Abstract:
A container having signaling capability is disclosed for use with medicine and other pharmaceutical related products. The container preferably includes a conventional bottle-type body with a rotatably secured closure. A sensor means is structured to determine the position of the closure and thereby provide an indication of cap rotation indicative of the patient using the medicine. A processing means and display means are also included in the container to provide an indication of the current state of the container with respect to its contents. In addition, the container can include a button means to permit a user of the container to scroll through indicia shown on the display means. In another aspect of the container, a base station is provided for transmitting data to/from a signal means incorporated into the container. The base station includes a body having at least one receptacle for suitably receiving a container therein. A method of using the container is also provided.

Description:
BACKGROUND OF THE INVENTION  
         [0001]    1 Field of Invention  
           [0002]    This invention relates to containers for medicine and, more specifically, to a container for medicine which incorporates a compliance device for reminding the user to take the medicine contained within the container.  
           [0003]    2 Background Information  
           [0004]    The prevalence of the use of medicine in a modem society cannot be overstated. Medicines are used by persons of all ages to treat simple illnesses to life threatening diseases. Often, a variety of medications will be required to treat a single illness. Successful treatment of such medical conditions through the use of medication depends on the patient taking the prescribed dose of medication according to a prescribed schedule. Failure to comply with the prescribed schedule reduces the effectiveness of the medicine and may prolong the treatment. Given the complexity of dosage schedules and/or the number of medications being taken, not to mention the fact that the patient may be impaired by the illness or as a side effect of the medication, it is desirable to have a device to remind the patient when to take a dose of a medicine.  
           [0005]    Medication compliance devices are known in the prior art. A medication compliance device or system is a device designed to manage the medication regimen of a patient. The compliance device typically tracks the type of medication(s) the patient is taking and reminds the patient to take a dose of the medicine according to the schedule prescribed by a physician. Some compliance devices use programmable computers to track the type of medication and dosage schedule for an individual patient. The compliance device may, for example, include a container coupled to a computer operated control device. The control device opens the container on a prescribed schedule to allow the patient access to the medicine. The device may also include a camera, or other such device, to record compliance by the patient. Other systems include a “beeper” like device which is activated according to the prescribed schedule. When the beeper alarm sounds, the patient is reminded to take the medicine. The disadvantage of the former system is that it is too large to be easily carried by the patient. The disadvantage of the latter system is that the beeper unit is not coupled to the medicine container and, as such, the user may forget to carry both the beeper and the medicine container. Additionally, the beeper system fails to track whether the patient takes the medicine. Of course, such a system could incorporate a system wherein the patient actively inputs when a medicine is taken. Additionally, these systems generally require the patient to input information including, but not limited to, the time of the initial dose.  
           [0006]    An improved compliance device is disclosed in U.S. Pat. No. 5, 495, 961. This device includes container holder which incorporates a display/alarm device. The display/alarm device is programmable according to a prescribed schedule. The container for the medicine is inserted into the holder, thereby ensuring the medicine and alarm are in proximity to each other. There are several disadvantages to this device as well. For example, the device does not provide a means for tracking compliance by the user. Also, when a patient has more than one prescribed medicine, the wrong medicine bottle could be inserted in the holder resulting in the patient taking a first medicine according to the schedule for a second medicine.  
           [0007]    Another compliance device, disclosed in U.S. Pat. No. 4, 617, 557 utilizes a blister pack design, e.g. a plastic cover and foil backing which requires the patient to push a pill through the foil in order to remove the pill. The blister pack includes a control module having a display/alarm as well as a system of conductive pathways, i.e. wires, disposed within non-conductive layers adjacent to the foil. The display alerts the patient when a pill should be taken. Additionally, as the patient breaks the foil, the electronic connection associated with that pill location is severed. The control module records when a pill is removed from the system. There are several disadvantages to this device as well. The monitoring system is always “on” and therefore a constant drain on the battery of the control module. The device also requires additional non-conductive layers between the plastic cover and the foil. These layers make the, often difficult, task of opening the blister package more burdensome. Moreover, this system is only functional with medicines that are packaged in a blister pack.  
