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Tuesday, December 14, 2010

Ventolin with GPS: Good idea?

I think a wise doctor will always know what medicines his patient is using and when he is using them. This wisdom should be obtained by monitoring pharmacy records and by a good question and answer seminar at each doctor's apointment. To me that's the job of a gallant doctor.

However, I don't think most doctors do that. I think most doctors write a prescription and let you do with it what you want. They assume you are using the medicine as prescribed. Yet they have no proof. They may ask at the appointment, but some patients lie. I dont', you may not, yet many do.

Well, I have lied in the past. When I was a kid I would never let the ER doctor know I had just used up 200 puffs from my Ventolin inhaler over the past 4 hours. I didn't, but I also thought there was some kind of test to determine how much I used. I certainly didn't want him to find out.

Yet while the ER doctor may not have known, Lord knows my regular doctor should have. Yet what choice did he have. I needed Ventolin, and he continued to renew my prescription. I asked him about it once, and he said, "If you need it you need it. It's better than not breathing and dying."

He was right. But that was way back in 1984 when my asthma was really bad and asthma wisdom was not what it is today.

So should doctors have a better way of monitoring when you use your Ventolin inhaler and how much you use? This was a topic brought up recently in the question section over at

Here is the question:

My FIRST Lego League team has been researching asthma. We are working to create an innovative solution for asthma treatment that will provide an improvement in patient care. We need experts to confirm that our idea is valid. Our idea is to add a couple of features to the rescue inhaler. We want to provide physicans with specific puff counts as well as GPS locations. We'd like the inhaler to have GSM networking capabilities for sending the information to a physican database. The doctor could then have access to more accurate information for each patient. We feel that this information could be used to better identify triggers and improve overall patient care. We believe that these features could be very compact and not change the 'portabilty' of the inhaler.

I'd appreciate any input.
After much thought about this, I wrote the following:

Sounds like a good idea yet is also sounds kind of scary. In a way the idea reminds me of the book 1984 where the government knows everything everyone does and punishes people for not living ideal lives.
Of course I had no intention of being smart or facetious, I was simply being honest. While I think it's a good idea for doctors to know where and when Ventolin is being used, this kind of power plays right into the hands of people who like to abuse power.

I think if a doctor wants to know how much we are using our Ventolin they can just ask. If a patient is too ignorant to tell the doctor the truth, then that's his problem. It's called individual responsibility.

Or am I out of whack here? Perhaps a Ventolin with a GPS system in it might be a good idea after all. Let me know what you think?



kerri said...

I agree with your thoughts here, Rick. Once you've got confirmed asthma, what choice do they have but to give you the Ventolin you need? [Especially since some of us have racked up not only our primary doc, but pulmonologists and allergists who can prescribe when we need it, too].

However, there's also the other point of using GPS-enabled inhalers for research studies--environmental asthma triggers/response and medication use . . . and perhaps even us patients being able to GPS track where the heck our inhalers are and find them when they go missing. Which, you know, would be awesome.

Pissed Off Patient said...

I'm all for locator beacons so I can find lost/misplaced asthma meds and spacers. We couldn't find the toddler's spacer for a month! (Lucky I had a spare.)

Totally down with that.

As for the rest, doctors are so busy and overworked, I can not picture this kind of data dump being a priority. It doesn't seem efficient to me.

Rather, I would focus on patient education up front so they know why they need their meds to increase compliance.

I think increasing compliance because patients understand their care vs. being spied on is better. Also creates less hostility in the patient-doctor relationship.

Of course education means finding time and creating programs, which is probably more work and money than a data dump.

Plus, what if I'm finishing up meds from another prescriber? I'd look like a total non-compliant patient when I just hadn't gotten around to using the inhaler yet.

Eh, I say go fish for a better idea.


Rick Frea said...

GPS to find missing inhalers. That would be a great idea. For research it might be a good idea too. Yet only if by individual choice. IMO.

Rick Frea said...

Good point Pissed off patient.