision.
These and other objects of the invention are attained by providing a
programmable medicine-dispensing system including a removable data storage
unit in which regimen-related information may be stored to make the
information and appropriate medication available at required times and
wherein the patient must make a confirming entry to permit the medication
schedule to continue in accordance with the regimen. The regimen-related
information may be entered in a prescribing information storage unit by a
physician or in a dispensing information storage unit by a pharmacist or a
physician or the patient, or it may be entered in the dispenser by the
patient. In addition, the location of medication to be taken in a drawer
containing several compartments may be designated by an illuminated
indicator. Preferably, the system includes an arrangement for recording
each confirming entry made by the user as well as any user information
such as side effect indications.
The programmable medication-dispensing system of the invention is addressed
to the management of multi-prescription regimens of "self-administering"
or "home-care" patients with a minimum level of patient competency, for
patients who might have a variety of attendants at different times, are
under the care of more than one physician, and might obtain medication
from different pharmacists. In its most comprehensive form, the system
includes not only the dispenser used by the patient, but also the
prescription card encoded by a pharmacist, a card encoder for the
pharmacist, software for the pharmacist and for the physician and the
user, and various accessories for communication and ancillary devices to
facilitate the operation.
Although the dispenser can be embodied in many configurations, they all
have certain basic design aspects and the same method of operation. In
particular, the dispenser is a stand-alone unit which is portable,
programmable, interactive with the patient, simple to use, has large-scale
ergonomics and includes a memory and an alarm system, which may include
both sound and voice signals, a TV-interrupt and a remote alarm. It may
also be designed for telephonic communication, for example, with a
physician or pharmacist.
Among the capabilities and features of the dispenser are the storage and
display of information relating to interactions for all drugs to be taken
by the patient, and the display of appropriate warnings for interactions
which might be adverse, and a record of any patient toxicity, i.e.,
adverse drug reaction. The dispenser, which is programmable by either a PC
or a "Smart Card" or similar module, can devise the optimal daily schedule
for taking medication and can use a variety of loading strategies, either
daily or cyclical, from bulk supplies or prepackaged or from bottled
inventories.
At the actual time of dispensing the medication, the dispenser identifies
the medication to be taken, specifies the quantity to be taken and
provides instructions with respect to the taking of medication. Also, at
predetermined intervals, the dispenser can query the patient as to any
present symptomatic state and any drug response. Moreover, the dispenser
requires active, positive "confirmation" from the patient that the
medication was taken or specific instructions were read and followed, or
that a response to a specific inquiry has been made. Furthermore, the
system records the actual time and date when each medication was taken or
any failure to take medication when scheduled and each confirmed event
relating to the medication and any event for which confirmation by the
patient is required.
With respect to the scheduled taking of medication, the schedule is based
on prescribed interval tolerances and the dispenser may provide a variety
of alarms, for example, of variable frequency and tone. It also displays
the next scheduled taking, provides anticipatory alarms for
"critical-to-take" medications and, if any medication is taken early or
delayed, it can reschedule all of the remaining drugs to be taken during
that day. The dispenser further distinguishes between a "postponed" taking
of medication and a "late" taking of medication, and has an iterative
procedure for scheduled but "moving" events and can also adjust dosages.
With respect to unscheduled ("as-needed") taking of medication, the system
can display the limits on cumulative daily dose and frequency and can
condition dispensing on responses to specific inquiries, such as prior
symptomatic states.
The system can also intervene at any time by, for example, alerting the
patient with respect to a "critical" failure to take medication or
toxicity, i.e., adverse drug reaction situations and can provide
instructions to the patient regarding stoppage of medication and calling
for aid. The system can also allow the patient to select any one of
several applicable drugs. In addition, the system can be arranged to
adjust dosages depending on the response of the patient to symptomatic
inquiries and can recall and display stored information such as the last
drug taken and the last time any drug was taken, for example, and can also
provide more elaborated instructions if the patient is unable to
understand abbreviated instructions provided periodically.
Furthermore, the medication-dispensing system may provide information about
dressings, patient temperature, blood pressure, appointments and the like,
and the patient can enter information regarding his condition or
situation, i.e., the times of sleep, of mobility, of eating, of bodily
functions and the like. The patient's dispenser may also be arranged to
receive telephonic transmission of data and instructions, and a remote
alarm and locator for the dispenser can also be provided. The dispenser
can also maintain an inventory of pills within the dispenser and in the
patient's bottled supply and can provide alarm signals alerting the user
to reload, refill or reorder medication.
The system is especially adapted for the regulation of prescribed
pharmaceuticals in which the timing, sequence and dosage of medication
needs to be continuously adjusted or where the complexity of such
management is greatly compounded by the prescription of more than one drug
and where there is a wide range of patient competency for
self-administration such as may occur in connection with patients over the
age of sixty who require multiple medications for chronic conditions.
Although the medication-dispensing system of the present invention has
direct applicability to any regimen that requires a responsive and
flexible drug strategy and a high confidence of patient compliance, it is
particularly addressed to the prescription, coordination, interaction,
instruction and periodic monitoring and special compliance problems
relating to complex mono- and poly-pharmaceutical regimens.
In accordance with a preferred embodiment, the medication-dispensing system
of the invention includes a prescribing data entry station at which
instructions are encoded by a physician into a portable prescribing
module. The prescribing module may, for example, be a microcomputer
cartridge containing an appropriate memory in which instructions are
stored and from which a physician may retrieve compliance information
indicating the extent to which the patient has complied with instructions.
Preferably, the prescribing module is encoded by using a personal computer
attached to a prescribing adapter into which the prescribing module is
plugged.
Preferably, the system also includes a dispensing data entry station at
which a dispensing data storage module is programmed by a pharmacist, for
example, to store drug-specific information relating to the medication,
including times and dosages and refill information.
In addition, the system includes a medication dispenser operable by the
patient in which the prescribing data storage module and the dispensing
data storage module are received and which is responsive to the stored
data to display appropriate medication information and permit loading and
dispensing by the patient of the specific drugs prescribed by the
physician. To assure compliance with the prescribing and dispensing
instructions, the dispenser requires confirming entries to be made by the
patient at each step in the process. If desired, the dispenser may have,
for example, separate drawers for drugs to be taken on demand and drugs to
be taken only at specified intervals, each drawer containing a series of
compartments for different drugs with indicating lights designating the
compartment containing the drug to be taken or loaded by the patient.
BRIEF DESCRIPTION OF THE DRAWINGS
Further objects and advantages of the invention will be apparent from a
reading of the following description in conjunction with the accompanying
drawings, in which:
FIG. 1 is a schematic perspective view illustrating the arrangement of a
representative prescribing data entry station for use by a physician in
accordance with the invention;
FIG. 2 is a schematic perspective view illustrating the arrangement of a
typical dispensing data entry station for use by a pharmacist;
FIG. 3 is a schematic perspective view illustrating the arrangement of a
representative medication dispenser arranged in accordance with the
invention;
FIG. 4 is a schematic block diagram showing the major components of a
typical medication dispenser in accordance wi | | |
