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NextGen: Next Generation Ingestible Sensors for Medication Adherence Measurement

Sponsor
Brigham and Women's Hospital (Other)
Overall Status
Recruiting
CT.gov ID
NCT05592613
Collaborator
The Fenway Institute (Other)
30
Enrollment
1
Location
2
Arms
7.3
Anticipated Duration (Months)
4.1
Patients Per Site Per Month

Study Details

Study Description

Brief Summary

This study will investigate the use of a next-generation Reader as part of a digital pill system (DPS; ID-Cap System) to measure adherence to both antiretroviral therapy (ART) and pre-exposure prophylaxis (PrEP) in people living with HIV (PLWH) and HIV-negative individuals, respectively. During the first (non-human subjects) component of this study, we developed a wrist-borne Reader according to design specifications and preferences shared by DPS users from our previous studies. Early bench testing by etectRx (manufacturer of the ID-Cap System) demonstrated that the wrist-borne version of the Reader acquires signal from the digital pill. This study will therefore evaluate the usability of and user response to a wrist-borne Reader component of the DPS among PLWH on ART and HIV-negative individuals on PrEP.

Condition or Disease Intervention/Treatment Phase
  • Device: Next-generation Reader and ID-Cap System
  • Drug: Truvada for pre-exposure prophylaxis (PrEP)
  • Drug: Biktarvy for antiretroviral therapy (ART)
 Phase 3

Detailed Description

This is a single-arm, observational trial (N=30), which will enroll N=15 people living with HIV (PLWH) using Biktarvy as antiretroviral therapy (ART) and N=15 HIV-negative individuals using Truvada as pre-exposure prophylaxis (PrEP). Potential participants will be approached and pre-screened. Those who meet pre-screening criteria will attend a Screening Visit (Visit 1), where the informed consent process will be conducted and eligibility will be confirmed. Eligible participants will attend a total of 3 study visits: the Screening Visit (Visit 1), Enrollment Visit (Visit 2), and Month 1 Visit (Visit 3). Participants will take one digital pill per day (Biktarvy as ART or Truvada as PrEP) for 30 days total, while using the next-generation Reader with a digital pill system, the ID-Cap System. Timeline followback discussions will be conducted at the Month 1 Visit to understand the context of any nonadherence detected by the digital pill system. Qualitative user experience exit interviews, quantitative assessments, dried blood spots (DBS), and pill counts of unused medication will also be conducted at the Month 1 Visit.

Study Design

Study Type:
Interventional
Anticipated Enrollment :
30 participants
Allocation:
Non-Randomized
Intervention Model:
Parallel Assignment
Intervention Model Description:
For 30 days, the next-generation Reader and ID-Cap System will be used in an open-label, observational trial with N=30 participants (N=15 HIV-negative individuals on PrEP and N=15 PLWH on ART).For 30 days, the next-generation Reader and ID-Cap System will be used in an open-label, observational trial with N=30 participants (N=15 HIV-negative individuals on PrEP and N=15 PLWH on ART).
Masking:
None (Open Label)
Primary Purpose:
Other
Official Title:
ID Cap System: Next Generation Ingestible Sensors for Medication Adherence Measurement
Anticipated Study Start Date :
Dec 20, 2022
Anticipated Primary Completion Date :
May 30, 2023
Anticipated Study Completion Date :
Jul 30, 2023

Arms and Interventions

Arm Intervention/Treatment
Experimental: PrEP Participants

Participants will ingest one Truvada digital pill as PrEP per day, for 30 days total, while using the next-generation Reader and ID-Cap System.

Device: Next-generation Reader and ID-Cap System
The digital pill system (DPS) is comprised of an ingestible radiofrequency emitter, integrated into a standard gelatin capsule, which then over-encapsulates the study medication (PrEP or ART). On ingestion, the radiofrequency emitter is activated by chloride ions in the stomach, projecting a signal approximately three feet off the body. This radio signal is acquired by a wearable device (Reader) which stores and forwards data to a smartphone, enabling on-demand access to adherence data. The next-generation Reader is a wrist-borne device.
Other Names:
  • Digital pill system

    • Drug: Truvada for pre-exposure prophylaxis (PrEP)
    Participants will ingest one Truvada digital pill as PrEP per day, for 30 days total.
    Experimental: ART Participants

    Participants will ingest one Biktarvy digital pill as ART per day, for 30 days total, while using the next-generation Reader and ID-Cap System.

