For example, up to 20% of the HIV and hepatitis B infections in the UK are drug resistant. Even worse, 5% of the hepatitis infections are resistant to the very latest drugs, and influenza is becoming more drug resistant (1).
So what is causing this growing problem? Is it that the pathogens are getting stronger, or, in our ageing population where one’s immune system weakens as you get older, humans are getting weaker? Or a combination of the two? We can see a ‘perfect storm’ developing where, for example, as more and more people develop diabetes due to obesity, over time they suffer from associated problems such as ulcers, and these become infected with drug-resistant bacteria. Such cases are very difficult to treat.
Now doctors and engineers are fighting back with a variety of approaches to tackle the causes and effects of drug resistance.
Better drug delivery devices can help: a major cause of drug resistance is simply from patients not finishing the course of drugs that they’ve been prescribed. With tuberculosis for example, you may be prescribed drugs for 6 to 18 months, and it’s very common for patients to stop taking their medication as soon as their symptoms subside.
Stopping a course of treatment prematurely can mean that some the pathogens survive, and those that survive are by definition the most drug resistant. They then proliferate, and other people fall ill with the new ‘improved’ strain which will be more resistant to future courses of drugs.
So drug companies and device developers are developing better drugs and devices to encourage patients to adhere to their course of drugs. Example methods of maximising adherence include reminders from a device to help people to remember to take their drugs, and/or recording doses so that people know when they have taken their drugs. This provides an opportunity for health professionals to view the records and take advantage of what’s called the Hawthorne Effect: patients are more likely to take their medicine if they are aware that their doctor will know whether they have or not.
Gamification is a new trend that can encourage adherence, where patients gain points or are rewarded if they take their doses correctly and finish their medication. This opens up a whole world of opportunities for drug companies, payers and the patients: we could have rewards such as money-off coupons for future courses of treatment, or reduced medical insurance premiums.
There is also innovation in diagnostics to address the growing issue of drug resistance – as this has increased the importance of sterility in health settings. Currently if MRSA is detected in a hospital ward, in many cases all patients have to be removed, and a deep clean carried out. Tests are then undertaken to ensure that the MRSA has been killed, but accurate results can take up to 2 days. New handheld devices can give on-the-spot diagnoses as to whether the ward is clean, effectively meaning that patients can return to the ward within 10 minutes – a significant improvement for both hospital and its patients.
There are technological innovations to address drug resistance in wider settings than just the healthcare industry – for example, in your home. Companies are looking at ways of reducing pathogens on many household goods such as chopping boards, baby bottles and lunchboxes. Silver nanoparticles are being added to products so that they slowly leach out of the material and kill bacteria on surfaces. Regulations limit the use of extractables in drug delivery devices, however, because any leachable chemicals may change the behaviour of the drug. Some products are coated with a hydrophilic substance which attracts water and therefore repels the proteins and fats on which bacteria can thrive.
As the drug resistance problem continues to grow, some products are being sterilised at higher temperatures, or with more aggressive chemicals than before. Expert medical device and consumer product developers like those at Cambridge Design Partnership are creating new designs and using the latest materials in order to be tolerant to these environments.
Drug resistance is a huge and growing challenge for societies around the world, but take some comfort in the knowledge that the world’s best engineers and scientists are already working hard on improving everyone’s health, now and for the future.
References
1. BBC. Threat of drug-resistant viruses. BBC News. [Online] 28 07 2005. Cited http://news.bbc.co.uk/1/hi/health/4724613.stm
About Cambridge Design Partnership
Cambridge Design Partnership is a consulting company that develops 'first of a kind' products in the medical, consumer and cleantech sectors. We combine leading engineering talent with business acumen and a deep understanding of the technical and human needs that drive innovation.
Cambridge Design Partnership’s multi-disciplined experts and proven process will benefit any multinational or ambitious company aiming to maximise their return on investment in innovation.
Working as an integrated team, the company creates new products with a dynamic, flexible approach that leads to enduring client relationships, anchored by high quality work and excellent customer service. Our diverse team of engineers, scientists and designers has grown rapidly to establish a world leading reputation for technical excellence, astute project management and, above all, thinking differently.
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