One of the most difficult problems in managing chronic diseases that have intermittent signs and symptoms is to know when and how aggressively to intervene pharmacologically. The problem is that patient self-reports are notoriously inaccurate, particularly when generated retrospectively. Symptom diaries are widely used and can help with the problem if the patient is diligent in their use.
In adapting Med-ic® for prn analgesic use the idea of incorporating an electronic symptom diary into the medication package was developed. When the patient takes a tablet he or she is prompted to rate the severity of their pain at that moment by touching a scale printed on the package. The pain ratings can be downloaded later and incorporated therapeutically during follow-up visits and can guide medication and dose adjustments.
Out of this came the Med-ic® eDIARY – an electronic symptom checklist. Med-ic® eDIARY fits conveniently in the patient’s pocket and is self-contained. When the patient has a symptom or sign, he or she indicates the location and severity by touching one of the printed buttons. Unlike Med-ic smart packages, Med-ic® eDIARY can be used for months, storing thousands of symptom ratings to be downloaded at the next physician visit.
Med-ic® eDIARY can also be equipped with a random visual or auditory reminder to prompt symptom and severity data. The patient is prompted at random or other preprogrammed intervals to complete the symptom ratings at that moment, developing an increasingly accurate symptom profile over time. This can be especially useful in the management of chronic pain where the primary analgesic must be supplemented by a stronger analgesic for breakthrough pain.