Ngaba wake wakhawula ukuthabatha amayeza akho? Okanye, ngaba unqamle ikhosi ye antibiotics kusasa kuba sele usuziva ungcono? Ukuba kunjalo, awunabo. Ngama-50 ekhulwini abantu abangathathi amachiza njengoko kuchaziwe, ukunyanzeliswa kwamachiza kuye kwaba ngumngeni omkhulu kwinkqubo yokunakekelwa kwezempilo yase-United States.
Umzamo omkhulu uye wangena kwiindlela ezintsha zokuphucula ukuthotyelwa kwethu, kunye nezisombululo ezininzi zedijithali nezisezantsi ezisekhoyo kwimarike.
Iibhokisi zeepilisi, imiyalezo yombhalo kunye neebhotile ezixhotywe nge-chip zizonke zisetyenziselwa njengezicwangciso ezinokuphucula ukunyanzelisa imithi. Nangona kunjalo, ezi ndlela zinobuchule azange zinikezele ubungqina obunyanzelekileyo, ukuba ubungqina bokuba umntu uye wagxuba amayeza.
Ukufika kwe "ipilisi ehlakaniphile" ehlanganiswe nesinzwa ngoku inika indlela yokulandelela izilwanyana. Le teknoloji entsha yezobugcisa ithole ingqalelo enkulu kwenzululwazi kunye neendaba, kunye nokuphendula okuvela kuluntu. Ingaba i pilisi ekwazi ukuthumela ulwazi ukusuka kwigazi (okanye i-tractes tract) ixhasa impilo yethu ngendlela entsha? Kwaye, ngaba kukho nayiphi na ingqalelo malunga neepilisi zedijithali ezitsha ezifuneka zihlolwe ngaphambi kokufumana le teknoloji entsha?
I-FDA iyavuma iPilisi yokuqala yeDijithi
NgoNovemba ka-2017, i-US Food and Drug Administration (FDA) yavuma isigulo sokuqala esinesistim yokulandelela idijithali.
Iipilisi ezivunyiweyo zenziwa yi-Otsuka Pharmaceutical Co. Ukususela ngoJulayi 2012, u-Otsuka usebenze neenkampani zaseCalifornia inkampani iProteus Digital Health ukufaka isilwanyana se-antipsychotic esele ikhona i-Abilify (igama lomenzi we-aripiprazole) nge-marker ingerable marker (IEM). Imveliso entsha, i-Abilify MyCite, inokuyibona ukuba imithi ithathwe.
I-sensor eyenziwe yethusi, i-magnesium, kunye ne-silicon-yenzelwe ukuthumela uphawu lombane kummkeli wangaphandle xa iipilisi ixubana nesisu somthamo.
Umamkeli (okwangoku i-patch) igqitywe kwi-cube yomnquba osekhohlo. Iqhosha lidibanisa ne-app ye-smartphone nge-Bluetooth kwaye inikezela ngolwazi ngosuku kunye nexesha elithathwe ngamayeza. Le ngcaciso ingathunyelwa kwiqela labantu abakhethiweyo (ukuya kutsho) kusekelwe kwimvume yomsebenzisi. Ipilisi yedijithali enokulindeleke ukuba iphumelele ngo-2018 kwaye iyakulandelwa yiminye imikhiqizo kwisiza seziyobisi zedijithali.
I-teknoloji eyenziwe yiProteus ifakiwe kwezinye iindawo zonyango. I-sensor engabonakaliyo (ezizimeleyo nakweyiphi na isicatshulwa) ifunyenwe yi-FDA imvume kakade ngo-2012. Sekusetyenziswe ukusetyenziswa iziyobisi ezinokusetyenziswa kwegazi kunye nohlobo lwesibini lwe-diabetes. Izicwangciso zokulinganisa ukunyanzelisa abantu abane-Alzheimer's disease, i-hepatitis C kunye nalabo abasandul 'ukuphuma kwizibhedlele kuye kwabhalwa kwakhona. I-Abilify MyCite, ngoko ke, kuphela yilungu lentsapho yeProteus yeepilisi zedijithali.
Enyanisweni, ukukhethwa kwe-FDA yepilisi ye-digital yokuqala evunyelweyo kuye kwamangalisa ezinye iingcali.
