Patent Publication Number: US-11033461-B2

Title: Systems and methods for monitoring medication adherence and compliance

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
     This application is a continuation of U.S. patent application Ser. No. 15/331,097, filed Oct. 21, 2016, titled “Systems and Methods for Monitoring Medication Adherence and Compliance,” now U.S. Pat. No. 10,456,326, the entirety of which is hereby incorporated by reference. 
    
    
     FIELD 
     The present disclosure relates generally to the field of medication adherence and compliance, and more particularly, to systems and methods for monitoring medication adherence and compliance. 
     BACKGROUND 
     Medication adherence is the act of timely filling or refilling prescriptions for medications. Medication compliance is the act of taking medication on schedule or as prescribed by a physician. According to the National Council on Patient Information and Education, poor medication adherence can lead to unnecessary disease progression and complications, reduced functional abilities and quality of life, additional medical costs and physician visits, increased use of expensive, specialized medical resources, and unneeded medication changes. Medication noncompliance can also lead to these and other adverse effects—the average length of hospital stays due to medication noncompliance is 4.2 days. In the United States, 12 percent of people are 0% compliant (i.e., do not take their medication at all) even after they fill the prescription (i.e., are adherent). 
     There are a number of reasons why people are nonadherent and/or noncompliant with their medication regimen. The various factors that interfere with medication adherence and compliance include: social/economic-related factors such as age, race, economic status, literacy and costs; individual factors such as forgetfulness, treatment anxiety, misunderstood instructions and fear of addiction; medication-related factors such as the length or complexity of the treatment and the side-effects of the medication; and condition-related factors such as comorbidities and disabilities, and the overall severity of the condition. 
     By some estimates, up to 50% of patients are noncompliant to some extent, making it difficult for doctors to assess if a medication regimen is effective. If the patient is not accurately or truthfully reporting his or her compliance, doctors do not have a means of obtaining more accurate information. Furthermore, patient tracking of which medications to take and when can be cumbersome and can be confusing for some patients. 
     There are various techniques and systems that try and improve patient adherence and/or compliance. For instance, some devices have been developed for mounting on pill bottles, including for example, devices that detect opening and closing of the device and alert a patient when to take a medication using a timer. Although, these prior art approaches provide at least some means to improve medication adherence and compliance, there is much room for significant advancement and improvement in the technology in order to reduce the cost and friction to the patient while improving the functionality/ 
     SUMMARY 
     Embodiments of the present disclosure include systems and methods for monitoring medical adherence and compliance. Embodiments of this disclosure include, for example, medication containers (e.g., pill packages, bottles, etc.) with beacon transponders incorporated into the packaging (e.g., a cap or cover). 
     In one aspect, the present disclosure is directed to a medication monitoring system that includes a medication container and a cover. The medication monitoring system may also include a beacon system. The beacon system may include a beacon that transmits a wireless signal when the cover is removed from the medication container. 
     In another aspect, the present disclosure is directed to a method for monitoring medication adherence and compliance. The method may include detecting when a cover of a medication container is removed from the medication container. The method may also include transmitting based on the detection, a wireless signal from a beacon to a remote device, which indicates the opening of the medication container. 
     In another aspect, the present disclosure is directed to a medication monitoring system that includes a medication container and a cover. The medication monitoring system may also include a beacon system, which may include a beacon that transmits a wireless signal when the cover is removed from the medication container. The beacon system may also include two electrical contacts, and a rim of the medication container may include a conductor that connects the two electrical contacts when the cover is installed on the medication container. 
     Additional features and advantages of the disclosed embodiments will be set forth in part in the description that follows, and in part will be obvious from the description, or may be learned by practice of the disclosed embodiments. The features and advantages of the disclosed embodiments will be realized and attained by the elements and combinations particularly pointed out in the appended claims. 
     It is to be understood that both the foregoing general description and the following detailed description are examples and explanatory only and are not restrictive of the disclosed embodiments as claimed. 
     The accompanying drawings constitute a part of this specification. The drawings illustrate several embodiments of the present disclosure and, together with the description, serve to explain the principles of the disclosed embodiments as set forth in the accompanying claims. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The accompanying drawings, which are incorporated into and constitute a part of this specification, illustrate one or more certain examples and, together with the description of the example, serve to explain the principles and implementations of the certain examples. 
         FIG. 1  is a schematic illustration of a medication adherence and compliance system having a beacon system, according to an exemplary embodiment. 
         FIG. 2A  is a schematic illustration of the beacon system of  FIG. 1 , according to an exemplary embodiment. 
         FIG. 2B  is a cross-sectional perspective view of another beacon system, according to an exemplary embodiment. 
         FIG. 2C  is a schematic diagram of a beacon, in accordance with an example embodiment. 
         FIG. 3  is a flow chart illustrating a method for monitoring medication adherence and compliance, according to an exemplary embodiment 
     
    
    
     DETAILED DESCRIPTION 
     The disclosed embodiments relate to medication containers (e.g., bottles) including beacons signaling when a medication container has been opened by a user. As a result, the beacon&#39;s signals can be monitored to indicate patient adherence and compliance with a medical regimen. 
     Reference will now be made in detail to embodiments of the present disclosure, examples of which are illustrated in the accompanying drawings. Where possible, the same reference numbers will be used throughout the drawings to refer to the same or like parts. 
