Institute of Biomedical Engineering, National Tsing Hua University, Hsinchu, Taiwan; Department of Emergency Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Institute of Biomedical Engineering, National Tsing Hua University, Hsinchu, Taiwan.
J Control Release. 2022 Feb;342:26-30. doi: 10.1016/j.jconrel.2021.12.028. Epub 2021 Dec 24.
The Coronavirus Disease (COVID-19) pandemic has reshaped clinical chronic disease management. Patients reduced the number of physical clinic visits for regular follow-up care because of the pandemic. However, in developing countries, the scattered healthcare system hindered accessibility to clinical consultation, and poorly controlled chronic diseases resulted in numerous complications. Furthermore, the longer patients suffered from the chronic disease being treated, the more physical and psychological stress they experienced. "Diabetes Burnout," as an example, is a term to describe the phenomenon of psychological reluctance in long-term glycemic control. A comprehensive, patient-centered, and automatic drug administration and delivery model may reduce patient stress and increase compliance. Potential next-generation medication platforms, consisting of internal regulation and external interaction, may conduct autonomous dose adjustment and continuous selfmonitoring with the assistance of artificial intelligence, telemedicine, and wireless technologies. Internal regulation forms a closed-loop system in which drug administration is optimized in an implanted drug-releasing device according to a patient's physiopathological response. The other feature, external interaction, creates an ecosystem among patients, healthcare providers, and pharmaceutical researchers to monitor and adjust post-market therapeutic efficacy and safety. These platforms may provide a solution for self-medication and self-care for a wide variety of patients but may be life-changing for patients who live in developing countries where the healthcare system is scattered, as they could effectively remove healthcare barriers. As the technology matures, these self-administrated platforms may become more available and increasingly affordable, offering considerable impact to health and wellness efforts worldwide.
译文:
冠状病毒病(COVID-19)大流行改变了慢性病的临床管理模式。由于大流行,患者减少了进行常规随访护理的实体诊所就诊次数。然而,在发展中国家,分散的医疗保健系统阻碍了临床咨询的可及性,并且慢性疾病控制不佳导致了许多并发症。此外,患者患有的慢性病治疗时间越长,他们所经历的身体和心理压力就越大。“糖尿病倦怠”就是一个描述长期血糖控制中出现心理抵触现象的术语。综合的、以患者为中心的、自动药物管理和输送模式可以减轻患者压力并提高依从性。潜在的下一代药物平台,包括内部调节和外部互动,可能会在人工智能、远程医疗和无线技术的协助下,进行自主剂量调整和持续的自我监测。内部调节形成一个闭环系统,根据患者的生理病理反应,在植入式药物释放装置中优化药物管理。另一个特征是外部互动,它在患者、医疗保健提供者和制药研究人员之间创建了一个生态系统,以监测和调整上市后的治疗效果和安全性。这些平台可能为各种患者提供自我治疗和自我护理的解决方案,但对于那些生活在医疗保健系统分散的发展中国家的患者来说,这些平台可能会改变他们的生活,因为这些平台可以有效地消除医疗保健障碍。随着技术的成熟,这些自我管理的平台可能会变得更加普及和负担得起,从而对全球的健康和保健工作产生重大影响。