I-Abilify isilwanyana esisetyenziselwa unyango lweemeko ezithile zengqondo, kubandakanya i-schizophrenia, i-bipolar disorder, kunye noxinzelelo. Abanye bathi i-Abilify kwifomu yepilitidi ye-digital ayiyi kwamkeleka kakuhle ngabantu (sele bekhona) bafumana iinjongo ze-paranoid kwaye baneemvakalelo eziqhubekayo ezibukeleyo okanye ezitshutshiswayo. Ukucetyiswa kumntu onempawu ze-schizophrenia ukugwinya ipilisi eyoyithumela imiqondiso emzimbeni wayo inokuba nzima ngakumbi imeko yabo. Ngako oko, igalelo lamagqirha liya kuba luleke kakhulu ukuseka ukuba yeyiphi abantu abanokufumana inzuzo kwipilisi entsha yokulandelela kwaye inokubangelwa yingozi.
Ulungelelaniso lokuzilawula okanye uMzalwana Omkhulu?
Ngelixa iipilisi zedijithali zinganika ulwazi olubalulekileyo malunga nokunyanzeliswa kwamachiza (kunye nemeko yomntu kwezinye iimeko) ezininzi iinkxalabo ziye zaphakanyiswa malunga nokusetyenziswa kwazo (umzekelo, ukuziphatha, ubumfihlo kunye nokukhuseleko kwedatha). Ngokomzekelo, ukuba izidakamizwa zedijithali ziphakanyisiwe kubantu abangenalo ikhono lokuqonda yonke impembelelo yokwabelana ngedatha, ukunyusa lolu hlobo lwetheknoloji kubo kunokubhekwa njengento yokunyanzelisa. Omnye umzekelo wokusetyenziswa okungathandabuzekiyo kubandakanya iinkampani zomshuwalense ezinika inkxaso ephakamileyo yezipilisi ezineenzwa, ukunyanzelisa abanye abantu ukuba bathathe imishanguzo yedijithali enokuthi iyakwandisa ukusebenzisa ngokuthobela.
Kuye kwacetyiswa ukuba kwixesha elizayo, iipilisi zedijithali zingaba yimeko yokubhaliweyo. Bangaba yimeko yokukhutshwa esibhedlele-umntu unokucinga ukuba umhlaba uya kufuneke ukuba uvumele ukulandelela ukunyanzela kwakho unyango ngaphambi kokukhutshwa. Iinkampani ezifana ne-Otsuka ingxelo ingabi nolwazi lwezicwangciso ezinjalo. Nangona kunjalo, kunzima ukuqikelela ukuba le teknoloji izakusetyenziswa njani kwikamva.
U-Amelia Montgomery ubhala kwi- Vanderbilt Journal yezoLonwabo kunye neTeknoloji yoMthetho ukuba akucaci nokokuba imithetho yomsesekelo iza kusebenza kwiipilisi zedijithali e-United States. I-Montgomery icacisa ukuba iipilisi zedijithali zingenako ukuhlolisiswa koMthetho we- Inshurensi yokuPhathwa kwe-Intshuwalense kunye ne-Accountability Act (i-HIPAA) njengoko isebenza kwezinye iinkcukacha zezempilo. Kuya kuba nzima ukuba kuqinisekiswe ukuchithwa kwedatha. Iimvakalelo, ezinjengezo zenziwe ngu-Proteus, zinokubamba iinkcukacha ezininzi malunga nomntu, okwenza kube lula ukucwangcisa umntu ngeendlela umntu angaziqondi.
Ukunika Abantu Ikhethelo
Ngethamsanqa, amanyathelo amanyathelo okukhusela ayenzelwe ukunciphisa ezinye iinkxalabo zokuziphatha malunga neepilisi zedijithali. Ngokomzekelo, iipilisi ngoku zenzelwe ngokokuba umsebenzisi unamandla okulawula ngokumalunga nolwazi lwakhe nolwabelwana ngalo. Ukongezelela, umsebenzisi unokurhoxisa imvume kuyo nayiphi na into ngaphandle kokulandela. Kwakhona, ekubeni iteknoloji yedijithali yedijithali incike kubantu abembethe i-patch (okanye i-transmitter), kunye nokusebenzisa isicelo se-smartphone, ukuthatha inxaxheba kuxhomekeke ekuzimisele kwabo ukusebenzisa izixhobo ezongezelelweyo.