       FIG. 1  depicts an exemplary embodiment of a medication adherence and compliance system  10 , which in an illustrative embodiment may be a medication container, for example, a bottle  12  and a cover, for example, a cap  14 , and a beacon system  16 . Bottle  12  may be used to contain a medication (e.g., pills, tablets, capsules, suppositories, ampoules, subpackets of powder, etc.). Beacon system  16  may be designed to transmit a signal  17  to a remote device  18  when cap  14  is removed from bottle  12 , which may be considered an indication the patient has taken a dose of the medication. 
     While shown in  FIG. 1  as a medication bottle  12 , other medication containers can be employed, including for example, droppers (e.g., eye), tubes, medication packets, ammo-packs, and other suitable medication containers. As shown in  FIG. 1 , beacon system  16  may be associated with cap  14 . For example, beacon system  16  may be housed within or attached to cap  14 . In some embodiments, beacon system  16  may be molded into the material (e.g., plastic) of cap  14 . In other embodiments, beacon system  16  be attachable (e.g., fixedly or releasably) to cap  14 . In other embodiments, beacon system  16  may be associated with bottle  12  and/or cap  14 . In some embodiments, beacon system  16  may be incorporated into bottle  12  and/or cap  14  during manufacturing of the component(s). Beacon system  16  may be designed as described herein, such that the cost is sufficiently low that it can be incorporated into bottle  12  and/or cap  14  and be disposable with bottle  12  and/or cap  14  without being cost prohibitive. In some embodiments, cap  14  housing beacon system  16  may be reused by moving cap  14  from an empty bottle  12  to a new bottle when the medication prescription is refilled. 
     Turning to  FIG. 2A , a schematic representation of beacon system  16  according to an example embodiment of the present disclosure is shown. As shown in  FIG. 2A , beacon system  16  may be located within cap  14 . Beacon system  16  may include a beacon  20 . In some illustrative embodiments, beacon  20  may be a BLUETOOTH, BLUETOOTH Smart, BLUETOOTH 4.0, or BLUETOOTH Low Energy (BLE) beacon. In other embodiments, beacon  20  may use other protocols, for example, beacon  20  may use passive WiFi, ZIGBEE, 6LoWPAN or Z-Wave. 
     In some embodiments, beacon  20  may include an internal power source, as will be described in further detail below, or in other embodiments beacon system  16  may include a separate power source (not shown) operatively connected to beacon  20 . For example, the power source may be a battery, capacitor, or other power storage device. 
     Beacon system  16  may also include electrical contacts  24  operatively connected to beacon  20  and configured to be operatively connected to a conductive strip  26 . In some embodiments, as shown in  FIG. 2A , conductive strip  26  may be positioned along the rim of bottle  12 . Conductive strip  26  may extend part way or all the way around the rim of bottle  12 . In some embodiments, the rim or all of bottle  12  may be formed using a conductive plastic or polymer (e.g., carbon filled thermoplastic elastomer), thus enabling the conductive strip  26  to be incorporated into bottle  12  as part of the initial manufacturing (e.g., injection molding) of bottle  12 . 
     Beacon system  16  may be designed such that when cap  14  is screwed onto bottle  12 , as shown illustrated in  FIG. 2A , electrical contacts  24  contact conductive strip  26 . And when conductive strip  26  is contacting electrical contacts  24 , a closed circuit that “shorts” the electrical contacts  24  may be formed. For example, electrical contacts  24  may be connected to an input (e.g., a reset input) of beacon  20  and ground or other connection. Therefore, when cap  14  is installed on bottle  12 , conductive strip  26  can short electrical contacts  24  such that beacon  20  is held in reset. When in reset, beacon  20  may remain in low-power standby mode, but when cap  14  is removed and conductive strip  26  interrupts the “short” circuit the reset can be disengaged. With the reset is disengaged, beacon  20  can wake up and begin transmitting signal  17 , as will be described in detail further herein. Thus, when cap  14  is removed from bottle  12 , the short circuit is broken, which is detected by beacon  20 , causing beacon  20  to transmit signal  17  indicating that bottle  12  has been opened. 
     Other cap designs are also contemplated. For example,  FIG. 2B  shows a cross-sectional perspective view of another embodiment of a cap  14 ′ installed on bottle  12  that may be designed to detect the removal of cap  14 ′ from bottle  12 . Cap  14 ′ may include a liner  28  that may be contained within cap  14 ′ and designed to span the opening of bottle  12  and cover the rim of bottle  12  when cap  14 ′ is secured to the top, as shown in  FIG. 2B . Liner  28  may be designed to slide up or down within cap  14 ′ when cap  14 ′ is secured to or removed from bottle  12 . For example, when cap  14 ′ is removed from bottle  14 , liner  28  may slide down to the bottom of cap  14 ′ where an outer ring of liner  28  may rest on a ledge, tabs, clips, or other feature that may extend in from an outer wall of cap  14 ′. In some embodiments, liner  28  may be designed to slide down to the bottom of cap  14 ′ as a result of gravity. In some other embodiments, cap  14 ′ may include a spring  30  that forces liner  28  to slide down cap  14 ′ when cap  14 ′ is removed from bottle  12 . When cap  14 ′ is screwed on to bottle  14 , the rim of bottle  14  will apply a force on liner  28  causing it to slide up into cap  14 ′. For embodiments with spring  30 , the force created by screwing cap  14 ′ on to bottle  12  may be sufficient to overcome the force applied by spring  30 . 