           [0008]    There is therefore a need for a medicine container having an integral compliance device.  
           [0009]    There is a further need for a medicine container that passively tracks patient&#39;s compliance with a dosage schedule.  
           [0010]    There is a further need for a medicine container having an integral compliance device that is structured to communicate with an electronic medium which is also accessible by a physician, physician or other medical aid personnel.  
           [0011]    There is a further need for medicine container having an integral compliance device that is ready for use by the patient without having the patient actively input any information.  
           [0012]    There is a further need for a method of using a medicine container having an integral compliance device.  
           [0013]    There is a further need for a method of manufacturing for a medicine container having an integral compliance device.  
         SUMMARY OF THE INVENTION  
         [0014]    These needs, and others, are satisfied by the invention which provides a container having signaling capability structured for use with medicine and other pharmaceutical related products. The container preferably includes a conventional bottle-type body with a rotatably secured closure. A sensor means is structured to determine when the closure opens and closes thereby providing an indication of use. A processing means and communication means are also included in an electronic module in the container. The display provides an indication of when the patient should take the medicine, if the patient missed the most recent dose, and provides a warning of a possible double dose.  
           [0015]    The processing means is coupled to the sensor and tracks when the container is opened and closed. As such, the compliance device operates without active input from the patient. In addition, the container may include a button means to permit a user of the container to scroll through indicia related to the medicine on the communication means. In another aspect of the invention, a base station is provided for transmitting data to/from a signal means incorporated into the container. The base station includes a body having at least one receptacle for suitably receiving a container therein. A method for manufacturing and a method for using the container is also provided. 
       
    
    
     BRIEF DESCRIPTION OF THE DRAWINGS  
       [0016]    A full understanding of the invention can be gained from the following description of the preferred embodiments when read in conjunction with the accompanying drawings in which:  
         [0017]    [0017]FIG. 1 is an isometric view of a screw top bottle embodiment.  
         [0018]    [0018]FIG. 2 is an isometric view of a base station.  
         [0019]    [0019]FIG. 3 is a flowchart showing the electronic module functions.  
         [0020]    [0020]FIG. 4 is an isometric view of a snap fit bottle embodiment.  
         [0021]    [0021]FIG. 5 is an isometric view of a flip top bottle embodiment.  
         [0022]    [0022]FIG. 6 is an isometric view of a screw top bottle with a spray nozzle.  
         [0023]    [0023]FIG. 7 is an isometric view of a atomizer embodiment.  
         [0024]    [0024]FIG. 8 is an isometric view of a blister pack embodiment.  
         [0025]    [0025]FIG. 9 is an partial cross-sectional view of the blister pack embodiment.  
         [0026]    [0026]FIG. 10 is an isometric view of a box embodiment.  
         [0027]    [0027]FIG. 11 is an isometric view of a dual flap, flip top bottle. 
     
    
     DETAILED DESCRIPTION  
       [0028]    As used herein, “medicine” includes pharmaceutical products, vitamins, minerals, steroids, and drugs in any form, including, but not limited to, pills, liquids, tablets, injectable fluids, eye drops, cremes, powders, caplets, other oral dose forms, and topical medications.  
         [0029]    As used herein, “patient” includes aids, nurses, health care practitioners and other medical personnel or assistants who help the person who is ill. Except, of course, when a statement refers to a patient taking a medicine, which must be performed by the person who is ill.  
         [0030]    Generally, the container of the present invention includes a sensor which passively senses when the container is opened and closed. The sensor is coupled to an electronic module. The electronic module is encoded with a dosage schedule. The electronic module further includes a clock and a communication means, such as a display and/or speaker. By comparing data from the clock to the dosage schedule, the electronic module shows a countdown to the next scheduled dosage. The container may be a bottle with a screw top, a bottle with a snap-fit lid, a dropper, a blister pack, a box for medicines in the form of parenteral devices, powders topical cremes, or an atomizer. The battery for the electronic module is of a reduced size because the sensor only operates when the container is opened and closed, rather than constantly sensing the state of the container. Individual embodiments are described below.  
