Four key considerations addressing the challenges for oral dosing with minitablet dispensing innovations.
Medicines
Author: Bjørn Knud Andersen - director, Front-End Innovation and Head Technology Accelerators and IPR, Phillips-Medisize, a Molex company.
When it comes to orally dosing solid tablets and/or capsules, certain patient populations such as paediatrics, geriatrics and oncology may find it a tough pill to swallow – quite literally. These patients often need highly flexible oral dosing based on their age, weight, body surface area or other variables. Alternative liquid dosing such as syrups pose some disadvantages, including the need for refrigeration, poor taste (especially for children) and the possibility of microbial contamination.
Minitablets provide an easier to swallow alternative. However, the need to depend on the patient or caregiver’s ability to accurately handle and count the minitablets for the correct dose presents its own set of challenges. Most current systems rely on volumetric measuring principles using a syringe plunger to fill the cavity with minitablets, which can be imprecise.
How can the industry better meet the unique oral dosing needs of these special patient populations? Let’s explore some of the newer evolutions in device design, and where future innovation is headed. Here are four key considerations:
Eliminate Guesswork
There should be zero room for error. Newer minitablet dispensing innovations eliminate guesswork and enable patients and caregivers to more accurately and reliably administer the exact number of minitablets needed per dose. One example is a dispenser that mounts directly on a standard Ø38 mm tablet bottle neck and can be used with minitablets ranging from ~2.0–2.5 mm diameter. It can be integrated/co-packaged directly with the bottle or supplied separately to help meet the growing needs of patients who require consistent, customised oral dosing.
With the dispenser positioned directly on the bottle, only counted and dispensed minitablets come into contact with the outside environment. The patient simply unscrews the child-resistant bottle cap, mounts the dispenser onto the bottle and repositions the cap. When it’s time to dispense medication, the user inverts the bottle to shake the minitablets into the dispenser metering chamber, which has a transparent lid. The user then turns the bottle back upright and shakes it gently. The correct number of minitablets automatically fall into the indentations on the dosage disc (one per indentation) and the rest shake off and drop back into the bottle. After visually confirming that there’s a minitablet in each hole and therefore the count is correct, the user rotates the transparent metering chamber lid and pours the minitablets onto a spoon, food or other option.
Minimise Contamination Risk
The risk of contamination is heightened these days and minitablet dispensing innovations can reduce this possibility. The type of dispenser design described earlier helps to avoid situations where the medication could incur unnecessary environmental or surface exposure. It prevents any potential contamination that could occur if patients poured the minitablets into their hand or onto a countertop, counted out the ones needed, and returned the excess back into the bottle. With this design, the user can adjust the dispenser to the desired minitablet count between one and 20. This “set and forget” approach requires the patient to pre-set the dispenser dosing disc only once. However, the setting can easily be changed if the medication dosage needs to be adjusted at any point during treatment.
Incorporate Patient-friendly Features
Added design flexibility makes oral dosing dispensers particularly attractive to global pharmaceutical companies who continuously seek new ways to help ensure that patients are adhering to their medication regimens. While pharmaceutical and medical device manufacturers are making positive strides to address unique dosing needs, the industry will benefit from even more innovations that take into account human factors engineering (HFE) early in the design. The features of minitablet dispensing devices must be further validated to test child resistance and senior friendliness, as well as the need to accommodate other tablet dimensions and bottle formats.
Integrate Connectivity
In the future, such minitablet dispensing devices have the potential to be part of the growing connected health ecosystem. Integrating a low-cost connectivity electronics module into the dispenser could make it possible to detect tablet metering, dispensing activity and other patient behaviours – thereby helping to monitor and support medication adherence from afar. This is especially important as remote patient monitoring and telehealth become more popular.
Conclusion
For special patient populations with customised oral dosing needs where minitablets are the best option, innovative dispensers offer a promising solution. Patients and caregivers can experience improved accuracy in counting tiny pills without requiring a new or different bottle. At the same time, the container minimises the risk of contamination. The ability to add connectivity in the future will help encourage medication adherence.