Automatic therapy adjustments

• US 10,130,815 B2
• Filed: 02/11/2013
• Issued: 11/20/2018
• Est. Priority Date: 09/15/2003
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Singal, Ruchika, Jensen, Steven L., Skime, Robert M.
• Primary Examiner(s): Alter, Alyssa M
• Application Number:
  US13/764,054
• Publication Number:
  US 20130150921A1
• Time in Patent Office: 2,108 Days
• Field of Search: 607 17, 607 48
• CPC Class Codes: A61B 5/1116 Determining posture transitions
• CPC Class Codes: A61B 5/1118 Determining activity level
• CPC Class Codes: A61N 1/36071 Pain
• CPC Class Codes: A61N 1/36132 using patient feedback
• CPC Class Codes: A61N 1/36139 with automatic adjustment
• CPC Class Codes: A61N 1/36535 controlled by body position or posture
• CPC Class Codes: A61N 1/36542 controlled by body motion, e.g. acceleration
• CPC Class Codes: A61N 1/37264 Changing the program; Upgrading firmware
• CPC Class Codes: G16Z 99/00 Subject matter not provided for in other main groups of this subclass

Abstract

A medical device detects a previously defined event, and controls delivery of therapy to a patient according to therapy information associated with the previously defined event. In exemplary embodiments, the medical device enters a learning mode in response to a command received from a user, e.g., the patient or a clinician. In such embodiments, the medical device defines the event, collects the therapy information, and associates the therapy information with the defined event while operating in the learning mode. In some embodiments, the medical device defines the event based on the output of a sensor that indicates a physiological parameter of the patient during the learning mode. The sensor may be an accelerometer, which generates an output that reflects motion and/or posture of the patient. The medical device may collect therapy information by recording therapy changes made by the user during the learning mode.

Claims

1. A method, comprising:

defining an event via at least one processor;

monitoring therapy delivered by a medical device during occurrence of the defined event, wherein monitoring comprises receiving, from a user, during a learning mode of the medical device, and during the occurrence of the defined event, therapy information indicative of changes made by the user to the therapy delivered by the medical device during the occurrence of the defined event;

associating the therapy information indicative of the monitored therapy with the defined event;

subsequently detecting, via a sensor, the defined event; and

providing subsequent therapy to a patient via the medical device according to the therapy information in response to the detection of the defined event.

2. The method of claim 1, wherein subsequently detecting the defined event comprises:

monitoring an output of the sensor; and

comparing the sensor output to the defined event.

3. The method of claim 2, wherein the sensor output reflects at least one of motion and posture of the patient.

4. The method of claim 1, wherein providing subsequent therapy to the patient comprises automatically making changes to the provided therapy over time based on the therapy information.

5. The method of claim 4, wherein the therapy information comprises information indicative of multiple changes to therapy parameters over time, and wherein providing subsequent therapy to the patient comprises automatically making changes to the provided therapy over time based on the therapy information.

6. The method of claim 5, wherein the therapy information comprises time information indicative of how the therapy parameters are to be changed over time, and wherein providing subsequent therapy to the patient comprises automatically making changes to the provided therapy over time based on the time information.

7. The method of claim 1, wherein defining the event comprises sensing a signal reflecting a physiological parameter of a patient and wherein receiving, from the user and during the occurrence of the defined event, therapy information indicative of changes to therapy delivered by the medical device comprises receiving, from the user, therapy information indicative of changes made by the user to therapy delivered by the medical device while sensing the signal reflecting the physiological parameter of the patient.

8. The method of claim 1, wherein receiving, from the user, during the learning mode of the medical device, and during the occurrence of the defined event, therapy information indicative of changes made by the user to therapy delivered by the medical device comprises recording a change to the monitored therapy during the occurrence of the defined event and wherein associating therapy information indicative of the monitored therapy comprises associating therapy information indicative of the recorded change to the monitored therapy with the defined event.

9. The method of claim 8, wherein receiving, from the user, during the learning mode of the medical device, and during the occurrence of the event, therapy information indicative of changes made by the user to therapy delivered by the medical device comprises recording a time of the change to the monitored therapy and wherein associating therapy information indicative of the monitored therapy comprises associating therapy information indicative of the recorded time of the change to the monitored therapy with the defined event.