     Cap  14 ′ may also include a beacon system  16 ′ similar to beacon system  16 , which may be, for example, a print circuit board that may include a beacon  20 ′ and electrical contacts  24 ′ or a micro switch  32 . Beacon system  16 ′ may be secured to the upper surface of liner  28  and thus slide up and down with liner  28 . As shown in  FIG. 2B , cap  14 ′ may have an inner ring  34 , which is designed to contact micro switch  32  when cap  14 ′ is secured. Contact between micro switch  32  and inner ring  34  may be designed to complete the “short” circuit resetting beacon  20 ′ and stopping beacon  20 ′ from transmitting signal  17 . When contact between micro switch  32  and inner ring  34  is cut off, the short circuit may be broken, which is detected by beacon  20 ′, causing beacon  20 ′ to transmit the signal that bottle  12  has been opened. 
     In some embodiments, a conductive foam may be used as micro switch  32 . For example, in some embodiments, the conductive foam may be conductive electrostatic discharge (ESD) foam. In some embodiments, the conductive foam may be formed of a polymer (e.g., polyurethane, polyethylene, or the like). The conductive foam may be positioned such that when cap  14 ′ is installed on bottle  12 , the conductive foam is compressed (e.g., between beacon system  16 ′ and cap  14 ′), and when in the compressed state the conductive foam has a resistance sufficiently low to complete the closed circuit that “shorts” the electrical contacts  24 ′ that may be in contact with the conductive foam. When cap  14 ′ is removed from bottle  12 , the conductive foam may return to an uncompressed state and when in the uncompressed state the conductive foam may have a resistance sufficiently high to interrupt the “short” circuit between the electrical contacts  24 ′. 
     The resistance of the conductive foam in the compressed state and the uncompressed state can be selected based on the circuit design of beacon system  16 ′. The resistance of the conductive foam in the compressed state can be, for example, less than about 500 kOhm, 400 kOhm, 300 kOhm, 200 kOhm, 100 kOhm, or less. The resistance of the conductive foam in the uncompressed state can be, for example, greater than about 1 MOhm, 2 MOhm, 5 MOhm, 10 MOhm, or more. In some embodiments, beacon system  16 ′ may include an on-chip resistor having a resistance of about 1 MOhm and the resistance difference between the compressed and uncompressed state of the conductive foam may be about 10× difference from the on-board resistance of the on-board resistor. For example, the resistance of the conductive foam in the compressed state may be about 100 kOhm or less while the resistance of the conductive foam in the uncompressed state may be about 10 MOhm or more. In this example, the difference in the resistance of the conductive foam between the compressed and uncompressed state may be about 100×. It is contemplated that in other embodiments the difference in the resistance of the conductive foam in the compressed and uncompressed states may be greater than our less than about 100×, for example, about 125×, about 150×, about 175×, about 200×, about 75×, about 50×, about 25×, about 10×, about 5×, or about 2×. 
     The positioning of the conductive foam may vary depending on the construction of bottle  12 , cap  14 ′, beacon system  16 ′, and/or liner  28 ′. In some embodiments, the conductive foam may be secured to beacon system  16 ′, for example, across electrical contacts  24 ′ so when cap  14 ′ is removed it returns to its uncompressed state. In other embodiments, the conductive foam may be secured to cap  14 ′ (e.g., inner ring  34 ) and aligned with electrical contacts  24 ′ so that when cap  14 ′ is removed the conductive foam returns to its uncompressed state and depending on the thickness of the conductive foam it may completely separate from beacon system  16 ′ and electrical contacts  24 ′. The thickness of the conductive foam can vary, for example, between about 0.5 mm to about 3 mm, about 0.5 mm to about 2.5 mm, about 0.5 mm to about 2.0 mm, about 0.5 mm to about 1.5 mm, about 0.5 mm to about 1 mm, about 1.0 mm to about 3 mm, about 1.5 mm to about 3 mm, about 2.0 mm to about 3 mm, about 2.5 mm to about 3 mm, about 1 mm to about 2.5 mm, about 1.5 mm to about 2.0 mm. 
     In some embodiments, a coversheet (not shown) may be positioned between the beacon system  16 ′ and cap  14 ′ may cover at least a portion of beacon system  16 ′ and micro switch  32  (e.g., the conductive foam). The coversheet may protect inner ring  34  of cap  14 ′ as well as the beacon system  16 ′ from being damaged. The coversheet may also provide a wider contact surface for initiating the compression of the conductive foam in the event the conductive foam is not precisely aligned, for example, with inner ring  34  of cap  14 ′. In some embodiments, the conductive foam may be secured to the coversheet. 
     In some embodiments, instead of a micro switch  32 , electrical contacts  24 ′ and a conductive strip  26 ′ may be used to complete and cutoff the short circuit as described herein with regard to electrical contacts  24  and conductive strip  26 . Electrical contacts  24 ′ may be positioned on a surface of beacon system  16  (e.g., of the print circuit board) while conductive strip  26 ′ may be positioned on inner ring  34  or vice versa. 
