Injectable medication delivery: Should HCPs have to choose between safety and control?

August 23, 2019 |

Healthcare professionals (HCPs) taking part in an international survey published in a white paper in September, broadly recognised that using passive safety pen needles improves safety. Four in five respondents agreed that safety pen needles increase protection against needlestick injuries (NSIs) compared to conventional pen needles. This is an area that was explored in detail in an earlier article. However, the survey also shows that, for some HCPs, the use of passive safety pen needles comes with challenges. The most significant of which is that they compromise certainty of of medication dose delivery.

This article considers the implications of the survey results and seeks to provide an understanding of the challenges faced by some HCPs.

There can be no doubt that accurate and precise dosing is important for all patients and particularly when we consider the therapeutic index (also known as the therapeutic ratio or window). This is the range of doses between which a drug is effective without causing unacceptable adverse events.1

The larger the therapeutic index, the safer the drug. Some drugs (such as digoxin, insulin, chemotherapy, some anti-arrhythmic drugs and opiates) have a narrow therapeutic index (so-called critical dose drugs).1, 2 In other words, the effective dose is close to that causing unacceptable adverse events1.

If we use insulin as an example, inappropriately low doses of insulin can cause excessive levels of glucose in the blood (hyperglycaemia). This can result in a condition called ketoacidosis, which can lead to coma, swelling of the brain and even prove fatal. Conversely, inappropriately high doses of insulin can lead to low blood glucose levels (hypoglycaemia). 3 Low blood glucose levels can cause numerous compilations including nausea, falls and seizures. 3

It is essential that a HCP is confident using a device when providing care to patients. However, the survey, which involved HCPs who use passive safety needles on a regular basis revealed that many cannot see the needle as well as they would like with their current device.

Of those questioned, 71% agreed that the safety pen needle activates before they finished administering the injection. Of these, 69% agreed that premature activation of the safety pen needle makes them unsure that the full dose of medication has been delivered to their patient.

While 86% agreed that it is equally important for their pen needle to provide them with a combination of safety and control of the drug delivery during the injection process.

Both safety and control are key elements of clinical best practice, yet HCPs currently have to choose between compromising safety for control (with conventional pen needles) or control for safety (with passive safety

mechanisms). The question of whether this compromise is acceptable has been considered by Owen Mumford whose response is a solution that is designed to meet the needs of HCPs. This solution, which has been developed by bringing together world-class research, design expertise and engineering excellence, will be unveiled in September.

Look out for our first blog analysing the survey’s results, which considers the safety of HCPs using pens, and, in particular, needle stick injuries.


  1. Tamargo J, Le Heuzey J-Y, and Mabo P Narrow therapeutic index drugs: A clinical pharmacological consideration to flecainide European Journal of Clinical Pharmacology 2015;71:549-567
  2. Cohen MR Pharmacists’ role in ensuring safe and effective hospital use of insulin American Journal of Health-System Pharmacy 2010;67:S17-S21
  3. NCBI – Pharmacists’ role in ensuring safe and effective hospital use of insulin.



Owen Mumford is a major healthcare company and device manufacturer that commercialises pioneering medical products in its own brand and custom device solutions for the world’s major pharmaceutical and diagnostic companies. Owen Mumford’s goal is to enhance access to diagnostics, encourage adherence to treatment and reduce healthcare costs, making a world of difference to a world of people.