Nangona kunjalo, ezinye iingcali zikholelwa ukuba ukusetyenziswa kweepilisi zedijithali kufuneka kubekwe kwiimeko ezithile, ezifana nezilingo zamachiza apho kubalulekile ukuqinisekisa ukuba amayeza athatyathwa ngabathathi-nxaxheba ukunyusa ubungqina bophando. Enyanisweni, ukusebenzisa iipilisi zedijithali kunokunciphisa kakhulu iindleko zezilingo zamachiza, kunye nokuphucula ukuchaneka kwazo. Kulindeleke ukuba amanye amaqela abantu avuleke ngakumbi ukusebenzisa iipilisi zedijithali. Umzekelo, abantu asebekhulile abaye bahlakulela ubunzima beengcamango ezinokuthi zikhohlwe ukuthatha amayeza (okanye zithathe kabini) ngaphandle kokuba uncediswe lolu hlobo lwethekhnoloji yezempilo.
Abanye ke, bathi, ukulinganisela kufuneka kuhlaselwe phakathi kokukhusela ubumfihlo kunye nokugqithisa ummandla weepilisi zedijithali. UMontgomery uxela ukuba izingozi kubasebenzisi ziphantsi xa ziqhathaniswa nokulungelelanisa, ukunciphisa indleko kunye neenzuzo zezempilo ezi zinikezela ngeteknoloji entsha.
Ngethuba nje ukuba imvume enolwazi iqhutywe ngokukhawuleza xa iyalenza iipilisi zedijithali, ezininzi iinkxalabo zokuziphatha zingaphathwa. Ukuba abasebenzisi beepilisi ezintsha banikwa ngokubhengezwa kakuhle, kunye nokukwazi ukubuza imibuzo, oku kubanika amandla ukuba bamkele okanye bayeke iipilisi zedijithali ngaphambi kokuba bathenge. Ngakolunye uhlangothi, oku kungenzela umthwalo owongezelelweyo kunye noxinzelelo lwexesha kwiingcali, ngoko kusenokuba yintoni isisombululo esona sinene.
Ngaba iiPilisi zeDajari ziyakwandisa ngokwenene ukunyaniseka?
Akukasekwa ukuba izixhobo zedivayisi yezixhobo zonyango ziza kubangela ukunyanzelisa imithi. I-MyCite yamandla ibuye ne-disclaimer ukuba ukuqokelela kwedatha akufanele kusetyenziswe kwiimeko ezixakeka, njengoko ukulandelela kunokulibaziseka okanye kungenzeki nhlobo. Iingcali ngezempilo zedijithali, kuquka u-Eric Topol we-Scripps I-Scientific Translation, yatsho ukuba kuya kuthatha ixesha ngaphambi kokuba le teknoloji yezempilo entsha inokuchaphazela ukunamathela ngendlela eninzi. Abantu abasebenzisa iipilisi zedijithali banokwenqaba (okanye ukulibala) ukuba unxibe iqhosha elihambayo elifunekayo lokutshintshwa kwimihla ngemihla ezisixhenxe ukuqokelela ngokufanelekileyo impawu ezisuka kwipilisi eginyiweyo.
Izifundo zokuqala zokuthobela zifumene ukuba izixhobo ezahlukeneyo, zombini uphakamileyo kunye ne-tech-tech, ziphucula ukuthobela. Uphando oluqhutywe nguProteus lubonise ukuba abantu abanamachiza anokwenza isifo soxinzelelo olungalawulwayo kwaye uhlobo lwe-2 lwesifo sikashukela luphumelele kwiziphumo ezingcono (kwaye banokufikelela kwiinjongo zabo zonyango) xa kuthelekiswa nabantu abathatha imithi efanelekileyo. Oku kunokwenzeka ukuba kubangelwe ukunyanzeliswa kwamachiza okuphuculweyo.
Iingxaki zeeNkqubo zePilisi zePilisi
Okwangoku, abanye abantu kwi-Abilify bafuna le nkunkuma ye-antipsychotic kodwa bangahambisani ne-prescribed drug regime bafumana i-Abilify njenge-injection yenyanga nganye ukukhusela ukuvela kwakhona kweempawu zabo. Oku kubonisa ukuba sele sele sinesisombululo esincinci sokungahambelani. Akucaci ukuba kunjalo, ukuba abantu abanemiqathango yokuthobela bayakukhetha ipilisi yedijithali kumjovo. Ngaphezulu koko, kwezinye iindawo zonyango, iilenjini zenyanga aziyiyo inokukhetha. Ngako oko, iziyobisi ezinokwenzela izixhobo zingaphumelela ngakumbi kwiimeko ezinjalo.
