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Lights on prescription?
According to a recent report by the Royal Pharmaceutical Society, the average residential care home resident is prescribed 7.2 medicines per day, with an increased risk of falls just one potential side-effect of this potent cocktail that often includes psychotropic and antipsychotic drugs – The Right Medicine: Improving Care in Care Homes.
You might think that this population is taking multiple medications anyway – but another study notes a dramatic increase in psychotropic medication on admission to care – Psychotropic Medications and the Transition Into Care: A National Data Linkage Study.
The Society is on a mission to reduce the cost of all that medication, with one pilot average of £153 per resident, and a total of £135 million from preventable hospital admissions, appropriate prescribing and reduced waste- an estimated £24 million is lost every year due to wastage in care homes across England alone – Reducing the environmental impact of medicines from procurement to disposal.
What’s that got to do with the lights?
The right light at the right time can set your body clock and keep it on track – Fundamentals of circadian entrainment by light.
Your body clock drives metabolism, inflammation and even immune response – as you will know if you’ve ever noticed your ankles get swollen in the afternoon. So if you can time drug delivery to target the specific pathway – and so the drugs stay in your body long enough to do their work and then are naturally rinsed from the system – you can improve efficacy and reduce dose and side effects. This time-focused approach is known as Chronopharmacology – The right time for chronopharmacology: Drugs moving to the rhythm of life.
The problem is that people in healthcare settings struggle to maintain a steady circadian cycle as almost all the natural time cues are absent – including the natural cycle of bright days and dark nights – Enhancing circadian rhythms—the circadian MEGA bundle as novel approach to treat critical illness.
Older dults are especially specially when so few ever make it outside – less than one in three get outdoors once per month on average, even if they’re physically able to – Understanding the Barriers and Enablers to Using Outdoor Spaces in Nursing Homes: A Systematic Review.
Circadian-aware lighting could hold the key to effective chronopharmacology, cutting the cost of medication while reducing risks, side-effects- and reduce the carbon footprint too.
Blood pressure and hypertension medication taken at bedtime, instead of waking, shown to improve Ambulatory Blood Pressure control and significantly reduce the occurrence of major cardiovascular disease events. As these drugs can have mild side-effects, taking them at night is a good idea too – Bedtime hypertension treatment improves cardiovascular risk reduction: the Hygia Chronotherapy Trial.
Breakthrough pain in end of life care: Timing of opioid administration to target peak pain intensity to potentially prevent breakthrough pain episodes and reduce dependence on round the clock delivery and associated side effects – The Circadian Rhythm of Breakthrough Pain Episodes in Terminally-ill Cancer Patients.
Cancer – Various anticancer drugs have shown time-dependent efficacy and toxicity, with some studies suggesting better outcomes and fewer side effects for chemotherapy agents like 5-fluorouracil and oxaliplatin when administered during specific circadian phases – Chronopharmacology in cancer treatment: Optimizing drug timing for improved efficacy and reduced toxicity.
Antidepressant dose timing improves efficacy while reducing toxicity, while one study found that the timing of an antidepressant drug (citalopram) at the start of bright light exposure increased melatonin suppression in healthy adults by 47%, suggesting a powerful non-pharmacological option for improving circadian entrainment – Antidepressants and Circadian Rhythm: Exploring Their Bidirectional Interaction for the Treatment of Depression.
Circadian lighting just might hold the key to safer, more affordable and sustainable care.
Is your workplace like a Formula 1 car?
Inspired by the brilliant Tom Riby, guest on our panel at SmartTect 25 next week, the Formula 1 car is a great analogy for a truly smart, human-centric space – the dynamic intersection of vision, user experience and technology – and ultimately only as good as the people who drive it.
Please join the panel as we challenge our audience to ask how are you going to win prizes if you’re driving through the rear-view mirror? – EXPLORE THE FUTURE TRENDS IN SMART TECHNOLOGIES.
Bright streaks and horse sense
By the time you’re reading this, I’ll (hopefully) be relaxing on a beautiful farm learning from some remarkable horses. Here are three equine factoids for a Friday afternoon.
1. Racehorses, like athletes, need to hit their peak on time. Circadian lighting effectively boosted their body clocks – while standard stable conditions left them in the dark – Optimised Stable Lighting Strengthens Circadian Clock Gene Rhythmicity in Equine Hair Follicles.
2. If you’re breeding racehorses, you want to make sure they foal at the right time for the track. Blue light, directed at a single eye is enough to advance the breeding season, giving them a head start – and giving the stallions a break – Blue light from individual light masks directed at a single eye advances the breeding season in mares.
3. Loading a horse into a trailer can be stressful for horse and handler alike. Bright, cool, diffuse light inside the trailer can significantly reduce time to approach the trailer and stress levels once loaded. This may be because their eyes take longer than ours to adjust to different light levels – so light levels similar to those outside the trailer may be more comfortable for them – Effects of different LED lighting conditions on young horses during trailer loading and stationary confinement.