         [0031]    As shown in FIG. 1, in one embodiment, a container  10  includes a housing  12  and at least one closure  14 . As described below, the closure  14  moves between a first, closed position wherein the closure  14  engages the housing  12 , and a second, open position, wherein the closure  14  does not engage the housing  12 . The housing  12  includes a wall  16  having a top end  18  and a bottom end  20 . The wall  16  may be any shape, however, a four sided housing is preferred. The wall  16  defines a cavity  22 . The wall  16  includes at least one opening  20 , preferably disposed near the top end  18 . A collar  24  is disposed about opening  20 . The collar  24  includes integral threads  26 . At least one outwardly opening recess  28  is formed in wall  16 . An electronic module  30  is structured to fit within recess  28 . A sensor means  31 , such as a dome switch  32 , is disposed between the collar threads  26 . The sensor means  31  is structured to detect when the closure  14  moves between the open position and the closed position. The sensor means  31  produces an electronic signal and is in electronic communication with the electronic module  30 . A medicine  1  is disposed within cavity  18 .  
         [0032]    The closure  14  includes a body  34  having a planar member  36  and a generally perpendicular sidewall  38  extending therefrom. The planar member  36  has a size and shape corresponding to collar  24 . The sidewall  38  has an inner side  40  and outer side  42 . The sidewall inner side  40  includes closure threads  44  which are structured to engage collar threads  26 . An actuator  46  is disposed between closure threads  44 . The actuator  46  is, preferably, a rigid member that is structured to interact with the dome switch  32  as the closure  14  moves between the open position and the closed position.  
         [0033]    The electronic module  30  includes a processing means  49 , such as a programmable CPU with associated memory  50 , a communications means  51 , such as display  52  and/or speaker  54 . The processing means  49  includes a data storage means  55 , such as random access memory  56 , a controller means  57 , such as an integrated circuit controller  58 , a timing means  59  such as a clock  60 , a sensor interface  62 , and a communication interface  64 . The electronic module  30  may also include a linkage to a signaling/receiving means  65 , such as contacts  66 . The signaling/receiving means  65  may also be a wireless means such as a transmitter and antennae  67 . The data storage means  55 , timing means  59 , sensor interface  62 , communication interface  64 , and signaling/receiving means  65  are in electronic communication with the controller means  57 . The communication interface  64  is also in electronic communication with display  52  and/or speaker  54 . The sensor interface  62  is in electronic communication with the sensor means  31 .  
         [0034]    The electronic module  30  is powered by a battery  68 . Because the sensor circuit is only closed when the closure  14  is moved between the open and closed positions, the sensor circuit is not a constant drain on the battery  68 . Initially, the circuit which includes the battery  68  is maintained as an open circuit by a non-conductive material  69  disposed between the battery the other parts of the circuit. The non-conductive material  69  has a tab  69   a  that extends outwardly so that the tab  69   a  may be easily grasped. When the electronic module  30  is ready to be used, an operator, typically a pharmacist, pulls on the tab  69   a  and thereby removes the non-conductive material  69 . When the non-conductive material  69  has been removed, the circuit which includes the battery  68  is closed. Alternatively, the electronic module  30  may include an on/off switch means, such as a dual pin/jumper switch  169 . When the electronic module is ready to be used, an operator, typically a pharmacist, moves the jumper  169   a  from one pin  169   b  and replaces the jumper  169   a  over both pins  169   b,    169   c.  When the jumper  169   a  is placed over both pins  169   b,    169   c,  the power circuit is closed and the electronic module  30  receives power. Power to the electronic module  30  may be terminated by opening the power circuit, for example, by removing jumper  69   a.    
         [0035]    The display  52  is, preferably, a liquid crystal display (“LCD”). The display  52  is structured to indicate data in a form readable by the patient, including, but not limited to, showing time until the next scheduled dose, indicating a prescribed time to dose, verifying dose was taken, notifying of missed dose along with a suggested corrective action, warning of a possible double dose, the position of the closure  14 , and indicating whether the processing means  49  has engaged in data-transmission.  
