Dose Tracker Application for Monitoring Medication Usage, Symptoms, and Adverse Effects During Missions (Dose Tracker) - 07.28.16

Overview | Description | Applications | Operations | Results | Publications | Imagery

ISS Science for Everyone

Science Objectives for Everyone
Direct comparisons of how medications work in space compared to on Earth have not yet been performed, and scientists need more data to determine whether the drugs are working differently. Dose Tracker Application for Monitoring Crew Medication Usage, Symptoms, and Adverse Effects During Missions (Dose Tracker) uses an iPad app to collect information on members’ medication use during their missions. Results help determine whether medicines act differently on humans in space than they do on Earth.
Science Results for Everyone
Information Pending

The following content was provided by Virginia Wotring, Ph.D., and is maintained in a database by the ISS Program Science Office.
Experiment Details

OpNom: Dose Tracker

Principal Investigator(s)
Virginia Wotring, Ph.D., Center for Space Medicine, Baylor College of Medicine, Houston, TX, United States

Co-Investigator(s)/Collaborator(s)
LaRona Smith, MSN, RN, JES Tech, Houston, TX, United States

Developer(s)
NASA Johnson Space Center, Human Research Program, Houston, TX, United States

Sponsoring Space Agency
National Aeronautics and Space Administration (NASA)

Sponsoring Organization
NASA Research Office - Human Research Program (NASA Research-HRP)

Research Benefits
Space Exploration, Earth Benefits, Scientific Discovery

ISS Expedition Duration
September 2015 - March 2016; March 2016 - September 2017

Expeditions Assigned
45/46,47/48,49/50,51/52

Previous Missions
None

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Experiment Description

Research Overview

  • This study documents the medication usage of crew members before and during their missions by capturing previously unrecorded data regarding medication use during spaceflight, including side effect qualities, frequencies and severities. These research-oriented data are collected for research purposes, separate from medical records.
  • The data are expected to either support, or counter, anecdotal evidence of medication ineffectiveness during flight and unusual side effects during flight. It is also expected that specific, near-real-time questioning about symptom relief and side effects will provide the much needed data required to establish whether spaceflight-associated alterations in pharmacokinetics (PK), or pharmacodynamics (PD), is occurring during missions.
  • It is expected that this study should provide the evidence that either supports or counters the need for additional research; if additional research is warranted, the data from this study should prove useful for assigning research priorities.

Description

During spaceflight, the body undergoes a number of physiological changes that are expected to result in altered interactions with administered medications, but it is not yet known if, or to what extent, these actually occur. The potential for therapeutically relevant alteration in either pharmacokinetics (how the body handles administered medications) or pharmacodynamics (how administered medications act upon the body) has long been a concern. This observational epidemiological study is a proactive step toward addressing this issue via regular direct questioning of crew member volunteers, a model that the JSC Nutritional Biochemistry Discipline has proven to be both feasible and useful.
 
An iPad with the Dose Tracker Application is used to permit fast and efficient collection of data regarding crew members’ medication use on a near real-time basis, eliminating the current problems associated with recall over periods of weeks. Specific questions regarding medication use (somewhat different from the questions that physicians ask regarding patient health) are asked of each participating crew member. The data collection process is streamlined by using a flexibly programmed, computerized survey application that leverages the limited medication choices aboard, the doses available, typical dosing frequency, and side effects associated with each medication to provide an individualized short questionnaire for each medication use by the crew member.
 
Specifically, the questionnaire asks if the crew members have used medications since the last entry, what prompted them to use the medication, how well it seemed to work, how frequently they repeated doses, and if the medication seemed to cause side effects. Using logical programming, the questions and answers displayed are tailored for each individual participant as he or she provides answers; this streamlines the questionnaire-taking process for each use. For crew members who used no medications in a given week, their only task is to answer one question (Did you take any medications this week?). For each indication (pain, sleep problem, etc.), up to eight questions may be presented to the crew member. For indications that include pain, a diagrammatic Wong-Baker pain rating scale is included.
 
Coded (de-identified) data are delivered weekly to a secure server on the ground for analysis by study investigators. Preflight (ideally) or post-flight (after re-adaptation to Earth’s gravity), each participating crew member records his or her medication usage weekly (preferably more frequently) using the Dose Tracker Application, so that their ground medication usage frequencies, doses, and perceptions may be compared to those recorded during flight.

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Applications

Space Applications
Crew members sometimes take medications in space, but scientists do not have good information on how medications are used and whether spaceflight affects how the body handles those medications (pharmacokinetics) or how the medications work in the body (pharmacodynamics). This investigation asks crew members a series of questions about their medication use, including doses, frequency, how well it seemed to work, and whether it caused any side effects. Results are expected to provide information on changes in pharmacokinetics and pharmacodynamics in spaceflight as well as highlight specific medications that cause problems or unusual side effects, if any.

Earth Applications
For patients, the most important feature of a medicine-tracking program is simplicity and speed, but for physicians, the most important feature is comprehensive detail. Dose Tracker aims to meet both goals in a single, unobtrusive tablet app, making it easier for patients and their doctors to successfully track medicine use. In addition to tracking the use of medications by crew members, the app could be used by people on Earth.

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Operations

Operational Requirements and Protocols

Twenty-four crew members are asked to complete a computerized survey (Dose Tracker Application), modeled on the Food Frequency Questionnaire (FFQ) they already use, on (at least) a weekly basis. More frequent entries are preferred whenever possible.

The crew member unstows his or her personal iPad, and enters medication usage data since the previous entry into the Dose Tracker Application. The questionnaire asks if the crew member has used medications since the last entry, what prompted him/her to use the medication, how well it seemed to work, how frequently doses were repeated, and if the medication seemed to cause side effects. Using logical programming, the questions and answers displayed are tailored for each individual participant as he, or she, provides answers; this streamlines the questionnaire-taking process for each use. For any crew member who used no medications in a given week, the only task is to answer one question (Did you take any medications this week?). For each indication (pain, sleep problem, etc.), up to eight questions may be presented to the crew member. For indications that include pain, a diagrammatic Wong-Baker pain rating scale will be included. The first session should occur no later than Flight Day 7 (+1 day) and be repeated every 6-8 days throughout entire mission. One session per workday is desired. A downlink to retrieve the data occurs once per week.

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Decadal Survey Recommendations

Information Pending

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Results/More Information

Information Pending

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Results Publications

    Wotring V.  Medication use by U.S. crewmembers on the International Space Station. FASEB: Federation of American Societies for Experimental Biology Journal. 2015 November; 29(11): 4417-4423. DOI: 10.1096/fj.14-264838. PMID: 26187345.

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Ground Based Results Publications

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ISS Patents

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Related Publications

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Related Websites

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Imagery

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Dose Tracker Application Log-in Screen

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