Testing child resistant packaging for access by infants and the elderly

Thien, W.M.A.; Rogmans, Willebrordus Hendricus Johannes

doi:10.1016/0001-4575(84)90012-5

Cited by 9 publications

(9 citation statements)

References 4 publications

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“…Younger children may have been more likely to put the bottles in their mouths, but younger children have not participated reliably in previous studies. 28,29 Nonetheless, because none of the youngest children in our study (36-41 months) removed even 5 mL of liquid and most ED visits for unsupervised medicine ingestion are by still younger children (1- and 2-year-olds), 10,11 we likely underestimated the efficacy of flow restrictors for the children who are at greatest risk.…”

Section: Discussionmentioning

confidence: 87%

Efficacy of Flow Restrictors in Limiting Access of Liquid Medications by Young Children

Lovegrove¹,

Hon²,

Geller³

et al. 2013

The Journal of Pediatrics

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Objectives Annually, tens of thousands of children are brought to emergency departments for unsupervised medicine ingestions. We assessed whether adding flow restrictors to liquid medicine bottles can provide additional protection against unsupervised medicine ingestions by young children, even when the child-resistant closure is not fully secured. Study Design From April – May 2012, we conducted a block randomized trial with a convenience sample of 110 3- and 4-year-old children from 5 local preschools. Participants attempted to remove test liquid from an uncapped bottle with a flow restrictor and a control bottle without a flow restrictor (with either no cap or an incompletely-closed cap). Results Ninety-six percent (25/26) of open controls and 82% of incompletely-closed control bottles (68/83) were emptied within 2 minutes. Only 6% (7/110) of bottles with flow restrictors were emptied during the 10-minute testing period, none before 6 minutes. Overall, children removed less liquid from bottles with flow restrictors than from open or incompletely-closed controls (both P < .001). All children assigned open controls and 90% assigned incompletely-closed controls removed ≥25 mL liquid. In contrast, 11% of children removed ≥25 mL liquid from uncapped bottles with flow restrictors. Older children (54 – 59 months) were more successful than younger children at removing ≥25 mL liquid (P = .002) from bottles with flow restrictors. Conclusions Findings suggest that adding flow restrictors to liquid medicine bottles limits the accessibility of their contents to young children and could complement the safety provided by current child-resistant packaging.

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Section: Discussionmentioning

confidence: 87%

Efficacy of Flow Restrictors in Limiting Access of Liquid Medications by Young Children

Lovegrove¹,

Hon²,

Geller³

et al. 2013

The Journal of Pediatrics

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“…Child‐resistant requirements were put into place after the Poison Packaging Act in the 1970s in the United States. Research debating child resistance versus senior friendliness emerged after that . Child resistance and senior friendliness is a see‐saw trade‐off, meaning that the more one does to produce a child‐resistant package, the more difficult it will be to open, and vice versa.…”

Section: Discussionmentioning

confidence: 99%

“…It is not unusual that medication packaging becomes a burden in the friendliness emerged after that. [68][69][70][71] Child resistance and senior friendliness is a see-saw trade-off, meaning that the more one does to produce a child-resistant package, the more difficult it will be to open, and vice versa. An important consideration here is that protection in medication packaging not only relates to keeping the medication safe along its journey through the supply chain but also refers to the safe use of the medication, which includes avoiding misleading use or counterfeiting.…”

Section: Protection Versus Openabilitymentioning

confidence: 99%

Towards patient‐centered packaging design: An industry perspective on processes, functions, and constraints

Lorenzini

Olsson

2018

Packag Technol Sci

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Medication packaging is essential to provide patients with guidance and correct use of their medicines for effective treatment. This research aims to increase knowledge about the medication packaging innovation process and its uptake towards patient‐centered packaging design. The study applied a qualitative research approach based on data from 25 in‐depth interviews with stakeholders involved in medication packaging design. The empirical data analysis revealed four themes that can improve and advance user‐centered packaging design: medication packaging innovation process, medication packaging functions and features, medication packaging design constraints, and patient‐centered medication packaging design. The findings suggest that medication packaging design is strongly affected by an emphasis on protective and safety packaging functions rather than on patients' needs. Packaging innovation usually is constrained by rigid incremental development processes, where compliance with regulations, extensive documentation, avoidance of manufacturing complexity, and considerations on cost prevail. These findings are discussed in relation to the three most evident trade‐offs for patient‐centered design: protection versus openability, utility versus cost, and complexity of manufacturability versus complexity of use. This research contributes with valuable input and additional evidence about the necessary shift to a user‐centered approach in a field that has not been design driven. This input complements previous research and provides an opportunity for industry decision makers and policy makers to lead patient‐centered packaging design that can benefit patients and relieve overloaded health care systems.

