Development of a remote medication dispenser for narcotic rehabilitation patients

Narcotic drug dependency rehabilitation programs aim to break with the routines and habits relating to the acquisition and use of illicit drugs. Most narcotic dependency rehabilitation patients have to visit a pharmacy daily to obtain supervised doses of narcotic rehabilitation medication. The aim of rehabilitation programs is often to progress patients to take away doses (TADs). However, there are inherent risks associated with TADs due to lack of security of the medication and monitoring of its use. This thesis documents the design, development, and testing of a \Remote Medication Dispenser\" device which can provide a secure home-based method of medication delivery for these patients in particular for those using TADs. Both clinical and functional requirements for the dispenser were considered in the consultation with an expert health professional in this field. To meet the requirements a secure and hands-free medication intake method was developed in which the device dispenses medication directly to the patient's mouth - under the tongue. The device has a micro-controller to internally control its operation with external control achieved through a computer-based user interface. The device has an enclosed housing thus if there is forced access to medication evidence will be prominent. Medication is loaded into the dispenser only by pharmacists. A \"dosing supervisor\" controls the dispensing operation through an internet connection; the medication is dispensed one by one and managed by the patient. Two prototypes of the dispenser were proposed and implemented. The first prototype is a multi-dose device which can contain and dispense up to four doses. It was developed to study and investigate the proposed storing and dispensing approach. The second prototype is a single-dose device that contains only one dose of medication. The design was developed based on the first prototype with simplification to make it more mobile and reliable. Moreover the second prototype has a remote control feature which allows control via an internet connection. Both devices dispense the same type of medication and apply the same storing and dispensing method. The operation of the dispensers was assessed with lab-based trials. They both operated as expected and met the design's specifications except for unreliability of the multi-dose dispenser which was related to its complexity. A patient trial was proposed using the second (single-dose) prototype with the remote control function. An Ethics Approval was granted in order to carry out the experiment. A questionnaire which concentrates on the design and its operation was developed to obtain feedback from patients when they use the device. The trials will be conducted subsequent to the submission of this thesis. In conclusion the concept of a remote medication dispenser was successful in terms of design and lab based assessment of the developed prototypes. The design has potential to be applied in research and development and in clinical settings particularly in narcotic rehabilitation programs."