     Cap  14 ′ and liner  28  may be made of the same material or different materials. For example, in some embodiments, cap  14 ′ may be made of a higher density more rigid material (e.g., high-density polyethylene) while liner  28  is made of a lower density more flexible material (e.g., low-density polyethylene). The flexibility of liner  28  may enable it to act as a liner and a seal when cap  14 ′ is installed on bottle  12 , thereby reducing or preventing contaminants or moisture from entering bottle  12 . For example, inner ring  34  and the rim of bottle  12  may act on liner  28  when cap  14 ′ is installed, as shown in  FIG. 2B , to deflect liner  28  creating a spring like force within liner  28  that cause a seal to form between liner  28  and the rim of bottle  12 . 
     For the purposes of this disclosure, all previous and subsequent description in reference to cap  14 , beacon system  16 , beacon  20 , electrical contacts  24 , and conductive strip  26  are all equally applicable to cap  14 ′, beacon system  16 ′, beacon  20 ′, electrical contacts  24 ′, and conductive strip  26 ′, and vice versa, besides where a distinction is noted. 
     It is contemplated that other techniques or mechanisms may be used to detect the removal of cap  14  from bottle  12 . For example, some embodiments may utilize a pressure sensor positioned between cap  14  and bottle  12  and when the pressure changes (e.g., when cap  14  is removed), the pressure sensor may interrupt the “short” circuit causing beacon  20  to transmit the signal that bottle  12  has been opened. 
     In some embodiments, the removal of cap  14  from bottle  12  may trigger a change in signal  17  transmitted from beacon  20  rather than simply initiating the transmitting of signal  17  from beacon  20 . For example, in some embodiments, beacon system  16  may be designed to transmit one identifiable signal while cap  14  is installed on bottle  12  and then change to or begin transmitting a second identifiable signal once cap  14  is removed from bottle  12 . The transmission of the second identifiable signal may be recognized as an indication the patient has taken a dose of the medication. 
     These one or more signals may be received by a remote device  18  (e.g., a smart phone) or other associated device, which can use the event (i.e., receiving of the sign or a change of the signal) as evidence that the patient has taken the medication. Beacon  20  may be a low-energy radio transponder. 
     Now the operation of an exemplary embodiment of beacon  20  will be described with reference to  FIG. 2C . As illustrated in  FIG. 2C , beacon  20  may include a packetizer  202  (e.g., a BLE packetizer), an oscillator  204 , a powertrain  210 , and an amplifier  206 . These components, as described herein, may be used to transmit signal  17  as shown in  FIG. 1  from beacon system  16 . In some embodiments, beacon  20  may be enabled to receive a signal from another device (e.g., remote device  18 ). In other embodiments, beacon  20  may be configured to operate as solely a transmitter. For example, beacon  20  may transmit a signal that may be received by remote device  18 , without pairing with remote device  18 . 
     Embodiments of beacon  20  with only transmitting capability may have decreased power consumption due to the elimination of the receiving hardware. In addition, eliminating the receiving hardware may also decrease the manufacturing cost of beacon  20 . Furthermore, the size of beacon  20  may also be decreased due to the elimination of the receiving hardware. 
     Returning to  FIG. 2C , packetizer  202  may receive a signal via host controller interface (HCI). In some embodiments, packetizer  202  may interface with a processor (not shown) of beacon system  16  or may interface with electrical contacts  24 . In some embodiments, the signal that packetizer  202  receives may include data, which may be included in the signal transmitted by beacon  20 . For example, in some embodiments where packetizer  202  interfaces with a process, the signal received from the processor may include parameters such as encryption parameters, modulation parameters, a mode of operation of beacon  20 , packet type, etc. Additional parameters may be used to configure beacon  20  to generate a specific signal, which may be transmitted by beacon  20 . 
     In some embodiments, the signal received via HCI may be indicative of a mode of operation of beacon  20 . For some embodiments, the mode of operation may depend on the functionality of beacon  20 . In some embodiments, the functionality of beacon  20  may be predetermined, for example, beacon  20  may be used in a specific application. 
     In some embodiments, the modes of operation of beacon  20  may include an advertising mode in which an advertising protocol (e.g., BLE) is used to periodically transmit data packets referred to as advertising packets (also referred to herein as “advertisement packets”). The advertising packets may carry data indicative of beacon  20  (e.g., a unique identification number (UID)). 
     In some embodiments, the mode of operation of beacon  20  may affect its power consumption. For example, beacon  20  may decrease power consumption by using advertising protocols. Advertising protocols may enable beacon  20  to operate with low power consumption by periodically broadcasting signal  17  during certain time intervals. For example, in some embodiments, beacon  20  may only advertise when cap  14  is removed and the “short” circuit is interrupted. During time intervals where beacon  20  is not broadcasting a signal, beacon  20  may be idle or turn-off in a standby mode (e.g., hibernate). By turning on only when transmitting a signal in active transmit mode, beacon  20  may decrease its power consumption, which may be advantageous for devices with a finite power source. As such, advertising protocols enable beacon  20  to advertise data to one or more remote devices  18  while maintaining low power consumption for beacon  20 . 
     BLE protocols may include different types of advertising packets. The advertising packet type may specify, for example, a configuration of beacon  20 . For example, the advertising packet type may specify whether beacon  20  is connectable and/or scannable. A connectable beacon  20  may pair with another device (e.g., BLUETOOTH device), and a scannable beacon  20  may broadcast and advertising packet in response to receiving a scan request from another device. (e.g., BLUETOOTH device). Furthermore, an advertising packet may be a directed packet. For example, a directed packet may include the beacon  20  address and remote device&#39;s  18  address, whereas an undirected packet may not be directed toward a particular remote device  18  (i.e., receiver). 