         [0036]    The data storage means  55  is structured to store data representative of information relating the medicine  1  contained in the container  10 , the prescribed schedule for the patient, and the dispensing history. The controller means  57  is structured to receive data from the signaling/receiving means  65  and store such data in the data storage means  55  or display such data on the display  52 . The controller means  57  is further structured to compare data, such a dosage schedule, to data provided by the clock  60  and provide information, e.g. a countdown to the next scheduled dosage, to the display  52 . The controller means  57  is further structured to receive input from the sensor interface  62  and relate that data to input from the clock  60 . The controller means  57  then stores the sensor interface/clock data in the data storage means  55 . The sensor interface/clock data is an indication of the dispensing history, indicating when the patient opened and closed the container  10 .  
         [0037]    The electronic module  30  is coupled to a label  70 . The label  70  includes an adhesive (not shown) to secure the label  70  to the housing  12 . The label  70  includes indicia  72 , such as a scanable symbol, e.g. a UPC code, writing or diagrams relating to the use of medicine  1  or use of the electronic module  30 . The label  70  also includes an identification number  74 . In a preferred embodiment, the label  70  also includes a user control means  75 , such as a label dome switch  76 . The label dome switch  76  is coupled to the controller means  57 . When the label dome switch  76  is activated, the controller means  57  will cause the display  52  to show different information (as described below). For example, the display  52  will typically show the countdown until the next scheduled dose. When the label dome switch  76  is activated, the display  52  may show the time the container was last opened. If the label dome switch  76  is activated again, the display  52  may show information relating to the medicine, such as warnings. If the label dome switch  76  remains unactivated for a period of time, the display  52  returns to a display of the name of the medicine. When the next scheduled dose is within thirty minutes, the display  52  shows a countdown until the next scheduled dose.  
         [0038]    A base station  80 , as shown in FIG. 2, is structured to have at least one receptacle  82  formed therein. The receptacle  82  is sized to hold a container  10 . The base station  80  is used to program the electronic module  30 . The electronic module  30  is programmed through the signaling/receiving means  65 . The signaling/receiving means  65 , for example may include a data input port  74  and a data output port  76 . Within the receptacle  82 , a data input port  84  and a data output port  86 , which correspond to container data input port  74  and container data output port  76 , are disposed. The base station  80  further includes an electronic communication means  87 , such as a modem  88 , that enables the base station  80  to communicate data to/from a communications medium, such as the Internet. Alternately, the electronic communications means  87  could be an input/output  88 &#39;device, such as an network “card,” that is in communication with a local area network. The electronic communications means  87  can also be structured to contact the patient via a communications device such as a pager or a telephone.  
         [0039]    In operation, the housing  12  and closure  14  are provided as described above. However, the electronic module  30  is not inserted into the recess  28 , the label  70  is not coupled to the electronic module  30  and the data storage means  55  does not contain data related to a patient or a medicine  1 . The power circuit is closed as described above and battery  68  is coupled to the electronic module  30 . The label  70  is then encoded with the identification number and then the label  70  is coupled to the electronic module  30 . The electronic module  30  is the disposed in the recess  28  in the housing and the sensor means  31  is coupled to the electronic module  30 . The electronic module  30  is secured in the recess  28  by adhering the label  70  to the housing  12 .  
         [0040]    Separately, a schedule of use for the medicine  1  is determined. Preferably, the determination of the schedule of use includes a physician prescribing the use of the medicine  1 . The determination of the schedule of use, however, may be determined by others, such as the manufacturer of a non-prescription medicine  1 . The schedule of use is then encoded into the electronic module  30 . The encoding of the electronic module  30  is performed using a base station  80  that is, preferably, located at a pharmacy. Alternatively, certain medicines, even prescription medicine, may have dosage schedule that is independent of the patient, e.g. once per day. Containers of such medicines may be filled and programmed at the manufacturer or at a filling operation. A filling operation is a manufacturing facility structured to fill containers  10  with medicine  1 . The filling operation also include larger base stations  80  structured to receive many containers  10  or the base station  80  may be part of an assembly line structured to program multiple containers  10 .  
