Open-label Study to Assess Usability of the Medical Information Device #1 (MIND1) System in Adults With Schizophrenia On Oral Aripiprazole

Poor adherence to medication is a well-recognized problem in psychiatric patients. Although a variety of treatment models have been developed to improve management of patients in general and medication adherence in particular, poor medication adherence remains a major barrier to achieving optimal health.

The MIND1 System includes a drug-device combination, a patch, and application software to convey level of activity and rest and to mark events through the act of ingestion.

The purpose of this open-label study is to determine the usability of the Medical Information Device #1 (MIND1) System in adults with schizophrenia. Approximately 32 subjects with schizophrenia, between 18 and 65 years of age (inclusive) who are currently prescribed and stabilized on oral aripiprazole, will be enrolled.

Inclusion criteria

• Subjects must be prepared and able to give written (signed and dated) informed consent, which includes adherence to study requirements and restrictions before enrolling in the study. Subjects must be willing to adhere to study procedures, including troubleshooting of the MIND1 System by a third party if needed (third party will be blinded to personal health information).
• Male and female subjects 18 to 65 years of age, inclusive, at time of informed consent.
• Subjects who have a primary current diagnosis of schizophrenia, as defined by Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria. Subjects may be symptomatic at screening, but must be able to be treated as outpatients.
• Subject is cooperative, able to ingest oral medication, and willing to complete all aspects of study.
• Subject is currently prescribed oral aripiprazole for schizophrenia at one of the following single daily doses (10, 15, 20, or 30 mg), and is deemed likely to remain on this same stable dose throughout the course of the study. Subject has not had any changes in their aripiprazole regimen or dose over the 2 weeks before screening.
• Subject must be able and willing to carry the MIND1 System smartphone on his/her person and complete all tasks, as well as adequately operate all devices, as applicable. Caregiver or other third-party assistance can be utilized, if needed, although all subjects should be encouraged to attempt all tasks themselves.
• Subject likely possesses the capacity to utilize the technology interfaces (eg, open and navigate software applications using the touch screen) and telephone features of a smartphone. The subject has satisfactory mobile phone reception (preferably 3 bars or more, or have Wi-Fi) at home and/or at work for study-designated wireless carrier.
• Subject is not pregnant or breast-feeding, and does not plan to become pregnant.
• Skin on the anterior chest just above the lower edge of the rib cage that is free of any dermatological problems (eg, dermatosis or dermatitis, open wounds, or other skin disorders such as warts, rashes, atopic dermatitis, or irritations).

Exclusion criteria

• Subjects with a current DSM-5 diagnosis other than schizophrenia, including major depressive disorder, bipolar disorder, schizoaffective disorder, delirium, major neurocognitive disorder (eg, dementia), intellectual developmental disorder, or any other diagnosis that might impact the subject's ability to participate in the study. Other disorders that are not the focus of treatment and will not impact the subject's ability to participate in all aspects of the study (eg, social anxiety disorder) may be included.
• Subjects with a current DSM-5 diagnosis of borderline, antisocial, paranoid, schizoid, schizotypal, or histrionic personality disorder.
• Subjects who exhibit prominent negative symptoms that, in the judgment of the investigator, will interfere with study procedures or unable to adhere with study requirements.
• Subjects who are currently on a long-acting injectable antipsychotic.
• Subjects who are likely to be incapable of using the MIND1 System technology, even with assistance.
• On the Columbia-Suicide Severity Rating Scale (C-SSRS) Subjects who answer "Yes" to Suicidal Ideation Item 4 (Active Suicidal Ideation with Some Intent to Act, Without Specific Plan) and whose most recent episode meeting criteria for this C-SSRS Item 4 occurred within the last 3 months, OR Subjects who answer "Yes" on the C-SSRS Suicidal Ideation Item 5 (Active Suicidal Ideation with Specific Plan and Intent) and whose most recent episode meeting criteria for this C-SSRS Item 5 occurred within the last 3 months, OR Subjects who answer "Yes" on any of the 5 C-SSRS Suicidal Behavior Items (actual attempt, interrupted attempt, aborted attempt, preparatory acts, or behavior) and whose most recent episode meeting criteria for any of these 5 C-SSRS Suicidal Behavior Items occurred within the last 1 year, OR Subjects who, in the opinion of the investigator, present a serious risk of suicide.
• Subject has received any investigational product within the last 30 days, including the MIND1 System (eg, subjects who participated in Cohort 1 of this study are not eligible for Cohort 2).
• Subjects who have a history or evidence of a medical condition that would expose them to an undue risk of a significant AE or interfere with assessments of safety or usability during the course of the study, including but not limited to, hepatic, renal, respiratory, cardiovascular, endocrine, neurologic, hematologic, or immunologic disease, as determined by the clinical judgment of the investigator.
• Subjects with epilepsy or a history of seizures (except for a single childhood febrile seizure, post traumatic seizure, alcohol withdrawal seizure, etc).
• Subjects with a history of neuroleptic malignant syndrome or clinically significant tardive dyskinesia, as assessed by the investigator.
• Subjects who are known to be allergic, intolerant, or unresponsive to prior treatment with aripiprazole or other quinolinones.
• Subjects with a history of hypersensitivity to antipsychotic agents.
• Subjects with a known allergy to adhesive tape or any pertinent components of the patch or IEM
• Sexually active women of childbearing potential who will not commit to utilizing 2 of the approved birth control methods or who will not remain abstinent during this study and for 30 days following the last dose of study medication.
• Sexually active males (unless sterile, defined as having had a bilateral orchiectomy) who will not commit to utilizing 2 of the approved birth control methods or who will not remain abstinent during the study and for 90 days following the last dose of study drug.
• Subject has a current history (within the past month) of a substance use disorder (excluding tobacco) which meets DSM-5 criteria, or demonstrates a positive result on the urine drug test during screening. Subjects with a positive drug screen for drugs of abuse (excluding cannabinoids) are excluded and may not be retested or rescreened. Subjects with a positive urine drug screen resulting from use of prescription (such as opioids) or over-the-counter medications or products that, in the investigator's documented opinion, do not signal a clinical condition that would impact the safety of the subject or interpretation of the study results may continue evaluation for the study following consultation and approval by the Medical Monitor.
• Subjects who, in the opinion of the investigator, are acutely psychotic or who exhibit symptoms currently requiring hospitalization.
• Subjects unwilling to refrain from the use of topical products on the skin patch sites.
• Subjects unwilling or unable to complete the evaluations included in this study, which include audio recording of the subject's voice and require the ability to distinguish colors (eg, subjects unwilling to be recorded and colorblind subjects are to be excluded from participation in this study)
• Any subject who, in the opinion of the investigator, should not participate in the study.