     The configuration of beacon  20 , which may be specified by the advertising packet type, may also affect the power consumption of beacon  20 . For example, beacon  20  in a connectable and scannable configuration may use more power than a beacon  20  in a non-connectable and non-scannable configuration. This is because beacon  20  in a connectable and scannable configuration has a longer active transmit time than beacon  20  operating in the non-connectable and non-scannable configuration. 
     As explained above, in some embodiments, beacon  20  may operate only as a transmitter and therefore may not be able to operate in a connectable configuration. Furthermore, in some embodiment, the transmitter may not be able to receive scan requests from other devices. Thus, in some embodiments, beacon  20  may be operating in a non-connectable and non-scannable configuration in order to decrease power consumption. 
     There are additional advantages besides lower power consumption that may be achieve by beacon  20  using BLE advertising protocols. For example, remote device  18  may discover BLUETOOTH device located near remote device  18  faster (and consuming less energy) using advertising protocols than by using other protocols. Advertising protocols may use three fixed channels of a wireless spectrum, e.g., the 2.4 GHz wireless spectrum. Thus, by not scanning the full wireless spectrum, remote device  18  may detect other BLUETOOTH device over the three fixed channels, enabling for the receiving and sending of BLE advertisement packets faster than the other protocols. 
     Returning now to  FIG. 2C , packetizer  202  may use the data included in the signal received via HCI to generate a data signal, which may include one or more data packets. Packetizer  202  may receive instructions to generate a data signal including one or more data packets according to an advertising protocol. In some embodiments, the instructions may detail the type of advertising event to broadcast. For example as explained above, the type of advertising event may determine whether the device is connectable and/or scannable, and/or whether the packet is directed. In an example, packetizer  202  may receive data indicative of instructions to generate a data signal that includes a non-connectable, non-scannable, and undirected advertising event. 
     Oscillator  204  may generate an RF carrier signal that may carry the data signal generated by packetizer  202 . The RF signal carrying the data may then be broadcasted by beacon  20 . As illustrated in  FIG. 2C , oscillator  204  may be a free-running oscillator, which may be used to directly generate an RF carrier signal. Thus, a free-running oscillator is an alternative to using a frequency synthesizer (i.e., Phase Locked Loop (PLL) synthesizer) to generate an RF carrier signal. Typically, a frequency synthesizer, which also includes a frequency reference circuit, may dissipate a significant portion of a transmitter&#39;s power. Accordingly, using a free-running oscillator may result in considerable power savings, which may be advantageous in achieve low power consumption operation for beacon  20 . 
     Both the turn-on time for the frequency synthesizer to lock to its frequency reference and the turn-on time of its frequency reference circuit may be significant compared to the packet duration. Therefore, the turn-on time (i.e., time to go from sleep mode to active transmit mode) for a transmitter using a frequency synthesizer may be greater than a transmitter using a free-running oscillator. A longer turn-on time may result in greater power dissipation. Accordingly, using the free-running oscillator, which may have a reduced turn-on time compared to a frequency synthesizer, may result in further power savings. 
     The free-running oscillator may directly generate the RF carrier signal, which may have a frequency within a wireless spectrum, e.g., the 2.4 GHz wireless spectrum. For example, the free-running oscillator may directly generate a RF carrier signal that has a frequency of one of the three channels in the 2.48 GHz band that are allocated to BLE advertising protocols according to BLUETOOTH specifications. The three channels are specified as 1 MHz wide channels with frequencies of 2.402 GHz, 2.480 GHz, and 2.426 GHz. 
     Note that the example oscillator provided in  FIG. 2C  and the accompanying description herein is for illustrative purposes only and should not be considered limiting. For instance, beacon  20  may include more than one free-running oscillator. In some embodiments, beacon  20  may include three free-running oscillators, each of which may be used to generate a carrier signal at a frequency of the three BLE channels. In such examples, beacon  20  may utilize methods such as multichannel transmission and frequency hopping. 
     In some embodiment, free-running oscillator  204  may be a Pierce oscillator, which is illustrated in  FIG. 2C . The Pierce oscillator  204  may include a transistor  212 , a biasing resistor  214 , capacitors  216  and  218 , and a resonator  220 . Resonator  220 , which may extend out from beacon  20 , may be used as a filter to filter the oscillation frequency. Further, the total capacitance of the two capacitors  216  and  218 , as seen by the resonator, may be referred to as the “load” capacitance.” The load capacitance may affect how far the oscillator loop is resonating, relative to the desired resonant frequency. Accordingly, selectively choosing the resonator, which may have a specific load capacitance requirement, may determine the oscillation frequency. 
     In some embodiments, the resonator  220  may be a thin-film bulk acoustic resonator (FBAR). An FBAR resonator  220  may include a piezoelectric thin film between two metal layers. FBAR are high-Q resonators that may have a stable and a low phase-noise center frequency, which may be the oscillation frequency. In some embodiments, FBAR resonators may have a Q of several hundred. In other embodiments, FBAR resonators may have an (unloaded) Q of over one thousand. Further, temperature compensation may be used to maintain the center frequency of FBAR resonator  220  at the frequency of the wireless channel. 