         [0041]    The housing  12  is then filled with the medicine  1 . Tracking of which medicine  1  belongs in the housing  12  is accomplished using the label  72  identification number and/or the electronic module  30 . The housing  12  is then coupled with the closure  14 . As the closure  14  is joined with the housing  12 , the actuator  46  interacts with the switch means  31  causing a signal to be communicated to the controller means  57 . The controller means  57  stores the time the container  10  was first closed in the data storage means  55 . The container  10  is then delivered to the patient.  
         [0042]    The next time the container  10  is opened, the actuator  46  will interact with the sensor means  31  and the time of the sensor input will be recorded by the controller means  57  in the data storage means  55 . Presumably, this is the time the patient will be taking the medicine  1 . As the container  10  is closed, the actuator  46  will again interact with the sensor means  31  and the time of the sensor input will be recorded by the controller means  57  in the data storage means  55 . The controller means  57  will use this time to start the countdown to the next dosage. The name of the medicine or a countdown to the next scheduled dosage will be shown on the display  52  as described above. When the countdown is complete, the display  52  will indicate that it is time for another dosage. Additionally, the speaker  54  may sound an alarm. The countdown to the next dose is reset after the controller means  57  receives input from the sensor means  31  indicating the container  10  has been opened and closed. In the event the container  10  is not opened and closed at the time of a scheduled dosage, the display  53  will show a message that a dosage was missed and indicate the corrective course of action. Additionally, the speaker  54  may sound an alarm, for example one beep every second for ten seconds, repeated every minute. An alarm may also warn of a possible double dose.  
         [0043]    The base station  80  communicates with an electronic medium, such as the Internet. The base station  80  is connected to a patient database  90 . Both physicians  2  and pharmacists  3  may access the patient database  90 , either through a base station  80  or through a computer  92 . In operation, the physician  2 , or his/her agent, enters a prescription in to the database  90 . When a patient is at a pharmacy, the pharmacist  3  will access the database  90  to obtain the prescription information. After the information is received, the container  10  is prepared as detailed above. Additionally, when a patient returns for a refill on the prescription, or upon directions from the physician  2 , the container  10  may be reinserted into the base station  80 . At this time, the base station  80  will access the dispensing history stored in the data storage means  55  of the electronic module  30 . The dispensing history is then communicated to the patient database  90  where a physician  2  may review the dispensing history. Additionally, when the patient receives prescriptions from different physicians  2 , or if the patient uses over-the-counter medicines, where the other medicine is stored in a similar container, the dispensing history of each medicine will be stored in the patient database  90 . The dispensing history for multiple medicines may be used to diagnose and/or prevent improper drug interactions.  
         [0044]    The base station  80  may also be provided to patients. A patient may store one or more containers  10  in the base station  80 . The base station communications means  87  can be structured to contact the patient database  90  at a specified interval, e.g. once per day. The patient&#39;s compliance with the schedule can thus be monitored on a daily basis. The database  90 , in cooperation with a communications program, can be structured to provide reminders to patients, e.g. via a display on the base station  80  or via e-mail, when the patient fails to take a scheduled dosage. Alternatively, the database  90  may be structured to provide the physician  2  or another person or service with information to foster compliance by the patient.  
         [0045]    The communications means  51 , in combination with the processing means  49 , may provide additional information to the patient. For example, as shown on FIG. 3, In addition to a countdown to the next scheduled dose, the communications means, through speaker  54  will sound an alarm once per second for thirty seconds at the time the dose should be taken. The alarm will repeat every sixty seconds until the container  10  is opened. As described above, opening and closing the container  10  will reset the countdown. If the container  10  is opened within a certain time period, more than thirty minutes before a scheduled dose for example, the communications means  51  will sound an alarm on speaker  54  and show a “Double Dose” warning on display  52 . If the container  10  is open for more than a certain period of time, for example 5 minutes, the display  52  will show an “Open Bottle” warning. The communications means  51  may also provide a warning when the supply of medicine  1  is low, for example, less than 80% of the supply. Such a warning will direct the patient to obtain a refill, if prescribed, and the number of refills remaining in the prescription. The communication means  51  may also provide warnings for a low battery and an expiration of the medicine  1 . The communications means  51  may also provide additional information such as a compliance score, i.e. a percentage of times the patient took the dosage on schedule, the time the last does was taken, total number of days the electronic module  30  has been in use, number of doses remaining in the container  10 , the physician&#39;s phone number, pharmacist&#39;s phone number, lot ID # for the medicine, and other such information. Such additional information is shown on the display  52  in response to input from the label dome switch  76 . Any displayed message may be accompanied by a alarm on the speaker  54 .  
