Software development and evaluation for remote control and audio-video communication for a narcotic dependency rehabilitation tablet dispenser based on LAN
Creators: name: Bajracharya, Aman
Publisher: name: University Of Tasmania
Year: 2023

description: There are often serious problems with misuse and diversion of narcotic rehabilitation medication when supplied to patients as Take Away Doses (TADs) rather than as a daily dose given under supervision at a pharmacy. Despite this, TADs are often supplied in narcotic rehabilitation programs to help patients live normal lives, promote rehabilitation, improve retention in treatment, reduce congregation at dispensing points and improve access to treatment. Problems arise because TADs are taken unsupervised with no monitoring to ensure that they are taken as prescribed. There is also no \intoxication\" assessment of the patients immediately prior to dosing to ensure it is safe for the patient to consume a TAD. There is also no suitable technology currently available to remedy this situation. The University of Tasmania Medical Engineering Research Group is working to develop suitable technology for secure remote storage and delivery of TADs together with remote assessment of patients immediately prior to TAD delivery. The use of this system has been named tele-drug-rehabilitation. This thesis is concerned with the communication and remote dispensing of tablets required for this technology. A new word 'tele-dosing' has been coined for this part. The tele-drug-rehabilitation system featured video and audio communication between a local (clinician) and remote (patient) PC and the remote control of a tablet dispenser in the remote location. LabV1EW graphical programming was used to develop the communication software the user interface and the external dispenser control. A laptop was used at the patient site and a desktop at clinician's site both running on Windows XP. A webcam and 3.5mm microphone and headset were used in each side. MJPEG and way format were used for video and audio respectively. The patient's computer and the clinician's computer were connected through a Local Area Network (LAN). The dispenser was connected to the patient's computer through a serial port. For remote dispensing the software provides a mechanism to remotely operate the medication dispenser. The tablet dispenser was designed to hold up to five tablets of buprenorphine. Through the system the clinician interacts with the patient through video and audio and provides supervisory control of the dispenser. This enables assessment of the patient prior to dispensing activation of the dispenser only after a satisfactory assessment outcome and monitoring of the dosing process. The concepts and the programs used in developing the system are described. The system was initially trialed with ten dummy patients using plastic tablets. User feedback was used for continuous improvement of the software and the hardware. Finally the system was trialed and evaluated with two real patients in a controlled environment. Buprenorphine tablets were used in the trials. The trials were successful. Each patient as well as the doctor was given a set of questionnaires to fill out after the experiment. The questions included the quality of video audio and audio-video combined the perception of safety successful dispensing comparison of the remote monitoring compared to going to the pharmacist the cost patients are willing to pay for the system and others. Trials with dummy patients found the compression level and resolution of image frames suitable for the system. MJPEG based video communication was found to be suitable enough for video communication. The user experience of audio communication was also positive. The dispensing of Buprenorphine tablets to real patients was successful and in the correct order in all trials with real patients. Feedback from the real patients was positive indicating the system was usable and functional and they would prefer home dosing with this system in preference to daily pharmacy visits."