nach oben

Journal of General Internal Medicine

Erschienen in:

01.03.2016 | Perspective

Ethical Questions in Medical Electronic Adherence Monitoring

verfasst von: Jeffrey I. Campbell, BA, Nir Eyal, DPhil, Angella Musiimenta, PhD, Jessica E. Haberer, MD

Erschienen in: Journal of General Internal Medicine | Ausgabe 3/2016

Einloggen, um Zugang zu erhalten

Abstract

Electronic adherence monitors (EAMs) record and report an array of health behaviors, ranging from taking daily medications to wearing medical devices. EAMs are utilized in research worldwide and are being investigated for clinical use. However, there is also growing popular concern about the extent to which electronic devices may be used to monitor individuals, including allegations in the media that EAMs represent a move towards “Big Brother” in medicine. Here, we highlight the unique benefits as well as the potential ethical challenges that electronic adherence monitoring generates. These challenges surround autonomy, privacy and confidentiality, trust, and ancillary care obligations. We describe key questions within each of these domains that warrant further investigation, and present potential solutions to many of the concerns raised.

Rand CS, Sevick MA. Ethics in adherence promotion and monitoring. Control Clin Trials. 2000;21:241S–7S.CrossRefPubMed

Rapoff MA. Adherence to pediatric medical regimens. New York: Kluwer Academic/Plenum Publishers; 1999.

Ganyo M, Dunn M, Hope T. Ethical issues in the use of fall detectors. Ageing Soc. 2011;31(08):1350–67. doi:10.1017/S0144686X10001443.CrossRef

Percival J, Hanson J. Big brother or brave new world? Telecare and its implications for older people’s independence and social inclusion. Crit Soc Policy. 2006;26(4):888–909. doi:10.1177/0261018306068480.CrossRef

Haberer JE, Kahane J, Kigozi I, Emenyonu N, Hunt P, Martin J, et al. Real-time adherence monitoring for HIV antiretroviral therapy. AIDS Behav. 2010;14(6):1340–6. doi:10.1007/s10461-010-9799-4.PubMedCentralCrossRefPubMed

Essen A. The two facets of electronic care surveillance: an exploration of the views of older people who live with monitoring devices. Soc Sci Med. 2008;67(1):128–36. doi:10.1016/j.socscimed.2008.03.005.CrossRefPubMed

Courtney KL, Demiris G, Hensel BK. Obtrusiveness of information-based assistive technologies as perceived by older adults in residential care facilities: a secondary analysis. Med Inform Internet Med. 2007;32(3):241–9. doi:10.1080/14639230701447735.CrossRefPubMed

Kribbs NB, Pack AI, Kline LR, Smith PL, Schwartz AR, Schubert NM, et al. Objective measurement of patterns of nasal CPAP use by patients with obstructive sleep apnea. Am Rev Respir Dis. 1993;147(4):887–95. doi:10.1164/ajrccm/147.4.887.CrossRefPubMed

DiCarlo LA. Role for direct electronic verification of pharmaceutical ingestion in pharmaceutical development. Contemp Clin Trials. 2012;33(4):593–600. doi:10.1016/j.cct.2012.03.008.CrossRefPubMed

10.

Lyimo RA, van den Boogaard J, Msoka E, Hospers HJ, van der Ven A, Mushi D, et al. Measuring adherence to antiretroviral therapy in northern Tanzania: feasibility and acceptability of the medication event monitoring system. BMC Public Health. 2011;11:92. doi:10.1186/1471-2458-11-92.PubMedCentralCrossRefPubMed

11.

Raz J. The Morality of Freedom. Oxford: Clarendon; 1986.

12.

Beauchamp TL. In: Miller F, Wertheimer R, eds. “Consent and Autonomy.” The Ethics of Consent. New York: Oxford University Press; 2010:55–78.

13.

Elster J. Ulysses and the Sirens: studies in rationality and irrationality. New York, NY: Cambridge University Press; 1984.

14.