         [0046]    A second embodiment is shown in FIG. 4. This container  210  is substantially similar to the embodiment described above, except the threaded closure  14  is replaced with a snap-fit closure  114 . The closure includes a discontinuous flange  144  instead of threads  44 . Similarly, the collar  124  is adapted to engage the snap fit closure  114  and, therefor includes a single corresponding discontinuous flange  126  rather than threads  26 . The dome switch  132  is disposed on the collar  124  at a location where the closure discontinuous flange  144  will contact the dome switch  132  as the closure  114  is removed from the housing  112 . Essentially, the closure discontinuous flange  144  acts as the actuator  146 . The remaining aspects of the invention, including the electronic module  130  and the base station  80 , are identical to the invention as described above.  
         [0047]    A third embodiment is shown in FIG. 5. This container  210  is substantially similar to the embodiment described above, except the snap-fit closure  114  is replaced with a flip top closure  214 . The flip top closure  214  is coupled to the housing  212 , for example, by a snap fit or other means. The flip top closure  214  has a planar member  236 , a sidewall  238  having an opening  220 . A portion of planar member  236  is formed as a movable flap  235 . The movable flap  235  is hingedly connected to the planar member  236 . The movable flap  235  moves between a first, closed position wherein the movable flap  235  covers opening  220  and a second, open position, wherein the movable flap  235  does not cover opening  220 . The movable flap  235  is maintained in the closed position by a latch means  240 . The latch means  240  is typically a projection with a shallow hook  242 . The sidewall  238  includes a ledge  244  structured to interact with the shallow hook  242 . The switch means  231  is disposed on a stationary portion of the ledge  244  adjacent to the latch means  240 . The actuator  246  is a rigid member that extends from the inner side of the movable flap  235 . As the movable flap  235  is opened and closed, the actuator  246  engages the switch means  231 . The remaining aspects of the invention, including the electronic module  230  and the base station  80 , are identical to the invention as described above.  
         [0048]    A fourth embodiment is shown in FIG. 6. This container  310  is substantially similar to the container  10  shown in FIG. 1 and described above. In this embodiment, however, the container  310  is structured primarily to contain a liquid. To that end, the opening (not shown) is covered by a nozzle  321  disposed on the collar  324 . The collar  324  includes external threads  326 . The closure  314  is structured to cover the nozzle  321 . The closure  314 , as before, includes a threaded portion  344  and an actuator  346 . The housing  312  includes a switch means  331 , such as a dome switch  332 , disposed among the collar threads  326 . The remaining aspects of the invention, including the electronic module  330  and the base station  80 , are identical to the invention as described above.  
         [0049]    A fifth embodiment is shown in FIG. 7. This container  410  is structured as an atomizer for spraying a liquid medicine. The atomizer container  410  includes a housing  412  having a top end  416  and a bottom end  418 . An opening  420  is located in the housing top end  418 . The opening  420  defines a plane  421 . The opening  420  is, preferably, surrounded by a collar  424 . The opening  420  is sealed by a spray nozzle closure  414 . The spray nozzle closure  414  is structured to move in a direction generally perpendicular to the plane of the opening  420 . The spray nozzle closure moves from a first position, distal to the opening  420 , to a second position, adjacent to the opening  420 . A valve (not shown) is disposed within the spray nozzle closure  414 . As is know in the prior art, as the spray nozzle closure  414  moves between the first and second position, a quantity of liquid medicine passes through the valve and is atomized before leaving the spray nozzle closure  414  as a mist. A switch means  431  is disposed on the collar  424 . An actuator  446  extends from the bottom of the spray nozzle closure  414 . When the spray nozzle closure  414  is in the second position, the actuator  446  engages the switch means  431 . The remaining aspects of the invention, including the electronic module  430  and the base station  80 , are identical to the invention as described above.  
