title: Learning from patients: Identifying design features of medicines that cause medication use problems.
abstract: Usability is a key factor in ensuring safe and efficacious use of medicines. However, several studies showed that people experience a variety of problems using their medicines. The purpose of this study was to identify design features of oral medicines that cause use problems among older patients in daily practice. A qualitative study with semi-structured interviews on the experiences of older people with the use of their medicines was performed (n=59). Information on practical problems, strategies to overcome these problems and the medicines' design features that caused these problems were collected. The practical problems and management strategies were categorised into 'use difficulties' and 'use errors'. A total of 158 use problems were identified, of which 45 were categorized as use difficulties and 113 as use error. Design features that contributed the most to the occurrence of use difficulties were the dimensions and surface texture of the dosage form (29.6% and 18.5%, respectively). Design features that contributed the most to the occurrence of use errors were the push-through force of blisters (22.1%) and tamper evident packaging (12.1%). These findings will help developers of medicinal products to proactively address potential usability issues with their medicines.
authors.affiliation: Centre for Health Protection, National Institute for Public Health and the Environment (RIVM), P.O. Box 50, 3720 BA Bilthoven, the Netherlands; Dutch Medicines Evaluation Board (MEB), P.O. Box 8275, 3503 RG Utrecht, the Netherlands. Electronic address: Kim.notenboom@rivm.nl.
authors.forename: Kim
authors.initials: K
authors.lastname: Notenboom
authors.affiliation: Dutch Medicines Evaluation Board (MEB), P.O. Box 8275, 3503 RG Utrecht, the Netherlands; Utrecht Institute of Pharmaceutical Sciences (UIPS), Department of Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, the Netherlands. Electronic address: h.g.m.leufkens@uu.nl.
authors.forename: Hubert Gm
authors.initials: HG
authors.lastname: Leufkens
authors.affiliation: Utrecht Institute of Pharmaceutical Sciences (UIPS), Department of Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, the Netherlands; Department of Clinical Pharmacy, University Medical Center Utrecht, Utrecht, the Netherlands. Electronic address: h.vromans@uu.nl.
authors.forename: Herman
authors.initials: H
authors.lastname: Vromans
authors.affiliation: Utrecht Institute of Pharmaceutical Sciences (UIPS), Department of Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, the Netherlands; SIR Institute for Pharmacy Practice and Policy, Leiden, the Netherlands. Electronic address: m.l.bouvy@uu.nl.
authors.forename: Marcel L
authors.initials: ML
authors.lastname: Bouvy
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004304:Dosage Forms; D004349:Drug Packaging / Q000379:methods / Q000592:standards; D005260:Female; D006801:Humans; D008297:Male; D010349:Patient Compliance; D004364:Pharmaceutical Preparations / Q000008:administration & dosage / Q000737:chemistry; D019338:Polypharmacy
chemical_list: D004304:Dosage Forms; D004364:Pharmaceutical Preparations
keywords: Medication use; Medicinal product design; Older patients; Packaging; Usability; Use errors