Advice

The technology

The technology

YOURmeds (Yourmedpack) is a smart medication management system for people with long-term conditions. The technology includes the following features:

  • an electronic smart tag and monitored dosage system

  • a smartphone app

  • a web-based monitoring portal that allows healthcare professionals to monitor whether people are taking their medication as intended.

The electronic smart tag and monitored dosage system work together to prompt a person to take their medication on time. The numbered monitored dosage system is filled with medication by the pharmacist and delivered to the person weekly. The smart tag sits at the top of the pack and when a dose of medication is due, an alarm will go off 3 times. The smart tag flashes red and displays the correct blister number of the electronic pill pack to take. The company's patented IP (intellectual property) has an electronic circuit so that the device knows exactly which medication door has been opened. Using a bespoke algorithm, it can advise whether the person has taken the correct one, the wrong one or too many (potential overdose). Pharmacists will charge the tag fully before delivery. The tag device uses mobile data, so no Wi‑Fi or broadband is needed. The user can also nominate up to 5 people to help support them to take their medication on time. If the user has not taken their medication within 10 minutes of the initial alarm, the tag will inform the first supporter to give them a quick call to remind them to take their medication. This process continues every 10 minutes until all 5 supporters have been notified within 1 hour. Notifications will continue until either the medication is taken or the round ends. If the round ends and the medication is not taken, 2 things happen. The round is terminated and recorded as missing. But if the medication is taken after the round ends, it is recorded as late. The system moves on to alerting for the next round when it is due. Supporters are given a unique login to the app, through which they can see when medication is needed and if the wrong medication is taken or too much has been taken.

YOURmeds is not compatible with liquids, inhalers or injectables.

Innovations

The company claims that YOURmeds is the first digital medication dosage system that allows real-time monitoring of medication adherence. It monitors if the right medication is taken and if the patient may have suffered an overdose, in which case support is offered. The technology enables pharmacists to dispense medication in a conventional way directly to the patient, without a carer having to load the system. Other innovative aspects include the ability to correlate the medicines prescribed with the adherence data to show efficacy and support patient-centred care, creating a real-time support network for each patient to improve adherence and allow monitoring in a person's own home. The technology can also be used to help audit and record medication being taken.

Current care pathway

Medication management includes the administration of medication, prescribing, dispensing, and supporting people to take their medication. People need an assessment to see whether they need medication support, and the discussions and decisions need to be recorded in the provider's care plan. This is generally done by social workers, who then inform the GP and pharmacies. Supporting people to take their medicines may involve helping people to take their medicines themselves (self-administration), including medication in their original packaging and pharmacy-filled monitored dosage systems, or giving people their medicines (administration).

The following publications have been identified as relevant to this care pathway:

Population, setting and intended user

YOURmeds is intended to help people manage long-term conditions including diabetes, mental health and behavioural conditions, multiple long-term or genetic conditions, neurological conditions such as Parkinson's and dementia, and cardiovascular conditions such as stroke.

About 26 million people in England have at least 1 long-term condition. Long-term conditions include hypertension, depression, asthma, diabetes, coronary heart disease, chronic kidney disease, hyperthyroidism, stroke, chronic obstructive pulmonary disease, cancer, atrial fibrillation, mental health conditions, heart failure, epilepsy and dementia. It is estimated that between 30% and 50% of medicines prescribed for long-term conditions are not taken as intended. Poor adherence can lead to inadequate management of long-term conditions and so result in reduced health outcomes, which costs more for the NHS and society.

The technology is designed to be used in the community, in people's homes. The company says that it can be used by anyone who needs medication support, when independence and self-management are primary goals.

Training is needed for pharmacists because they need to know how to dispense the medication. The company provides training free of charge through Microsoft Teams or, if needed, in person. It also says that it has a weekly drop‑in session online at which support can be given and questions can be asked, and the company regularly visits pharmacies. This training can also be delivered to any other pharmacy staff.

Costs

Technology costs

The annual cost is £628 per person in year 1 and £468 in year 2, because the tags have a 2‑year life.

  • The cost is £80 per smart tag. Two tags are needed per user (£160). Each tag is under warranty for 12 months and lasts on average 2 years. If the tag is faulty, it will be replaced free of charge. If the smart tag is dropped or damaged, a replacement costs £50.

  • There is a weekly monitoring fee of £8 charged by the company (£416 per year). This includes:

    • YOURmeds smart packaging

    • SIM card costs so that the data can be sent and received by the device

    • pharmacy staff filling the pack and delivering it to patients

    • up to 5 app users per person

    • use of the YOURmeds dashboard that monitors adherence by responders who may include family and friends, or if there are none, then by the monitoring centre; the company claims that the time needed to monitor adherence is extremely low.

  • The app and monitoring portal are free.

  • There is an optional weekly £1 cost for insurance: £52 per year.

  • The company also pays the pharmacy £10 per patient per month, and provides all the packaging for free. Typically, the pharmacy receives around £120 per patient per year from the company, plus the free packaging.

Costs of standard care

The company says that the cost of medication support and management depends on geography and NHS services. It says that medication support averages about £6,400 per year in a council in the North East of England, based on one 15‑minute medication visit per day costed at £17.50. The company also says that some councils do bundle medication support visits. The medication support is part of 30‑minute personal care visits. The full visit costs about £20, but the medication support is estimated to take 10 minutes and costs about £6 per visit (£2,200 per year).

Resource consequences

YOURmeds is used in 1 NHS trust. But it is mainly used in social care and by pharmacists to dispense medication.

The company says that the technology could help increase capacity in social care by reducing medication visits through remote monitoring. It may also help speed up discharge from hospital, reduce hospital admissions, reach hard-to-reach groups and allow people to maintain their independence in their own homes for longer, reducing long-term care costs.

The company says that no practical difficulties or changes in facilities and infrastructure are associated with adopting the technology. YOURmeds uses mobile SIMs and can be used without a smartphone.