Reinforcing sharps safety beyond the hospital
By George I’ons,
Head of Product Strategy and Insights,
Owen Mumford Pharmaceutical Services
The combined pressures of staff shortages, lack of funding and an ageing population have propelled the move towards self-administration for patients with chronic diseases, outside traditional healthcare settings. Today, as the pandemic continues to put acute pressure on our hospitals and clinics, this migration of certain lower-risk medical procedures makes even greater financial and practical sense.
Shifting away from the clinical setting benefits hospitals seeking to manage overcrowding and reduces unnecessary trips to the hospital, at a time when preventing the spread of infection is especially critical. Post-pandemic, easing some of the pressure on healthcare systems will continue to be a priority, given the estimate that by 2050 one in six people in the world will be over the age of 65 – representing 16% of the global population [1]. Additionally, the increased prevalence of chronic diseases is likely to be exacerbated as populations recover from the impact of the virus.
Self-administration, typically through subcutaneous injections, is particularly well-suited to existing and newer biological therapies entering the market, as these treatments can require frequent injections. This kind of injection regime would be far too costly and impractical on both ends if patients were dependant on visiting a clinic for each injection. Enabling patients to take control of their own medication regime helps them to incorporate treatment into their daily activities – while also taking some of the weight off healthcare professionals and establishments.
Sharps safety
The benefits of encouraging self-administration for injectables are clear; however, it is vital that careful consideration be given to the safety of sharp devices and best practice injection procedures. Needlestick injuries continue to cause issues within the hospital setting, averaging 1,000 reported sharps injuries per day in US hospitals [2], so there is still a potential risk in non-clinical environments given there may be no presiding medical professional. Needlestick injuries are more likely to occur in non-compliant settings, and data suggests that in the US more than half of non-clinical settings are in violation of Occupation Safety and Health Administration (OSHA) laws for needlestick injury prevention [3].
Healthcare workers are already at risk of blood borne infections from unprotected sharps, but this shift in injection location now places patients and nearby non-users at risk of exposure too. Unwanted infections including HIV and hepatitis B and C can be spread through sharps injuries, so it is vital that proper care be given to minimizing this occurrence especially if the patient’s status is unknown. Part of this entails an education programme to raise awareness for patients and their family members about the risk presented by a contaminated sharp. Currently, up to half of sharps injuries go unreported [4], which can in part be explained by a lack of awareness of the associated risks. This means that family members and neighbours could be exposed and fail to subsequently seek treatment.
Manufacturer responsibility
Given the potential risks of bringing drug administration into the homes of patients, manufacturers must also take on some of the responsibility of protecting people against the dangers of needlestick injuries. Drug delivery device design plays an important role in determining the likelihood of sharps injuries, with some designs providing better protection than others. In fact, studies show that a staggering 80% of needlestick injuries can be prevented by using safer needle devices. For instance, devices with hollow-bore needles or syringes that retain an exposed needle after use are very high-risk [5].
For manufacturers, this implies a responsibility to continue carrying out thorough Human Factors (HF) studies and developing patientcentric devices that are designed for non-healthcare professional users and which minimize the risk of injuries or misuse. For hospitals and healthcare providers, this means choosing suppliers which can prove to have thoroughly mitigated and eliminated any design features which could make the product a higher risk. The benefit for healthcare providers is two-fold in that selecting safer devices improves the safety of their working environment for their staff and carers, but also encourages patient adherence, especially those with needle phobia. This is turn supports the continued success of the self-administration trend which is central to alleviating some of the pressure on acute and primary care services.
The pre-filled solution
The exponential growth in demand for pre-filled safety syringes therefore comes as no surprise. At its current projection, the global safety syringe market is expected to reach $1.137 billion by 2023, up from $772 million in 2018 – representing an impressive CAGR growth rate of 8.1% [6]. With self-administration on the rise, pre-filled safety syringes help to diminish the risks associated with unsupervised self-injection within a home setting by facilitating the injection procedure for patients. They are a more convenient option for older, debilitated or less dextrous patients, which in turn makes them more suited to the growing self-administration trend. More specifically, needle mechanisms which are activated passively during use of pre-filled safety syringes – meet both safety and usability requirements and help to prevent dosage errors.
As the appetite for remote patient management and monitoring grows as a result of the pandemic, we are also likely to see an increase in connected drug delivery development. Digitalisation has the potential to further empower patients by giving them greater oversight of their own treatment, as well as helping to keep them compliant with dosage regimens. For clinicians, the data generated by connected devices can help to improve patient and therapy management, in a way that was not previously possible. As the capabilities of drug delivery devices, including safety syringes, become ever more sophisticated, it is likely that they will only continue to earn greater shares of the market alongside the growing trend of home-administration.
References
- 2019 Revision of World Population Prospects, 2019: https://population.un.org/wpp
- OSHA, http://www.osha.gov/SLTC/etools/hospital/hazards/sharps/sharps.html
- Medical Devices: Evidence and Research, Vol 10, Clinical, economic, and humanistic burden of needlestick injuries in healthcare workers, 2 May 2017
- CDC, https://www.cdc.gov/nora/councils/hcsa/stopsticks/sharpsinjuries.html
- World Health Organization, Needlestick Safety and Prevention, Independent Study
- Market Data Forecast, Safety Syringes Market by Technology, Oct 2018