10. The method of claim 9, wherein providing subsequent therapy to the patient comprises automatically changing the provided therapy according to the therapy information indicative of the recorded change and at a time determined by the therapy information indicative of the recorded time of the change.

11. The method of claim 1, wherein receiving, from the user, during the learning mode of the medical device, and during the occurrence of the event, therapy information indicative of changes made by the user to therapy delivered to the patient comprises receiving multiple changes to the therapy over time during the occurrence of the defined event and wherein associating therapy information indicative of the monitored therapy comprises associating therapy information indicative of the multiple changes to the therapy over time with the defined event.

12. The method of claim 1, wherein the medical device comprises an implantable medical device, and wherein receiving, from the user, during the learning mode of the medical device, and during the occurrence of the event, therapy information indicative of changes made by the user to therapy delivered by the medical device during the occurrence of the defined event comprises receiving user input to control the monitored therapy via a programming device.

13. The method of claim 1, wherein associating therapy information indicative of the monitored therapy with the defined event comprises associating therapy information indicative of multiple therapy parameter values with the defined event.

14. The method of claim 1,

wherein defining the event via at least the one processor comprises defining the event during an initial occurrence of the event, and

wherein receiving, from the user, during the learning mode of the medical device, and during the occurrence of the defined event, therapy information indicative of the changes made by the user to the therapy delivered by the medical device comprises receiving, from the user, during the learning mode of the medical device, and during the occurrence of the initial occurrence of the event, therapy information indicative of the changes to the therapy during the initial occurrence of the event.

15. The method of claim 1, further comprising, subsequent to defining the event, receiving input from the user to indicate that the event is about to occur.

16. The method of claim 15, wherein the event is a patient activity, and wherein receiving the input from the user indicates the patient is about to undertake the activity.

17. The method of claim 1, wherein providing subsequent therapy to a patient via the medical device according to the therapy information comprises receiving input from the user to change the therapy information.

18. The method of claim 1, wherein defining the event comprises defining the event to occur after the patient maintains an activity or posture for a predefined duration.

19. A medical device, comprising:

a therapy delivery module configured to deliver therapy to a patient;

a sensor configured to generate an output; and

a processor configured to;

define an event;

monitor delivery of the therapy delivered during occurrence of the defined event, wherein to monitor, the processor is configured to receive, from a user, during a learning mode of the medical device, and during occurrence of the defined event, therapy information indicative of changes made by the user to therapy delivered during the occurrence of the defined event;

associate the therapy information indicative of the monitored therapy with the defined event;

detect, via the output of the sensor, the defined event; and

control delivery of subsequent therapy to the patient according to the therapy information in response to the detection of the defined event via the sensor.

20. The medical device of claim 19, wherein the processor is further configured to detect the defined event by monitoring an output of the sensor and comparing the sensor output to the defined event.

21. The medical device of claim 20, wherein the sensor is configured to provide an output that reflects at least one of motion and posture of the patient.

22. The medical device of claim 19, wherein the processor is configured to control delivery of subsequent therapy to the patient by automatically making changes to the delivered therapy over time based on the therapy information in response to detecting the defined event.

23. The medical device of claim 22, wherein the processor is configured to associate the therapy information with the defined event that comprises information indicative of multiple changes to therapy parameters over time, and wherein the processor is configured to control delivery of subsequent therapy to the patient by automatically making changes to the delivered therapy over time based on the therapy information.

24. The medical device of claim 23, wherein the processor is configured to associate the therapy information with the defined event that comprises time information indicative of how the therapy parameters are to be changed over time, and wherein the processor is configured to control delivery of subsequent therapy to the patient by automatically making changes to the delivered therapy over time based on the time information.

25. The medical device of claim 19, wherein the sensor is configured to provide an output that reflects a physiological parameter of the patient, and wherein the processor is configured to receive, from the user, during the learning mode of the medical device, and during the occurrence of the defined event, therapy information indicative of changes made by the user to therapy delivered by the medical device by receiving, from the user, during the learning mode of the medical device, and during the occurrence of the defined event, therapy information indicative of changes made by the user to therapy delivered by the medical device while monitoring the output of the sensor that reflects the physiological parameter of the patient.