     The example resonator  220  shown in  FIG. 2C  and the accompanying description herein is for illustrative purposes only and should not be considered limiting. Any suitable resonator may be used. For example, the resonator may be any high frequency resonator, which may provide an oscillation frequency with stability and an accuracy that may meet BLUETOOTH standards. In other examples, the resonator may be a crystal resonator. For one example, the resonator may be a quartz resonator. 
     As noted above, the RF carrier signal generated by oscillator  204  may be used to carry the data signal generated by packetizer  202 . More specifically, the data signal generated by packetizer  202  may act as a tuning code, which may have a specific symbol rate. Further, the tuning code may be used to directly modulate the RF carrier signal. Accordingly, the modulated RF carrier signal may carry the data signal generated by packetizer  202 . Within examples, the tuning code may modulate the RF carrier signal according to at least BLE&#39;s protocols. 
     For instance, BLE protocols specify using Gaussian Frequency Shift Keying (GFSK) as the modulation scheme to modulate the RF carrier signal. Accordingly, the tuning code may be used to modulate the RF carrier signal to two different frequencies of the same advertising channel according to GFSK. Additionally and/or alternatively, the tuning code may be used to modulate the RF carrier signal to two different frequencies of the same advertising channel according to Binary Frequency Shift Keying (BFSK). Oscillator  204  may include a bank of switched capacitors, represented by variable capacitors  216  and  218  in  FIG. 2C , which may be used to adjust the load capacitance of Pierce oscillator  204 . As explained above, adjusting the load capacitance of Pierce oscillator  204  may adjust the oscillation frequency. The digital data signal, indicative of digital “0” and “1”, may be used to modify the load capacitance of Pierce oscillator  204 , such that oscillator  204  may generate a modulated signal of two frequencies, one of which corresponds to digital “0” and the other to digital “1.” 
     The modulated RF signal, carrying the data signal, may be transmitted to a class-D power amplifier  206 , as illustrated in  FIG. 2C . In some embodiments, at least a portion of the modulated signal may be transmitted to a prescaler  208 . Prescaler  208  may scale the signal and provide the scaled signal to packetizer  202 , where it may be used as a clock source. For example, prescaler  208  may scale down the 2.48 GHz signal to a 1 Mhz or 8 Mhz signal. By using a portion of the carrier signal as a clock source for packetizer  202 , there may be no need for a separate timing source for packetizer  202 , thereby further decreasing power consumption. 
     As illustrated in  FIG. 2C , the modulated RF carrier signal may be amplified using class-D power amplifier  206 . The amplified signal may then be transmitted to the radio (represented as “RF” in  FIG. 2C ) where it may be broadcast over the air as signal  17 . As explained above, in some embodiments, beacon  20  may be operating in advertising mode, which involves beacon  20  periodically transmitting advertising packets. Accordingly, the broadcasted RF signal may include advertisement packets, which may be received by one or more remote devices  18 . 
     Beacon  20  may be powered by powertrain  210 . Powertrain  210  may include a low dropout regulator (LDO)  228 , a power on reset (PoR)  222 , a bandgap voltage reference (Bandgap)  226 , and a real time clock (RTC)  224 . Note that the RTC  224  may have a low frequency and may operate without a crystal reference, as packetizer  202  may use a signal from oscillator  204  as described above. 
     Beacon  20 , as described herein, may transmit a signal to one or more remote devices  18  by carrying out one or more steps or functions, as described below. First, beacon  20  may generate, based on data, a data signal comprising one or more data packets. In some embodiments, the data may include information such as encryption parameters, modulation parameters, mode of operation of the device, packet type etc. In some embodiments, the data packet may be a non-connectable, non-scannable advertising packet. For the next step, beacon  20  may generate an RF signal using an oscillator circuit. Next, beacon  20  may directly modulate the RF signal, based on the data signal, to generate a modulated RF signal. As noted above, the modulated RF signal may conform to BLE protocols. Further, the RF signal may be directly modulated by using the data signal to adjust the load capacitance of oscillator  204  using the bank of switched capacitors. For the next step, beacon  20  may amplify the modulated RF signal. Next, beacon  20  may broadcast the amplified RF signal (i.e., signal  17 ) on the wireless channel. As described here, the wireless channel may be a channel in the 2.4 GHz spectrum. 
     As discussed herein, beacon  20  can be configured to turn on and transmit signal  17  when cap  14  is removed. In some embodiments, beacon  20  may transmit signal  17  for the duration cap  14  is while in other embodiments beacon  20  may transmit signal  17  for a fixed duration once cap  14  is removed. 
     As described herein, in some embodiments, remote device  18  can be detected by beacon  20  when it comes in range and opens communication. Various protocols may be used for this, including for example, proximity beacon application program interface (API) and Eddystone protocol available from Google. As will be appreciated from this disclosure, other communication protocols may be utilized. 
     In some embodiments, beacon  20  can broadcast encrypted data. For example, system  10  can include an encryption key, such as a QR or bar code on bottle  12  or cap  14 . Remote device  18 , or other device, can be used to scan the code (e.g., using an on-board camera), input the code, or otherwise receive the encryption key, and use the key to receive encrypted data from beacon  20 . In this way, only authorized devices may receive and decrypt data from signal  17 , which can increase security, for example when undirected transmissions are used. 