    Device: Next-generation Reader and ID-Cap System
    The digital pill system (DPS) is comprised of an ingestible radiofrequency emitter, integrated into a standard gelatin capsule, which then over-encapsulates the study medication (PrEP or ART). On ingestion, the radiofrequency emitter is activated by chloride ions in the stomach, projecting a signal approximately three feet off the body. This radio signal is acquired by a wearable device (Reader) which stores and forwards data to a smartphone, enabling on-demand access to adherence data. The next-generation Reader is a wrist-borne device.
    Other Names:
  • Digital pill system

    • Drug: Biktarvy for antiretroviral therapy (ART)
    Participants will ingest one Biktarvy digital pill as ART per day, for 30 days total.

    Outcome Measures

    Primary Outcome Measures

    1. Feasibility of Next-Generation ID-Cap System to Measure PrEP/ART Adherence [Month 1 study visit]

      Participants' engagement with the digital pill system (DPS) -- the next-generation ID-Cap System -- will be measured over the 30-day study period. The percentages for the total expected ingestions recorded by the DPS each month will be compared to adherence detected by the DPS.

    2. Correlation of PrEP/ART Adherence with DBS Concentrations and Pill Counts [Month 1 study visit]

      Correlation of PrEP/ART adherence patterns, as detected by the next-generation ID-Cap System, with tenofovir diphosphate concentrations in dried blood spots (DBS) and pill counts of unused digital pills following the 30-day study period.

    3. Acceptability of Next-Generation ID-Cap System, via System Usability Scale [Month 1 study visit]

      Acceptability will be measured via the System Usability Scale (SUS). The SUS is a 10-item measure of perceived usability of a technological system, scored on a 5-point Likert scale (1: strongly disagree, 5: strongly agree), with higher scores indicating greater perceived usability. A mean score of >68 will be used to indicate that the technology is acceptable.

    4. Acceptability of Next-Generation ID-Cap System, via Qualitative Interviews [Month 1 study visit]

      Acceptability will be evaluated via qualitative interviews exploring participants' lived experiences operating the next-generation ID-Cap system and suggestions for improving the design of the technology.

    Eligibility Criteria

    Criteria

    Ages Eligible for Study:
    18 Years and Older
    Sexes Eligible for Study:
    All
    Accepts Healthy Volunteers:
    No
    Inclusion Criteria:
    1. PrEP Participants:

    • Age 18 or older

    • HIV negative

    • Prescribed and currently taking Truvada for PrEP for at least 30 days

    • Qualifying labs for PrEP (Cr clearance in past 6 months, HBV vaccination, liver function tests)

    • Owns a smartphone with Android or iOS

    1. ART Participants:

    • Age 18 or older

    • Diagnosed with HIV

    • Prescribed and taking Biktarvy for at least 6 months

    • Undetectable viral load during prior 6 months

    • Owns a smartphone with Android or iOS

    Exclusion Criteria:
    1. PrEP Participants:

    • Does not speak English

    • History of Crohn's disease or ulcerative colitis

    • History of gastric bypass or bowel stricture

    • History of GI malignancy or radiation to abdomen

    • Allergy to gelatin, silver, or zinc

    • Implanted cardiac device, nerve stimulator, or drug infusion pump

    • Not willing to operate DPS

    1. ART Participants:

    • Does not speak English

    • History of Crohn's disease or ulcerative colitis

    • History of gastric bypass or bowel stricture

    • History of GI malignancy or radiation to abdomen

    • Allergy to gelatin, silver, or zinc

    • Implanted cardiac device, nerve stimulator, or drug infusion pump

    • Not willing to operate DPS

    Contacts and Locations

    Locations

    Site City State Country Postal Code
    1 Fenway Health Boston Massachusetts United States 02215

    Sponsors and Collaborators

    • Brigham and Women's Hospital
    • The Fenway Institute

    Investigators

    • Principal Investigator: Peter Chai, MD, MMS, Brigham and Women's Hospital

    Study Documents (Full-Text)

    None provided.

    More Information

    Publications

    None provided.
    Responsible Party:
    Peter R Chai, Emergency Medicine Physician, Brigham and Women's Hospital
    ClinicalTrials.gov Identifier:
    NCT05592613
    Other Study ID Numbers:
    • 2022P002497
    First Posted:
    Oct 24, 2022
    Last Update Posted:
    Dec 22, 2022
    Last Verified:
    Dec 1, 2022
    Individual Participant Data (IPD) Sharing Statement:
    No
    Plan to Share IPD:
    No
    Studies a U.S. FDA-regulated Drug Product:
    Yes
    Studies a U.S. FDA-regulated Device Product:
    Yes
    Product Manufactured in and Exported from the U.S.:
    No
    Keywords provided by Peter R Chai, Emergency Medicine Physician, Brigham and Women's Hospital
    Digital Pill System
    Pre-Exposure Prophylaxis
    Antiretroviral Therapy
    Adherence
    Additional relevant MeSH terms:
    HIV Infections
    Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination
    Anti-Retroviral Agents

    Study Results

    No Results Posted as of Dec 22, 2022