Functional Ability of Patients to manage Medication Packaging: A Survey of Geriatric Inpatients

Atkin, Philip A.; Finnegan, Terence P; Ogle, Susan J.; Shenfield, Gillian M.

doi:10.1093/ageing/23.2.113

Cited by 99 publications

(96 citation statements)

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“…In all, 9.4% of patients were unable to read instructions on a medicine container and 14.6% had difficulty opening a plastic flip-top medicine bottle. A study of geriatric admissions by Atkin et al 6 showed that over 40% of patients were unable to perform one or more tasks necessary to gain access to their own medications. More importantly they Modified technique with manual force application.…”

Section: Discussionmentioning

confidence: 99%

Force requirements in topical medicine use—the squeezability factor

Connor

Severn

2011

Eye

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Section: Discussionmentioning

confidence: 99%

Force requirements in topical medicine use—the squeezability factor

Connor

Severn

2011

Eye

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“…The patient's skills, capabilities, co-morbidities, disabilities, or impairments can actually serve as predictors of potential medication problems and errors. For example, patients with significant manual dexterity impairments may not be able to break a tablet by hand (10,11) or access medication in a package. Anticipating the patient characteristics of the target patient population and its subsets at the time of product design and initial development is likely to result in a drug product that addresses the needs of patients in the real world, resulting in an improved therapeutic outcome (12).…”

Section: Introductionmentioning

confidence: 99%

Defining Patient Centric Pharmaceutical Drug Product Design

Stegemann

Ternik

Onder

et al. 2016

AAPS J

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Abstract.The term Bpatient centered,^Bpatient centric,^or Bpatient centricity^is increasingly used in the scientific literature in a wide variety of contexts. Generally, patient centric medicines are recognized as an essential contributor to healthy aging and the overall patient's quality of life and life expectancy. Besides the selection of the appropriate type of drug substance and strength for a particular indication in a particular patient, due attention must be paid that the pharmaceutical drug product design is also adequately addressing the particular patient's needs, i.e., assuring adequate patient adherence and the anticipate drug safety and effectiveness. Relevant pharmaceutical design aspects may e.g., involve the selection of the route of administration, the tablet size and shape, the ease of opening the package, the ability to read the user instruction, or the ability to follow the recommended (inuse) storage conditions. Currently, a harmonized definition on patient centric drug development/design has not yet been established. To stimulate scientific research and discussions and the consistent interpretation of test results, it is essential that such a definition is established. We have developed a first draft definition through various rounds of discussions within an interdisciplinary AAPS focus group of experts. This publication summarizes the outcomes and is intended to stimulate further discussions with all stakeholders towards a common definition of patient centric pharmaceutical drug product design that is useable across all disciplines involved.

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“…Additionally, multipart fragmentation leads to the discard of active portions, as reported by Fawell et al (1999) (12). Also, not all patients can split tablets satisfactorily, even if they are scored (1,37).…”

Section: Resultsmentioning

confidence: 99%

Evaluation of Quality Attributes of Propranolol Split Tablets: Focus on Dose Variability

Eserian

Lombardo

2017

Infarma

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Tablet splitting is a widespread practice among patients and health professionals aiming the administration of lower doses and the reduction of the cost of prescriptions. Nevertheless, potential concerns such as weight variation, stability and uneven drug content of the halves are related to this practice. The objective of this study was to evaluate the uniformity of half-tablets regarding weight and drug content in three different commercial products containing propranolol. Also, it was assessed drug content for whole tablets. Weight variation and drug content uniformity tests were evaluated for whole and split tablets, as well as the weight loss due to the splitting process. Drug content evaluation for whole tablets showed that all products were satisfactory. All the products were approved in the weight variation and drug content uniformity tests before splitting, with results close to 100%, but the halves of all products failed the tests, presenting a high variability between the portions. In one of the products, halves ranged from 75.5 to 120.4% of the target drug content, indicating that when administered to patients, daily doses may vary around 45%. Splitting propranolol tablets might compromise clinical treatment, affecting blood pressure and consequently producing side effects. Clinical implications due to tablet splitting might not be critical in some cases. Nevertheless, the high variability between doses should be considered by healthcare professionals when prescribing a therapy involving this practice.Keywords: tablet splitting; uniformity of dosage; propranolol RESUMO A divisão de comprimidos é uma prática comum entre pacientes e profissionais da área de saúde visando à administração de doses mais baixas e redução do custo do tratamento. No entanto, problemas potenciais como variação no peso, estabilidade e distribuição desigual de substância ativa nas metades estão relacionados a esta prática. O objetivo deste estudo foi avaliar a uniformidade de comprimidos divididos em relação ao peso e conteúdo de substância ativa em três medicamentos comerciais diferentes contendo propranolol. Também avaliou-se o teor dos comprimidos inteiros. A determinação de peso e uniformidade de conteúdo foram avaliadas tanto nos comprimidos inteiros quanto nas metades, assim como a perda de massa devido ao processo de divisão. O ensaio de teor dos comprimidos inteiros foi satisfatório para todos os medicamentos. Os ensaios de determinação de peso e uniformidade de conteúdo apresentaram resultados satisfatórios para todos os medicamentos antes do processo de divisão, com resultados próximos a 100%, mas suas metades apresentaram resultados insatisfatórios, evidenciados pela alta variabilidade entre as mesmas. Em um dos medicamentos, as metades variaram de 75,5 a 120,4% do conteúdo de substância ativa, indicando que, quando administradas aos pacientes, as doses podem variar cerca de 45%. Dividir comprimidos de propranolol pode comprometer o tratamento clínico, afetando a pressão sanguínea e consequentemente produzind...

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Functional Ability of Patients to manage Medication Packaging: A Survey of Geriatric Inpatients

Cited by 99 publications

References 0 publications

Force requirements in topical medicine use—the squeezability factor

Force requirements in topical medicine use—the squeezability factor

Defining Patient Centric Pharmaceutical Drug Product Design

Evaluation of Quality Attributes of Propranolol Split Tablets: Focus on Dose Variability

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