26. The medical device of claim 19, wherein the processor is configured to receive, from the user, during the learning mode of the medical device, and during the occurrence of the event, therapy information by recording a change to the monitored therapy while sensing the signal and to associate therapy information indicative of the recorded change to the monitored therapy with the defined event.

27. The medical device of claim 26, wherein the processor is configured to receive, from the user, during the learning mode of the medical device, and during the occurrence of the event, therapy information by recording a time of the change to the monitored therapy and to associate therapy information indicative of the recorded time of the change to the monitored therapy with the defined event.

28. The medical device of claim 27, wherein the processor is configured to control delivery of subsequent therapy to the patient by automatically changing the delivered therapy according to the therapy information indicative of the recorded change and at a time determined by the therapy information indicative of the recorded time of the change.

29. The method of claim 19, wherein the processor is configured to receive, from the user, during the learning mode of the medical device, and during the occurrence of the event, therapy information by receiving multiple changes to the therapy over time while sensing the signal and to associate therapy information indicative of the multiple changes to the therapy over time with the defined event.

30. The medical device of claim 19, wherein the medical device is an implantable medical device, and further comprising a telemetry module configured to receive user input to control the delivery of subsequent therapy during occurrence of the defined event.

31. The medical device of claim 19, wherein the processor is configured to associate therapy information indicative of multiple therapy parameter values with the defined event.

32. The medical device of claim 19, wherein the processor is configured to receive input from the user subsequent to defining of the event to indicate that the event is about to occur.

33. The medical device of claim 32, wherein the event is a patient activity, and wherein receiving the input from the user indicates the patient is about to undertake the activity.

34. The medical device of claim 19, wherein the processor is configured to receive input from the user while controlling delivery of subsequent therapy to the patient, the input being provided to change the therapy information.

35. The medical device of claim 19, wherein the processor is configured to define the event to occur after the patient maintains an activity or posture for a predefined duration.

36. A medical system, comprising:

a medical device, comprising;

a therapy delivery module configured to deliver therapy to a patient; and

a sensor configured to generate an output; and

one or more processors configured to;

define an event;

monitor delivery of the therapy delivered by the medical device during occurrence of the defined event, wherein to monitor, the one or more processors are configured to receive, from a user, during a learning mode of the medical device, and during the occurrence of the defined event, therapy information indicative of changes made by the user to the therapy delivered during the occurrence of the defined event;

associate the therapy information indicative of the monitored therapy with the defined event;

detect, via the output of the sensor, the defined event; and

control delivery of subsequent therapy to the patient according to the therapy information in response to the detection of the defined event via the sensor.

37. The medical system of claim 36, wherein the one or more processors comprises a processor external to the patient.

38. The medical system of claim 36, wherein the one or more processors comprises a processor implanted in the patient.

39. The medical system of claim 36, further comprising a programmer configured to communicate telemetrically with at least one of the one or more processors.

40. A non-transitory computer readable storage medium storing instructions to cause a programmable processor of a medical device to:

define an event;

monitor therapy delivered by a medical device during occurrence of the defined event, wherein the instructions that cause the programmable processor to receive comprise instructions that cause the programmable processor to receive, from a user, during a learning mode of the medical device, and during the occurrence of the defined event, therapy information indicative of changes made by the user to therapy delivered by the medical device during the occurrence of the defined event;

associate therapy the information indicative of the monitored therapy with the defined event;

subsequently detect, via a sensor, the defined event; and

provide subsequent therapy to a patient via the medical device according to the therapy information in response to the detection of the defined event.

41. A system, comprising:

means for defining an event;

means for monitoring therapy delivered by a medical device during occurrence of the defined event, wherein the means for monitoring comprises means for receiving, from a user, during a learning mode of the medical device, and during the occurrence of the defined event, therapy information indicative of changes made by the user to therapy delivered by the medical device during the occurrence of the defined event;

means for associating the therapy information indicative of the monitored therapy with the defined event;

means for subsequently detecting the defined event; and

means for providing subsequent therapy to a patient according to the therapy information in response to the detection of the defined event.