     In some embodiments, beacon  20  may broadcast signal  17  not just when cap  14  is removed from bottle  12 , but instead beacon  20  may broadcast signal  17  (i.e., send data) that may be received by remote device  18  when idle. For example, beacon  20  may broadcast an idle status signal that may be terminated when beacon  20  begins broadcasting the signal indicating cap  14  is removed. 
     Remote device  18  may be a smart phone, a smart watch, or other programmable user interface device with a mobile operating system. The smartphone or device may include a controller. The controller may include one or more hardware processors, such as one or more central processing units (CPUs). The processor(s) may execute a set of instructions to perform operations. The set of instructions may be programmed and stored in one or more memory devices. Examples of memory devices include non-volatile memory (e.g., a flash memory), volatile memory (e.g., a random access memory (RAM)), and other memory components. In some embodiments, the controller may be configured run programmed instructions or software to execute operations, as described herein. The controller may also include one or more interfaces to communicate with beacons of packets or packet bundles. 
     Remote device  18  may run or execute a programmable application (“the app”) designed to interface with beacon system  16 . The app may be downloadable to remote device  18  via the internet or an app store, for example, the PLAY STORE operated by Google. 
     The app may be programmed with a wide range of functionality. For example, the app may be programmed to receive medication prescription information. The medication prescription information may include, for example, the patient&#39;s name, patient identifier (e.g., a date of birth), the type of medication, the strength or the dose of medication (e.g., 100 mg, 200 mg, one pill, two pill, etc.), the frequency of dose (e.g., daily, twice daily, as needed, etc.), the duration of the prescription (e.g., three days, four days, five days, six days, 1 week, 2 weeks, indefinitely, etc.), the number of doses, the number of refills prescribed, the route by which it is to be delivered (e.g., orally), the time of day doses are to be taken, or other relevant information (e.g., take with food, take with water, etc.). The app may receive the medication prescription information in a variety of ways. For example, the medication prescription information may be transmitted to the app when the prescription is picked up at the pharmacy or downloaded (e.g., via an internet based patient login). Alternatively, the medication prescription information could be contained on the label (e.g., written out, as a bar code, or a QR label) and may be scanned by remote device  18  (e.g., using an on-board camera) and loaded into the application. The medication prescription information could also be input manually by a patient, a caregiver, or other individual by typing it in or speaking into remote device  18 . 
     In some embodiments, remote device  18  may upload and/or cross-check some or all of the medication prescription information to patient&#39;s medical record by accessing, for example, the cloud where the patient&#39;s medical records may be stored. This can enable a patient&#39;s medical records to be updated real time with all of their medication prescriptions. 
     The app may be programmed to detect each time a signal from beacon  20  is transmitted, which is representative that the medication is being taken, and log the time and date at which the medication is taken. If the patient is taking multiple medications the app may be programmed to differentiate the signal from each beacon  20  and log the time and date corresponding to the correct medication. For some embodiments, the app may be programmed to display a prompt asking the patient to confirm they took the medication. 
     For some embodiments, the app may be programmed to remind the patient to take a medication. For example, if the app has not detect a signal indicating cap  14  has been removed within a prescribed window in which the patient was supposed to take the medication, then the app can prompt the user to take the medication. 
     The app may be programmed to prompt the user in a variety of ways. For example, remote device  18  may display a message on the screen, ring, vibrate, or flash light (e.g., flash screen or flash on-board camera flash). The app may be programmed to escalate the intrusiveness of the prompt based on various factors (e.g., the urgency or importance of the medication or the length of time that has passed since an initial prompt was issued. The app may be programmed to enable the patient to override a prompt. For example, if the patient took the medication, but remote device  18  missed the signal transmission from beacon  20  because it was out of range, for example, the patient may input that they took the medication. 
     In some embodiments, the app may be programmed to send a prompt reminding the patient in advance of when they should be taking a medication. This may be advantageous if a medication requires that the user eat before or take with a drink so the reminder can enable the patient to plan accordingly. 
     In some embodiments, the app may be programmed to send a prompt to the patient if the app detects that the patient may be taking the wrong medication. For example, if the patient is on two or more medications and at the time the patient is scheduled to a take a first medication the patient opens the bottle for a second medication, the app may prompt the patient to the error. 
     In some embodiments, the app may be programmed to prompt the patient with instructions corresponding to taking of the medication. The corresponding instructions may include, for example, take with food, take with water, take with a certain quantity of water, do not drink alcohol while taking, do not drive after taking, etc. 
     For some embodiments, the app may be programmed to prompt the patient if the patient is taking the medication outside a prescribed window. For some embodiments, where the patient&#39;s prescription “is as needed,” the app may be programmed to prompt the patient to input the dose amount of the medication taken each time bottle  12  is opened so the doses can be logged. For some embodiments, the app may keep track of the number of doses left in bottle  12  and may prompt the patient to request a refill prior to being empty or in some embodiments the app may generate and send a refill request directly to a caregiver and/or a pharmacy. 
