Injectable medication delivery: Should HCPs have to choose between safety and control?
Healthcare professionals (HCPs) who took part in an international survey, published in a white paper in September, widely agreed that using passive safety pen needles helps improve safety.
Four out of five respondents agreed that safety pen needles offer better protection from needlestick injuries (NSIs) than traditional pen needles. This was discussed in detail in an earlier article. However, the survey also shows that, for some HCPs, using passive safety pen needles can have drawbacks. The biggest concern is that they reduce certainty about how much medication is actually delivered.
This article looks at what the survey results might mean and aims to shed light on the challenges some HCPs are facing.
There’s no question that giving the right, accurate dose matters for every patient, especially when considering something called the therapeutic index (also known as the therapeutic ratio or window). This is simply the range of doses where a medicine works without causing side effects that are too dangerous.1
The larger the therapeutic index, the safer the medication. Some medications (like digoxin, insulin, chemotherapy drugs, some anti-arrhythmics, and opioids) have what’s called a narrow therapeutic index—these are critical dose medicines.1, 2 That means the dose that helps can be close to the dose that causes problems.1
For example, with insulin, if the dose is too low, blood sugar can get too high (hyperglycemia). This can lead to ketoacidosis, which could cause coma, brain swelling, or even be fatal. On the flip side, too much insulin can drop blood sugar too low (hypoglycemia).3 Low blood sugar can cause severe problems, including nausea, falls, and seizures.3
Healthcare professionals must feel confident using their devices to care for patients. But the survey found that many regular users of passive safety needles have a hard time seeing the needle as clearly as they’d like with their current devices.
Of those surveyed, 71% said the safety pen needle activates before they’ve finished giving the injection. Of this group, 69% agreed that premature activation makes them unsure whether the full dose of medication actually goes into the patient.
Meanwhile, 86% agreed it’s just as important for their pen needle to give them both safety and control when delivering medication during an injection.
Both safety and control are important for best clinical practice, but right now HCPs must often trade one for the other—either sacrificing safety for control (with standard pen needles) or vice versa (with passive safety
mechanisms). Owen Mumford has addressed whether this trade-off is acceptable by developing a solution designed around HCP needs. This solution—built on world-class research, expert design, and advanced engineering—will launch in September.
Watch for our first blog breaking down the survey results, focusing on HCP safety when using pens, especially needle stick injuries.
References
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.
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