Bogard W. Surveillance assemblages and lines of flight. In: Lyon D, ed. Theorizing surveillance: the panopticon and beyond. Devon, UK: Willan Publishing; 2006:97-122.

15.

Nicholson GP, Ferguson-Pell MW, Smith K, Edgar M, Morley T. The objective measurement of spinal orthosis use for the treatment of adolescent idiopathic scoliosis. Spine. 2003;28(19):2243–50. doi:10.1097/01.BRS.0000085098.69522.52. discussion 50-1.CrossRefPubMed

16.

Krezanoski P, Santorino D, Campbell J, Nambogo N. Maternal acceptability of objective monitoring of household bednet use in Uganda. Proceedings of the 63rd Annual Meeting of the American Society of Tropical Medicine and Hygiene; New Orleans, LA, November 2-6, 2014.

17.

Bachman Desilva M, Gifford AL, Keyi X, Li Z, Feng C, Brooks M, et al. Feasibility and acceptability of a real-time adherence device among HIV-positive IDU patients in China. AIDS Res Treat. 2013;2013:957862. doi:10.1155/2013/957862.PubMedCentralPubMed

18.

Pisarski E, Wyatt M, Tam M, Atukunda E, Musiimenta A, Haberer J, et al. Experiences of Wisepill-Facilitated HIV Disclosure in Rural Southwestern Uganda. Proceedings of the 10th International Conference on HIV Treatment and Prevention Adherence. Miami, FL, June 28-30, 2015.

19.

United States. Health Insurance Portability and Accountability Act of 1996. Public Law 104-191. United States statutes at large. 1996;110:1936-2103.

20.

Abelson R, Goldstein M. Millions of Anthem Customers Targeted in Cyberattack. New York Times. February 5, 2015; Sect. B:1. Accessed online at: http://www.nytimes.com/2015/02/05/business/hackers-breached-data-of-millions-insurer-says.html. Last accessed July 1, 2015.

21.

Townsend B. mHealth Regulation Impact Assessment: Africa. Accessed online at: http://www.gsma.com/mobilefordevelopment/wp-content/uploads/2015/03/003-GSMA-RIA-Africa-27feb15.pdf. Last accessed July 1, 2015. Sponsored by the Groupe Speciale Mobile Association.

22.

Moore A. Privacy: its meaning and value. Am Philos Q. 2003;40:215–27.

23.

Safren SA, Kumarasamy N, Hosseinipour M, Harwood MM, Hoffman I, McCauley M, et al. Perceptions about the acceptability of assessments of HIV medication adherence in Lilongwe, Malawi and Chennai. India AIDS Behav. 2006;10(4):443–50. doi:10.1007/s10461-006-9094-6.CrossRefPubMed

24.

Konkle-Parker DJ, Erlen JA, Dubbert PM. Lessons learned from an HIV adherence pilot study in the Deep South. Patient Educ Couns. 2010;78(1):91–6. doi:10.1016/j.pec.2009.04.010.PubMedCentralCrossRefPubMed

25.

van der Straten A, Montgomery E, Pillay D, Cheng H, Naidoo A, Cele Z, et al. Feasibility, performance, and acceptability of the Wisebag for potential monitoring of daily gel applicator use in Durban. South Africa AIDS Behav. 2013;17(2):640–8. doi:10.1007/s10461-012-0330-y.CrossRefPubMed

26.

Thom DH, Hall MA, Pawlson LG. Measuring patients’ trust in physicians when assessing quality of care. Health Aff. 2004;23(4):124–32.CrossRef

27.

Wolff J. Fairness, respect and the egalitarian ethos. Philos Publ Affairs. 1998;27:97–122.CrossRef

28.

Simoni JM, Montgomery A, Martin E, New M, Demas PA, Rana S. Adherence to antiretroviral therapy for pediatric HIV infection: a qualitative systematic review with recommendations for research and clinical management. Pediatrics. 2007;119(6):e1371–83. doi:10.1542/peds.2006-1232.CrossRefPubMed

29.