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“…Nine studies focused on the ease of opening medication containers. 30,[32][33][34][35][36][37][38][39] Seven studies assessed the physical functionality of medication packages and user capability combined with administration of medication and competence, 31,40,41 packaging acceptability, 42 consumer behaviour and decision-making process 43 and self-application through eyedroppers. 44,45 Packaging orientationchild-resistant containers (CRCs).…”

Section: Research Stream Onephysical Functionality and User Capabilitymentioning

confidence: 99%

“…Problems with openability were frequently mentioned in connection with the CRCs. Ten studies assessed CRCs alone 37,39 or in comparison with other types of packages. [32][33][34][35][40][41][42][43] CRCs were mainly associated with difficulties in accessing the medication through the packages and with a lack of senior friendliness.…”

Section: Research Stream Onephysical Functionality and User Capabilitymentioning

confidence: 99%

Medication Packaging and Older Patients: A Systematic Review

Lorenzini

Hellström

2016

Packag Technol Sci

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The global challenges posed by demographic change call for more senior-friendly medication packaging. This paper presents a comprehensive integrated view and synthesis of the literature on medication packaging and older people. Considering the multidisciplinary nature of the research field, a systematic review was conducted in four databases (Scopus, Web of Science, Medline and Engineering Village), limited to original research studies containing empirical data and English-language papers, published until January 2015. Manual reference mining was carried out for other relevant papers, and a critical appraisal methodology was applied to judge the quality of the papers. In total, 34 studies are fully reviewed and classified according to the main characteristics of the studies, information about older patients and impact of the packaging on medication use. As a result, the review indicates the literature to be fragmented and diverse yet composed of two major interconnected research streams (physical functionality and user capability; medication management) and orientations (packaging; user). The physical functionality and user capability stream of research with a packaging orientation addresses child-resistant containers (CRCs), whereas the useroriented studies address openability, i.e. the ease of opening the medication. In contrast, the medication management stream of research with a packaging orientation focuses on the adherence outcomes of different package aids, whereas the user-oriented studies focus on the counselling provided by healthcare professionals and coping strategies for older patients to handle the packages. These original findings provide valuable input to researchers and practitioners and offer guidance for the further development of medication packaging.patients. According to Stegemann, 5 this '(…) means designing, developing and delivering drug products that patients can understand from the perspective of their health and wellbeing, as well as being able to manage and administer them properly'. In contrast, ranging from the social inclusivity of the aged adults to economic aspects related to healthcare costs, 6 the older population will require more healthcare expenditures, 1 including chronic disease therapies at the domiciliary level. 7 From a medication packaging point of view, these challenges draw attention to the development and design of more senior-friendly packages. Poor medication packaging can cause inconvenience, serious harm or even patient death. 8 In contrast, a patient-friendly medication package has the ability to improve medicine availability and dosing, 9 patient safety 8,10 and mobility. 11 In the development and design of senior-friendly packages, regulations must be fulfilled, and tradeoff decisions must be made. For instance, since the 1970s, there has been an ongoing debate regarding the dilemma of making medication packages safer for children 12 but still senior-friendly. 13,14 Additionally, the impact of packaging on medication use by seniors must be considered. As an e...

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Testing child resistant packaging for access by infants and the elderly

Cited by 9 publications

References 4 publications

Efficacy of Flow Restrictors in Limiting Access of Liquid Medications by Young Children

Efficacy of Flow Restrictors in Limiting Access of Liquid Medications by Young Children

Towards patient‐centered packaging design: An industry perspective on processes, functions, and constraints

Medication Packaging and Older Patients: A Systematic Review

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