         [0050]    A sixth embodiment is shown in FIGS. 8 and 9. In this embodiment, the container  510  is a blister pack. The blister pack container  510  includes a first plastic layer  512  having a plurality of pockets  514  sized to contain one or more medicine pills or tablets  1 . The pockets  514  in the first plastic layer  512  are sealed with a layer of conductive foil  516 . Adjacent to the conductive foil  516 , on the side opposite the first plastic layer  512 , is a spring action cell foam  518 . The spring action cell foam  518  is further adjacent to a second plastic layer  520  so that the spring action cell foam  518  is sandwiched between the first and second plastic layers  512 ,  520 . Both the second plastic layer  520  and the spring action cell foam  518  include a plurality of pill openings  522  which correspond to the locations of the pockets  514  in the first plastic layer  512 . Each of the pill openings  522  has at least one time  524  projecting into the spring action cell foam  518  toward the fist plastic layer  512 . The tips of the tines  524  include a conductive surface  526 . The conductive surface  526  is further coupled to a wire  528 . Both the conductive foil  516  and the conductive surface  526  are coupled to an energy source  529 . Because the conductive foil  516  and the conductive surface  526  are normally in a spaced relationship, being held apart by the spring action cell foam  518 , the circuit formed by the energy source, the conductive foil  516  and the conductive surface  526  is an open circuit. When the patient pushes a pill out of the pocket  514 , the first and second plastic layers  512 ,  520  will deform until the conductive foil  516  contacts the conductive surface  526 . When the conductive foil  516  contacts the conductive surface  526 , the circuit formed by the energy source, the conductive foil  516  and the conductive surface  526  is closed. A sensor means  531  is coupled to the circuit to detect when the circuit closes.  
         [0051]    After a pill has been removed from a pocket  514  and the patient releases pressure on the container  510 , the spring action cell foam  518  causes the conductive foil  516  and the conductive surface  526  to separate, thereby opening the circuit. As before, the sensor means  531  transmits a signal to the electronic module  530  indicating that the container  510  has been opened. In this embodiment, however, the countdown is reset after a single input from the sensor means  531  as this container  510  is not subsequently closed.  
         [0052]    A seventh embodiment is shown in FIG. 10. This container  610  is, generally, a box that contains a plurality of parenteral devices, such as, but not limited to, syringes, suppositories, or dermal patches. The box container  610  has a plurality of side members  612  defining a cavity  622 . One side member  612  includes an opening  620 , and extension  613 . The extension  613  is adjacent to the opening  620  and extends into the cavity  622 . A flap closure  614  is coupled to a side member and is disposed adjacent to the opening  620 . The flap closure  614  includes a first member  615  and a second member  616 . The first and second members  615 ,  616  are coupled to each other at a generally right angle. The first member  615  is coupled to the side member  612 . The second member  616  is coupled to the first member  615  and has an unattached distal end. The second member further includes a slot  617 . The flap closure  614  moves between a first, closed position wherein the flap closure  614  covers opening  620  and a second, open position, wherein the flap closure  614  does not cover opening  620 . The flap closure  614  is maintained in the closed position by friction between the extension  613  and the second member  616 . A sensor means  631 , such as a dome switch, is coupled to the extension  613 . When the flap closure  614  is in the closed position, the sensor means  631  is disposed within slot  617 . The portion of the second member  616  between the slot  617  and the distal end of the second member  616  acts as the actuator  644 . As the flap closure  614  moves between the first and second position, the actuator  644  moves across the sensor means  631  activating the switch. The remaining aspects of the invention, including the electronic module  630  and the base station  80 , are identical to the invention as described above.  
