Method and apparatus for controlled individualized medication

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128924, 395924, A61M 3100

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active

056721544

DESCRIPTION:

BRIEF SUMMARY
This application is a 371 of PCT/SE93/00708 filed Aug. 27, 1993, published as WO94/06088 Mar. 17, 1994.


BACKGROUND OF THE INVENTION

This invention relates to a method for controlled individualised medication.


FIELD OF THE INVENTION

Many chronic diseases in man require the administration of various substances in order to counteract the disease and/or to keep down its symptoms. Medication often includes several different pharmaceutical preparations, each having its specific properties, duration of action, and so forth. Dosage and time intervals between administrations depend on the status of the disease, patient-specific factors, such as inheritance, age, weight, general state of health as well as diet and physical activities. As a result, medication is a fairly complicated task to perform. In practice, this will manifest itself as variations in the patient's state of health. In the case of some diseases, such as Parkinson's disease, the symptoms may in a single day vary from making the patient incapacitated for work (rigidity, tremor, etc.) to leaving the patient almost untroubled.
There are several different methods used for providing recommendations as to the dosage and the time intervals between administrations. These recommendations are often founded on the adjustment of an initial concept based on pharmacokinetic information on the various preparations. The adjustments are made on the basis of recordations of the patient's condition on various occasions. This information is interpreted by specialists, and used for adjusting the dosage and the time intervals.
However, the methods currently used do not yield desirable results, the reason being that the pharmacokinetic effects of the preparations are not absolutely clear. The way the preparations move through the body is affected by interactions with other preparations, enzymes and so forth, during the absorption and the distribution phase as well as during the metabolism and the secretion phase. Thus, the actual concentration of a preparation in the biophase, the duration of action and the effect cannot be predicted statistically using monotonic models. Another reason is that the evaluation of the patient's data is a complex operation since it involves many dependent variables and since it further is difficult to lay down analytical models.
It is likely that the state of health of certain groups of patients can be drastically improved by optimum, individualised and situation-dependent medication. This would result in enhanced quality of life, as well as fewer sickness pensioners.
GB 2,218,831 teaches an apparatus for helping people suffering from chronic diseases, such as diabetes, to determine medication doses and keep a suitable diet, thereby to improve their state of health. This apparatus has a key pad for entering data on the blood glucose levels as well as the physical activity of the patient, a memory where e.g. data on the prescribed dosage are stored, a program for computing suitable doses of insulin on the basis of inputted data as well as data stored in the memory, and a display for showing the doses of insulin computed.
Similar apparatus are described in U.S. Pat. No. 5,019,974 and EP Patent Application 0 128 054.
These prior-art apparatus are all based on there being a known relationship between a condition of the patient, such as the blood glucose level, and the well-being of the patient, and on the medication having a known effect on the patient. Thus, one may establish fixed medication rules valid for comparatively long periods of time.
However, in the case of other chronical diseases, such as Parkinson's disease, epilepsy and abnormal blood pressures, there does not exist any single actual value or condition of the patient that can be measured and correlated with the well-being of the patient. For these diseases, medication generally includes several medicines, whose precise interactions and effects on the patient are not fully known. In addition, the health condition of the patient is affected by a plurality of external factors. T

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