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Smart pills are medications that have minute sensors incorporated inside which can be ingested and can be used to monitor patient compliance. The sensors are activated by the acid in the stomach and connect to a smart wearable device which relays data to a smartphone application. The Abilify MyCite was a revolutionary smart pill which ultimately failed commercially. This contained aripiprazole (Abilify, Otsuka Pharmaceuticals) an antipsychotic medication used in psychiatric disorders like schizophrenia and was approved by the FDA in 2017 [25]. It incorporated the Proteus ingestible event marker (IEM) made from dietary minerals in very small quantities. The integrated circuit is the size of a grain of sand and is embedded in each medication tablet [26]. Activation of the sensor results in emission of a signal to the tablet computer indicating successful ingestion of the medication and ticks the checklist for dosing along with the time of ingestion. This ensures that the elderly are compliant with much needed medications. But the smart pill also necessitates wearing a smart device using a tablet computer which the elderly may find difficult. This smart pill was supposed to revolutionize medication dosage but the company Proteus Digital Health ran into financial troubles and filed for bankruptcy in 2020 after being unable to find funds due to the COVID-19 crisis after the drug major Otsuka pharmaceutical withdrew financial support from the project [27]. This may indicate that smart pills may not be financially viable despite their promise of technology and medicine merging to offer better compliance [28].

Studies of medications with sensors in chronic diseases like diabetes and hypertension demonstrate that digital health improves compliance by reminding patients to take their dose of medication at the appropriate time and also improve medication safety [29]. Newer ingestible or injectable nanosensors may one day be the early warning systems for diseases. But such embedded wearables also raise legal and ethical issues regarding privacy and security. An implantable chip containing medical records of a patient which were implanted in some Alzheimer’s patients in 2002 raised several issues resulting in banning of forced implants resulting in the technology being shelved [30].