         [0053]    An Eighth embodiment is shown in FIG. 11. There are times when different dosages of a single medicine are prescribed for a patient. For example, a patient may take two pills in the morning and three pills at night. This container  710  is substantially similar to the flip top embodiment  210  described above, except the flip top closure  214  having a single movable flap  235  has been replaced with multiple flip top closure  714  having at least two separate movable flaps  735   a  and  735   b.  The separate movable flaps  735   a  and  735   b  may be of different sizes. The multiple flip top closure  714  is coupled to a housing  712 . The housing  712  defines a cavity  711 . The multiple flip top closure  714  has a planar member  736 , and a sidewall  738  having two openings  720   a,    720   b.  A hinge support member  722  having two ends  724 ,  726  extends between openings  720   a  and  720   b.  Each hinge support member end  724 ,  726  is attached to side wall  738 . At least two portions of planar member  736  are formed as a movable flaps  735   a,    735   b.  The movable flaps  735   a,    735   b  are hingedly connected to the hinge support member  722 . The movable flap  735   a,    735   b  each move between a first, closed position wherein the movable flap  735   a,    735   b  covers an opening  720   a,    720   b,  respectively, and a second, open position, wherein the movable flaps  735   a,    735   b  do not cover openings  720   a,    720   b.  Each movable flap  735   a,    735   b  is maintained in the closed position by a latch means  740   a,    740   b  respectively. Each latch means  740   a,    740   b  is typically a projection with a shallow hook  742   a,    742   b,  respectively. The sidewall  738  includes two ledges  744   a,    744   b  disposed within openings  720   a,    720   b  respectively. Each ledge  744   a,    744   b  is structured to interact with the shallow hook  742   a,    742   b  respectively. A switch means  731   a,    731   b  is disposed on a stationary portion of each ledge  744   a,    744   b  adjacent to each latch means  740   a,    740   b.  Each switch means  731   a,    731   b  has an associated actuator  746   a,    746   b  which is a rigid member that extends from the inner side of the movable flap  735   a,    735   b,  respectively. As each movable flap  735   a,    735   b  is opened and closed, the actuator  746   a,    746   b  engages the associated switch means  731   a,    731   b.  Both switch means  731   a,    731   b  is coupled to an electronics module  730 . The remaining aspects of the invention, including the electronic module  730  and the base station  80 , are identical to the invention as described above. As shown in FIG. 11 and as described, the multiple flip top closure  714  has two openings  720   a,    720   b  and two movable flaps  735   a,    735   b.  This invention further contemplates a flip top closure having more than two openings and associated flaps. Additionally, the housing  712  may include an internal divider  713  that divides the cavity  711 . Thus, pills having different dosages of a medicine may be kept in the same housing  712 , but still be separated.  
         [0054]    Use of the multiple flip top closure  714  is essentially as described above. The difference is that the patient&#39;s compliance with the schedule is tracked based upon which switch means  731   a,    731   b  is activated. For example, a patient may be scheduled to ingest a first dose of two pills in the morning and second dose of three pills at night. As shown in FIG. 11, flap  735   a  is larger than flap  735   b.  The electronics module  730  is programmed to associate the activation of switch means  731   a  with a three pill dosage and the activation of switch means  731   b  with a two pill dosage. The patient will be instructed to remove the second dose of medicine via the large flap  735   a  at night and the first dose of medicine via the small flap  735   b  in the morning. The size of the flap  735   a,    735   b  serves as a reminder to the patient whether the dosage is large, three pills, or small, two pills. The flaps  735   a,    735   b  may also be marked with an indicia  736   a,    736   b  such as “PM” and “AM” to assist the patient in using the proper flap. Data regarding the size of the dose taken, based upon which switch means  731   a,    731   b  is activated, is recorded by the electronics module  730 .  
         [0055]    While specific embodiments of the invention have been described in detail, it will be appreciated by those skilled in the art that various modifications and alternatives to those details could be developed in light of the overall teachings of the disclosure. For example, the container is more pleasing to the eye when the electronic module is maintained in a recess. The electronic module, however, may simply be attached to the container. Accordingly, the particular arrangements disclosed are meant to be illustrative only and not limiting as to the scope of invention which is to be given the full breadth of the claims appended and any and all equivalents thereof.