UProfesa oncedisayo uPeter Chai, ugqirha wezoxakeka kwi-Brigham kunye neSibhedlele seBhinqa eBoston, wasebenzisa iteknoloji yedijithali kwiphando lwakutshanje ukuzama ukukhusela ukusetyenziswa kakubi kwe-opioid-umcimbi osasazayo eMelika. Ama-opioids amaninzi atyunjwe kwisiseko esifanelekileyo kubantu abaneentlungu ezinzima. Umthamo kunye namaxesha amaninzi zihlala zisekwe ekuqaliseni kwintlungu yesifo, esenza ingozi yokugqithisa ngokweqile kunye nokusetyenziswa kakubi. U-Chai kunye neqela lakhe bafumene ukuba iinkqubo zeepilisi zedijithali zinokukunceda ukujonga ukungena kwe-opioid ngexesha langempela.
Bacetyisa ukuba ukungenelela kungasetyenziselwa kungekudala ukusetyenziswa gwenxa, ukunciphisa ingozi yengozi. Abantu abaye bathatha inxaxheba kwisifundo sabo bafumana iipilisi zamanqaku ezidibeneyo kwaye zizimisele ukuqhubeka zizithatha. Ucwaningo lwe-Chai lubonisa ukuba iipilisi ezinokuncedisa inzwa zinomlinganiselo obanzi wokusetyenziswa, umzekelo, kunye neyeza ezinobungozi obuphezulu kunye namaqela abantu abangaqhagamshelana rhoqo nabaqeqeshi bempilo.
Ukujonga Ngomso
Iipatches (eziquka ezo zisetyenziswe ngeepilisi zedijithali) sele zikwazi ukuqokelela ezinye iinkcukacha ze-biometric, njengeendlela zokulala, iimpawu ezibalulekileyo kunye nesimo somzimba. Ukusebenzisa i-patch kwimithombo emininzi yedatha, inkqubo yezobugcisa yedijithali inokudala umfanekiso opheleleyo womntu othabatha isilwanyana esithile-kuquka imiphumo emibi kunye neepatheni zokungenisa. Kule nkalo, ezi nkqubo zinethuba lokuguqula indlela esiphathwe ngayo ngamayeza.
> Imithombo:
> Brown MT, Bussell JK. Ukuxhomekeka kweMithi: WHO uyayikhathalela? IMayo Clinic Proceedings . 2011; 86 (4): 304-314. i-doi: 10.4065 / mcp.2010.0575.
> Buono E, Vrijens B, Bosworth H, Liu L, Zullig L, Granger B. Ukuza isangqa esipheleleyo kwimilinganiselo yokunamathela kwamachiza: amathuba kunye nempembelelo ekunakekelweni kwezempilo. Ukunyamezela ngesineke nokuxhomekeka . 2017; 11: 1009-1017.
> Chai P, Boyer E, uMeya K, et al. Iipilisi zedijithali ukulinganisa iipatheni zokungenisa i-opioid kwizigulane zesebe eziphuthumayo ezineentlungu eziqhekezayo: isifundo somqhubi. Umbhalo woPhando lwe-Intanethi yezoNyango , ngo-2017; 19 (1).
> I-Montgomery A. Kanye into eyenziwa ngugqirha: ukukhusela ubumfihlo ngaphandle kokuphazamisa ukuphuhliswa kweepilisi zedijithali . I-Vanderbilt Journal of Entertainment kunye neThekhinoloji yoMthetho . 2016; (1): 147-175.
> Mullard A. Ngaba ufuna iichips kunye na? Iipilisi zedijithali zedijithali, ezibekwe ukutshatyalaliswa kweemarike ngokukhawuleza, zinike ithuba lokujongana nemingeni yokunyanzelisa izidakamizwa eziphambili kwiinkqubo zonyango kunye nokuhlolwa kweeklinikhi. Ukuhlolwa Kwezilwanyana Ukufumaneka kweMithi . 2015; (11): 735-735.