Diapositive 1

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MEMS FaxBack
The Knowledge
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A basic principle

• Drugs dont work in patients who do not take
  them
• Former Surgeon General C. Everett Koop

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Introducing the missing link in
biopharmaceutical sciences
harmionicswhat the patient does with the drug
P
Pharmacokinetics what the body does to the
drug Pharmacodynamics what the drug does to
the body
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Need for a new discipline Pharmionics

• Pharmionics is the discipline concerned with
  quantitative assessment of whatpatients do with
  prescription drugs
• It is akin to avionics in the control of flight
• ion -- to go the going of the drug (or the
  plane)

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Need for a simple, robust taxonomy
ADHERENCE/COMPLIANCE
QUALITY OF
EXECUTIONof the drug regimen
Acceptance
Discontinuation
Drug prescription
Endprescription
Vrijens Urquhart, 2005 Journal of Antimicrobial
Chemotherapy
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Introducing reliable measures of dosing histories
Medication Event Monitoring System (MEMS)
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An individual example of Pharmionics
A perfect patient
0Sunday1Monday 2Tuesday, , 6Saturday
Pharmionic Knowledge Centre NOV 06
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An individual example of Pharmionics
A patient with delayed intake during the weekends
0Sunday1Monday 2Tuesday, , 6Saturday
Pharmionic Knowledge Centre NOV 06
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An individual example of Pharmionics
A random  patient
0Sunday1Monday 2Tuesday, , 6Saturday
Pharmionic Knowledge Centre NOV 06
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An individual example of Pharmionics
0Sunday1Monday 2Tuesday, , 6Saturday
Pharmionic Knowledge Centre NOV 06
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A population Pharmionics view
Pharmionic Knowledge Centre N 20,000 subjects
100
90
80
Proportion of subjects
Persistence
70
60
50
40
0
100
200
300
Days
Pharmionic Knowledge Centre NOV 06
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Electronic compilation of dosing histories allows

• Detailed analysis of the distributions of times
  elapsed between successive doses, the variable
  with the largest explanatory power
• Run long term projections of clinical outcomes on
  top of real life dosing histories
• Study the occurrence of most frequent errors in
  dosing like (delayed dose, skipped dose,
  overdosing, drug holiday, )
• Identify specific problems (i.e. higher
  occurrence of missed doses on weekends or with
  evening dosing)
• Detailed and timely detection of treatment
  discontinuation
• To set up the basis for successful interventions
  intended to enhance patient compliance and
  maintain long term adherence

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PKC Pharmionic Knowledge Centre offers

• A library of adherence related documents that are
  full text searchable
• More than 1,000 documents
• More than 400 peer reviewed publications
• An indexed data warehouse with pre-processed
  adherence outcomes
• More than 20,000 subjects
• More than 12 different pathologies
• A group of trained experts with proven experience
  in adherence research
• Full access to the above databases