“An E-Medicine Delivery and Treatment Monitoring Service For Patients With Heart Disease In The NHS” - Project proposal ISSN 2753-8176 (online) (DOI:10.13140/RG.2.2.34395.03360)

“An E-Medicine Delivery and Treatment Monitoring Service For Patients With Heart Disease In The NHS” - Project proposal ISSN 2753-8176 (online) (DOI:10.13140/RG.2.2.34395.03360) Ana Pedro1 1Gwyntwr1386 Healthcare CIC, Regus Chester Business Park, Heronsway, Chester, CH49QR, UK. Coronary heart disease (CHD) is the most common type of heart and circulatory disease and the most common cause of heart attack and the single biggest killer worldwide. However, survival of post-myorcardial infarction can be improved if adherence to secondary prevention medication is maintained. Patient care can also be improved by monitoring cardiac troponin complex proteins which are well established as diagnostic biomarkers of myocardial injury in the context of CHD (1). These troponins are routinely screened for in a a point-of-care (POC) reliable lateral flow immunoassay in the NHS (2,3). Also, most MCA (medicine-compliance aids) patients are elderly and suffer of combined cardiovascular disease (4). Gwyntwr1386 Healthcare CIC, intends to provide a new, online clinical delivery and treatment monitoring service for the NHS based on an e-Box . In an automated fashion, this will deliver medication in a "smart" paper blister package which incorporates an electronic module and printed sensor grid inside the package, both of which are invisible to the patient. The hidden technology records the time, date and location when a dose is removed from the blister package and will be coupled with a POC troponin testing device in each hole for patients with CHD. This improved e-Box, will improve quality of life and contribute to the observance of treatments as well as the measure of specific biomarkers for CHD such as troponin through a POC testing device, saving time and money in what concerns obtained clinical lab analysis results which will be necessary for clinicians to make decisions about treatment and also assuring the correct and adjusted medication is taken properly and when to arrange new face to face appointments with Doctors. This development is logistically robust as the established e-Box component is based on the blister-pack technology currently already in use within NHS. The POC test is based also on technology that has been tested for use at NHS and has been showing promising results and its total expected costs in the primary care setting is lower than the laboratory-led pathway (5). In an additional important development both the medicine taking by the patient and the troponin test result will be transmitted via a Wifi enabled communicating device app to healthcare practitioners by SMS alerts and emails and all the information will be automatically integrated on an online platform which allows to monitor patient compliance. These practioners can be pharmacists or the attending physician either in a community pharmacy or hospital or GP surgery or care home. Subsequently, this clinical data will be transferred to the central electronic patient health record. Ana Pedro, will coordinate this project and will need access to the e-Box system and to technical help in terms of hardware and software development to couple the troponin POC testing device to the e-box. Both the e-Box and POC troponin testing device have been fully developed and have published efficacy data (2, 6-9) however we would like to ascertain the feasibility of both systems together in terms of likely patient benefits. For this reason, the outcomes of treatment (fidelity (10), adherence (11) and acceptability (12), efficacy (13), adverse reactions (14), costs (15)) will be measured by comparing a group of 18 patients using the e-Box+POC troponin system with a group of 18 patients receiving the standard treatment (treated with the drugs and lab based clinical analysis). We will ascertain if our new system is truly less costly compared with the traditional system. Moreover, after this cardiovascular service is set up, we aim to develop this same service for other chronic diseases as well as for infectious diseases and for oncologic diseases.