The transdermal route of delivery has increased in popularity over the past decade with a wide range of medicines now being available [1]. However with.

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Presentation transcript:

The transdermal route of delivery has increased in popularity over the past decade with a wide range of medicines now being available [1]. However with the increase usage of patches concerns relating to patient harm have started to emerge. In July 2014 a joint safety alert announcement by the EMA and MHRA was sent to healthcare professionals (HCPs) outlining the possible dangers of incorrect application of fentanyl patches [2]. Furthermore, there have been several case reports of fatalities with transdermal administration due to a lack of patient and/or HCP knowledge on safe application of patches [3]. Further evidence in literature suggests an increased risk of administration errors with transdermal formulations compared with solid oral dosage forms [4]. Literature reviews suggest that a lack of knowledge and understanding on behalf of the HCPs or patient around the application of patches has resulted in harm or death to patients [5]. Figure 3 demonstrates the lack of advice provided by pharmacists to HCPs which could be one factor in contributing towards HCPs using/applying the patch incorrectly leading to adverse outcomes for patients (See MHRA safety alert to HCPs [2]). The importance of understanding the factors that can affect drug absorption via the skin is crucial for HCPs. Figure 2 indicates that 14.2% of respondents acknowledged heat as being a factor that could influence the rate and extent of absorption of drug which has been a causative factor in some fatalities related to fentanyl [6]. However all of the factors mentioned can in some way affect drug absorption and HCP’s should be aware and consider all of them when applying patches. Findings from this study (figure 1) further reiterate and support a study done by Small and Dubois (2007) who found that the transdermal route of administration was preferable to HCPs due to ease of administration [7]. Being such a popular route of administration this study found that 31.2% of respondents found applying patches a difficult task and 73.8% respondents felt that they would prefer extra training on application of patches if it was available indicating more information/counselling needed to be given to HCPs regarding applying patches. [1] Bajaj, S., Whiteman, A. and Brandner, B. (2011) Transdermal drug delivery in pain management. Continuing Education in Anaesthesia, Critical Care & Pain, 11 (2), [2] Medicines Health Regulatory Agency (2014). Fentanyl skin patches: importance of safe use and disposal. [3] Lee, M. and Phillips, J. (2002) Transdermal patches: high risk for error. Drug Topics, 146 (7), [4] Alldred, D. and Standage, C. (2011) Medication errors in care homes. Nursing Times, 107 (24), [5] Sindali, K., Sherry, K., Sen, S. and Dheansa, B. (2012) Life-threatening coma and full-thickness sunburn in a patient treated with transdermal fentanyl patches: a case report. J Med Case Rep, 6 (1), 220. [6] Small, G and Dubois, B. (2007) A review of compliance to treatment in Alzheimer's disease: potential benefits of a transdermal patch. Current Medical Research & Opinion :11, [7] Singh, I. and Morris, A. P. (2011) Performance of transdermal therapeutic systems: Effects of biological factors. International Journal of Pharmaceutical Investigation, 1 (1), 4-9. An investigation of the knowledge and practice of healthcare professionals relating to the use of transdermal patches. Room for improvement? H Zaman a, L Breen b, W Nabi a, A Mahmood a, F Mansoorali a, Z Patel a, A Naseem a, M Amin a a Bradford School of Pharmacy, Faculty of Life Sciences, University of Bradford, UK b Bradford School of Management, Faculty of Management and Law, University of Bradford, UK Introduction A questionnaire methodological design was used to collate data which contained both qualitative and quantitative aspects. A combination of open/closed/Likert scale questions were used to capture data. The questionnaire was piloted, amended and circulated to HCPs qualified to administer medications. 488 questionnaires were posted to staff selected on the basis of convenience/purposive sampling. Staff were recruited from different practice settings such as hospices, care homes and private hospitals based in England and Scotland. 12.3% questionnaires were returned from February 2014 to April % questionnaires were completed by nurses, 21.3% by care assistants, 4.9% by support workers and the remainder by other qualified HCPs. Method HCPs should be aware that the knowledge required to apply patches is complex in that it requires an understanding of science relating to conditions that can affect absorption of drugs from patches. Despite a relatively low return rate from the questionnaire, the results indicated further training regarding application/counselling on warnings associated with patches to HCPs involved in applying patches. This study highlights that pharmacists should be giving appropriate advice/counselling to HCPs when supplying patches to minimise any chance of harm to patients. Conclusion Results References Aim & Objective To explore the views of HCPs in relation to their knowledge and understanding surrounding the application of transdermal patches. Discussion Figure % of healthcare professionals prefer transdermal patches as the top 2 choices for administering a drug to a patient which confers with the literature that transdermal route of delivery is popular among HCPs. Figure 3 – Over 60% of respondents have not been counselled on the correct application of transdermal patch by their pharmacists. Figure 2 – The different biological factors that can affect drug absorption most common quoted by respondents being skin condition, moisture, site of application, body temperature, heat, and age of patient.