Research database

This Research Database has been developed by HCPC Europe to create an overview of the available research in the field of patient-friendly and adherence packaging. The database is for all members of HCPC Europe. Members can register as a user to get access to the database. Is your organisation not a member yet? Then please register your organisation as a member or contact our Executive Director Ger Standhardt for more information.

Poison prevention packaging act, 1970: A human factors standard

This paper, the first of two, gives an account of legislation and regulations made in the USA requiring hazardous pharmaceutical and other household products to be packaged in child-resistant containers. Human factors test procedures and standards, in terms of which child-resistance is defined, are described. An account is given of those hazardous substances which regulations in the USA require should be packed in child-resistant containers. The paper concludes with a description of the effects of the regulations and of child-resistant containers in reducing mortality and morbidity associated with the ingestion of poisonous substances, particularly aspirin, in the USA.

The second paper will briefly describe the effects of legislation made in England and Wales requiring certain pharmaceutical products to be packaged in child-resistant containers. It will also give an account of experiments, carried out in England and Sweden, describing the difficulties and inconvenience which the elderly and disabled experience when they attempt to use such containers.

Patient safety, systems design and ergonomics

The complexity of the health care environments necessitates an holistic and systematic ergonomics approach to understand the potential for accidents and errors to occur. The health service is also a socio-technical system, and design needs must be met within this context. This paper aims to present the design challenges and emphasises the specialised needs of the health care sector, when dealing with patient safety. It also provides examples of approaches and methods that ergonomists can bring to help inform our knowledge of these systems and the potential towards improving their safety. Mapping workshops provide an example of such methods. Results from these are used to illustrate how the knowledge base required for better design requirements can be generated. The workshops were developed specifically to help improve the design of medication packaging and thereby reduce the probability of medication error. The issues raised are now the subject of further research, design requirements guidance and new design concepts. The paper illustrates the need to engage with the design community and, through the use of robust scientific methods, to generate appropriate design requirements.

Designing packaging to support the safe use of medicines at home

In the light of a number of serious incidents in the UK resulting from accidental overdoses of methotrexate, this study investigated how the design of methotrexate packaging can influence patient safety, and aimed to collect evidence to provide a basis for the development of new concepts for revised designs by the pharmaceutical industry. The research found that patients using methotrexate experience a number of difficulties in using their medicines packaging, and as a result, resourcefully adopt a variety of “coping strategies” which may increase the risk of dosing errors. By investigating both the practice of methotrexate users, and the design of the system that supports methotrexate use, additional problems were observed across the healthcare system, meaning that the function of medicines packaging in ensuring safety may be even more critical than first suspected. As a result of this research the National Patient Safety Agency responded with a UK-wide programme of work to improve safety for patients, and continues to work with the pharmaceutical industry to develop more user-friendly packaging and labelling.

Carpe diem, Carpe ampulla: A numerical model as an aid to the design of child-resistant closures


► Numerical modelling of a complex hand task is feasible.

► Higher stresses occur for smaller hand sizes.

► Simple geometry changes can be made to increase comfort.

The population of most developed countries is ageing. Despite continuing medical advances, ageing brings with it a host of issues, not least a loss in strength and dexterity. One major area of concern is the ability of elderly consumers to access packaged goods such as food and medicines. In previous studies, the authors developed a numerical model of a human hand that was used to investigate the effect of physical dimensions and choice of grip on joint stresses to aid the understanding between physical effort, ability and discomfort. This previous work was supported by ethnographic studies and led to recommendations for packaging design.

In this paper, a small ethnographic study is undertaken which identifies the grip types used to access to a product that is known to cause particular difficulties for the elderly, the “squeeze and turn” child-resistant closure or CRC, commonly used on medicines and cleaning products. One of the grip types used was chosen to be modelled using the numerical model developed in previous studies by the author. Model geometry and loading were adapted to simulate the “squeeze and turn” nature of the initial opening for closures of this type. A series of studies were then undertaken using different hand geometries; an average male hand, an average female hand and a fifth percentile female hand.

The prediction from the model here is that female users with smaller hands will experience more discomfort when accessing squeeze and turn CRC’s and that the turn process whilst maintaining the squeeze is problematic.