     For some embodiments, the app may be programmed to ask the patient questions associated with the medication prescription. For example, the app may ask the user to confirm they will not be drinking alcohol if the medication cannot be taken while drinking or the app may ask the user to confirm they will not be operating a vehicle if the medication cannot be taken if a patient will be operating a vehicle. For some embodiments, the app may ask the patient whether the patient is experiencing any side effects that may be associated with the medication. Whether the patient is experiencing side effects may then be transmitted to a caregiver (e.g., doctor, psychiatrist, nurse practitioner, etc.), which may use this information to evaluate and/or modify the prescription as needed. 
     For some embodiments, the app may be programmed to prompt the patient if the app determines that the patient is leaving home without their medication. For example, the app may be programmed to recognize the patient&#39;s home or other known wifi, GPS location, or vehicle BLUETOOTH connection and if the app determines the patient is moving (e.g., based on loss or change of wifi signal, change in GPS location, or detection of vehicle Bluetooth connection) and the app is not receiving a signal (e.g., a status signal from beacon  20 ) the app may prompt the user that their medication is not with them. The app may be programmed only to prompt the user if the patient is going to need to take the medication in the near future (e.g., the next two hours, next four hours, next six hours, or next eight hours). 
     The functionality of the app may be configurable by the patient. In other words, the patient may select what prompts they want to receive and what prompts they do not. For some embodiments, some prompts may be compulsory while other prompts may be selectable. For some embodiments a caregiver may select what prompts are active and not active. 
     Although system  10  is described primarily in reference to prescription medications, system  10  may also be used in conjunction with non-prescription medications, vitamins, supplements, etc. And, although system  10  is described primarily in reference to a pill or capsule bottle, system  10  may be incorporated into other medication containers, bottles, or dispensers. For example, system  10  may be used with eye drop bottles, ointment tubes, or other medication containers. 
       FIG. 3  shows an illustrative process  300  for monitoring medication adherence and compliance, consistent with embodiments of the present disclosure. Process  300  may be implemented using any of the exemplary embodiments of system  10  described herein, including those illustrated and described with reference to  FIGS. 1 and 2A, 2B, and 2C . 
     At step  302 , the system can detect when the cover or cap is removed from the medication container. For example, as discussed above, the removal of the cap may open a closed circuit thus resetting the beacon. At step  304 , the beacon can transmit based on the detection, a signal from the beacon to a remote device, which indicates the opening of the medication bottle. Optionally at step  306 , an application running on the remote device may recognize the signal as an indication that a patient has taken a medication from the bottle and create a record of when the patient takes the medication based on detection of the signal. Optionally at step  308 , the remote device may obtain prescription medication information by scanning a label of the medication, inputting by the user, or transmitting by the pharmacy, as described herein. Optionally at step  310 , the remote device may prompt the patient when to take the medication. For example, the remote device may prompt the patient with a reminder to take the medication in advance or may prompt the patient to take the medication if the patient has not taken the medication during a prescribed window. Optionally at step  312 , the remote device may prompt the patient to answer questions associated with taking the medication, as described herein. Optionally at step  314 , the remote device may upload or transmit the record and/or the patient&#39;s answers to the patient&#39;s medical record or to a caregiver. Process  300  as described herein may optionally include numerous other steps utilizing the above described functionality of system  10  and the application interfacing with beacon system  16 . Process  300  may vary based on the functionality selected by the patient and/or the caregiver. 
     The foregoing description has been presented for purposes of illustration. It is not exhaustive and is not limited to precise forms or embodiments disclosed. Modifications and adaptations of the embodiments will be apparent from consideration of the specification and practice of the disclosed embodiments. For example, the described implementations include hardware and software, but systems and methods consistent with the present disclosure can be implemented as hardware alone. In addition, while certain components have been described as being coupled to one another, such components may be integrated with one another or distributed in any suitable fashion. 
     Moreover, while illustrative embodiments have been described herein, the scope includes any and all embodiments having equivalent elements, modifications, omissions, combinations (e.g., of aspects across various embodiments), adaptations and/or alterations based on the present disclosure. The elements in the claims are to be interpreted broadly based on the language employed in the claims and not limited to examples described in the present specification or during the prosecution of the application, which examples are to be construed as nonexclusive. Further, the steps of the disclosed methods can be modified in any manner, including reordering steps and/or inserting or deleting steps. 
     Computer programs, program modules, and code based on the written description of this specification, such as those used by the remote device, are readily within the purview of a software developer. The computer programs, program modules, or code can be created using a variety of programming techniques. For example, they can be designed in or by means of Java, C, C++, assembly language, or any such programming languages. One or more of such programs, modules, or code can be integrated into a device system or existing communications software. The programs, modules, or code can also be implemented or replicated as firmware or circuit logic. 
     The features and advantages of the disclosure are apparent from the detailed specification, and thus, it is intended that the appended claims cover all systems and methods falling within the true spirit and scope of the disclosure. As used herein, the indefinite articles “a” and “an” mean “one or more.” Similarly, the use of a plural term does not necessarily denote a plurality unless it is unambiguous in the given context. Words such as “and” or “or” mean “and/or” unless specifically directed otherwise. Further, since numerous modifications and variations will readily occur from studying the present disclosure, it is not desired to limit the disclosure to the exact construction and operation illustrated and described, and accordingly, all suitable modifications and equivalents may be resorted to, falling within the scope of the disclosure. 
     Other embodiments will be apparent from consideration of the specification and practice of the embodiments disclosed herein. It is intended that the specification and examples be considered as example only, with a true scope and spirit of the disclosed embodiments being indicated by the following claims.