Ellingson K, Polgreen PM, Schneider A, Shinkunas L, Kaldjian LC, Wright D, et al. Healthcare personnel perceptions of hand hygiene monitoring technology. Infect Control Hospital Epidemiol : Off J Soc Hospital Epidemiol Am. 2011;32(11):1091–6. doi:10.1086/662179.CrossRef

30.

Robin AL, Novack GD, Covert DW, Crockett RS, Marcic TS. Adherence in glaucoma: objective measurements of once-daily and adjunctive medication use. Am J Ophthalmol. 2007;144(4):533–40. doi:10.1016/j.ajo.2007.06.012.CrossRefPubMed

31.

Mittelstadt B, Fairweather B, Shaw M, McBride N. The ethical implications of personal health monitoring. Int J Technoethics (IJT). 2014;5(2):37–60.CrossRef

32.

Haberer JE, Kiwanuka J, Nansera D, Muzoora C, Hunt PW, So J, et al. Realtime adherence monitoring of antiretroviral therapy among HIV-infected adults and children in rural Uganda. Aids. 2013;27(13):2166–8. doi:10.1097/QAD.0b013e328363b53f.CrossRefPubMed

33.

Richardson H. Moral Entanglements: The Ancillary-Care Obligations of Medical Researchers. New York: Oxford University Press; 2012.CrossRef

34.

Participants in Georgetown University Workshop on Ancillary-Care Obligations of Medical Researchers Working in Developing Countries. The ancillary-care obligations of medical researchers working in developing countries. PLoS Medicine. 2008;5(5):e90. doi:10.1371/journal.pmed.0050090

35.

Vervloet M, van Dijk L, Santen-Reestman J, van Vlijmen B, van Wingerden P, Bouvy ML, et al. SMS reminders improve adherence to oral medication in type 2 diabetes patients who are real time electronically monitored. Int J Med Inform. 2012;81(9):594–604. doi:10.1016/j.ijmedinf.2012.05.005.CrossRefPubMed

36.

Hettinga M, Gutter T, te Gussinklo J. Real Time Medication Monitoring with customized SMS reminders for people with refractory epilepsy. eTELEMED 2013, The Fifth International Conference on eHealth, Telemedicine, and Social Medicine. Nice, FR, February 24 - March 1, 2013.

37.

Lester RT, Ritvo P, Mills EJ, Kariri A, Karanja S, Chung MH, et al. Effects of a mobile phone short message service on antiretroviral treatment adherence in Kenya (WelTel Kenya1): a randomised trial. Lancet. 2010;376(9755):1838–45. doi:10.1016/S0140-6736(10)61997-6.CrossRefPubMed

Titel: Ethical Questions in Medical Electronic Adherence Monitoring
verfasst von: Jeffrey I. Campbell, BA
Nir Eyal, DPhil
Angella Musiimenta, PhD
Jessica E. Haberer, MD
Publikationsdatum: 01.03.2016
Verlag: Springer US
Erschienen in: Journal of General Internal Medicine / Ausgabe 3/2016
Print ISSN: 0884-8734
Elektronische ISSN: 1525-1497
DOI: https://doi.org/10.1007/s11606-015-3502-4

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

25.04.2024 Allergien und Intoleranzreaktionen Nachrichten

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 3/2016

Capsule Commentary on Stevens et al., Variation in Inpatient Consultation Among Older Adults in the United States

The Role of Behavioral Health in Optimizing Care for Complex Patients in the Primary Care Setting

Barriers Influencing Linkage to Hypertension Care in Kenya: Qualitative Analysis from the LARK Hypertension Study

Patients’ Satisfaction with and Preference for Telehealth Visits

Detection of Delirium in Hospitalized Older General Medicine Patients: A Comparison of the 3D-CAM and CAM-ICU

Capsule Commentary on Bell et al., Impact of a Randomized Control Educational Trial to Improve Physician Practice Behaviors Around Screening for Inherited Breast Cancer