With the level of drug related deaths (DRD) across the UK (and Scotland in particular) having reached crisis point, innovative solutions are being sought to address this challenge.
This led to the establishment of Scotland’s Digital Inclusion for Drug Related Death Prevention Group - an inclusive network of non-commercial stakeholders – interested in exploring the opportunities of using Telehealthcare and digital technology to reduce drug related deaths (DRD).
This collaborative network brings together a wealth of skills, experience and knowledge and comprises representatives from:
“Collaborative innovation to address key health and social care challenges is central to our strategy in Health Innovation SE Scotland. Drug related deaths are a clear priority and under-researched area given current trends and the links to social deprivation and inequality. This programme provides a real opportunity to improve care and support for people at risk of this tragic cause of death. The programme is an excellent fit for the collaborative working between academic, NHS, social care, and private sector partners which we believe can provide innovative solutions to improve the lives of our citizens.”
[Professor Tim Walsh. Director of Research & Innovation NHS Lothian and HISES]
Moira Mackenzie, Deputy CEO of the DHI advised “innovative collaborations like this are invaluable in creating opportunities to utilise technological advances for societal good”.
Tele-healthcare
“Telehealth involves the use of telecommunications and virtual technology to deliver health care outside of traditional health-care facilities.” [World Health Organisation]
The last decade has seen considerable investment and interest in tele-healthcare solutions to supporting independent living for the frail, elderly and those with long term conditions such as diabetes and epilepsy.
No bespoke product is yet commercially available in the UK for the detection of overdose and prevention of DRD. However, there are several products with potential for the target population of people who use drugs.
Vital signs monitoring
Technology to monitor vital signs is an obvious application to consider.
All opiates supress respiration. In an overdose the rate of breathing falls such that there is insufficient oxygen in the blood to supply vital organs and the heart stops. This effect will be accentuated if there has been ingestion of other sedatives such as benzodiazepines or alcohol.
There are a few vital sign monitoring devices which are being tested and explored for DRD prevention. The technologies involved include:
Movement/accelerometers for gross motor movement
Pulse oximetry which measures blood oxygen levels
Heart rate monitors
Electrodermal activity which measure skin temperature and sweating
Respiration movement– using either sonar or radar
Heart rate monitors
These technologies are included in devices which can be worn as chest straps/arm monitors/wristband; finger sensors (blood oxygen) and patches that measure ECG and respiration.
Challenges to using this technology
Having a sufficiently quick response to emergency situations
The increasing number of ageing people who use drugs and live alone
There has been a rise (in Scotland) in cases in which benzodiazepines and gabapentinoids are implicated in DRD. This may alter the physiological manifestation and time between drug(s) being ingested and overdose effect
Acceptability of any potential devices to the target population. Consultation with people with lived experience indicated some people may be wary about wearing any monitors in case of data sharing or police tracking
Opportunities to using this technology
The big technology companies who operate in the wearables and telehealth sector have not yet shown interest in this application of their technology. Development thus far has been through small start-up and university spin-off companies but the time to secure the required approvals and licenses for new medical devices may be a barrier for bespoke DRD tele-healthcare devices in the UK.
Using existing technologies provides an expedient opportunity if we are to harness the benefits of technology in our current DRD crisis.
The Current Situation
The types of tele-healthcare currently being tested or considered for people at risk of DRD are:
Wearables –wristbands, patches, tags for DRD prevention
Room monitors: smartphone apps, monitors for DRD prevention
Alert Buttons for emergency response to DRD
Smartphone apps for naloxone network emergency response
Smartphone apps for information on overdose prevention
Smart phone apps for recovery support
Professor Catriona Matheson, Chair of the Drug Deaths Taskforce said, “the application of technology in this area in Scotland is currently very limited and must be developed at pace to meet the challenge of reducing DRD.”
Testing and implementing technological contributions to a reduction in DRD in a timely and effective manner will need buy-in from professionals working with people, technologists as well as policy makers.
The Drugs Research Network Scotland (DRNS) are coordinating the development and testing of tele-healthcare via the Digital Inclusion for DRD prevention group.
If you are keen to develop collaborations in this area, are involved or interested in testing or developing any such technology please get in touch.
Blog author:
Catriona Matheson, Health Research Consultant, Professor of Substance Use, University of Stirling