Could you describe your academic background and explain how you came to work in research on pharmaceutical packaging?

I have a background in Visual Design and Industrial Engineering. I did my PhD at the Faculty of Engineering, at Lund University, where I worked in a research group called Packaging Logistics. As a designer, I have always been fascinated by the multiple roles and functions packages play. Packaging allies, for instance, graphic design, product design, communication, user behaviour. My journey on exploring specifically medication packaging started with my PhD, in which I investigated the complexities that surround the industry processes of innovating and designing patient-centred pharmaceutical packaging. I continued this journey with a postdoc project, at the same institution, but focused on learning from older adults using multiple medications at home on their routines and strategies to take their medication correctly, and the use of medication packaging in their daily lives. 

After that, I got a position as Assistant Professor at the Department of Engineering Technology, at the Technical University of Denmark. This is very interdisciplinary department, where we have a co-joint focus on technology implementation. This suits me quite well, as my research has also expanded from medication packaging to self-care and smart technologies implemented at home, such as welfare technologies to support people (especially older people) with their care. As populations age, homecare staff gets limited and more expectations are put on technology, I see this as a broad field that I hope will develop for the benefit of many people. I still see medication packaging as very important, as we put more and more responsibility for managing complex medication regimes and the intake of multiple medications in the hands of patients, and we need packaging innovation and other integrated technologies to support on that.

What is the overall aim of your research today?

Nowadays, my research has expanded from a niche field to a broader scope. Much of the knowledge I gained throughout my PhD years still supports much of what I research about today. My focus is on implemented technologies (or technologies going to be implemented), to support healthcare at home, in particular welfare technologies. I take a socio-technical approach to it, to consider that both humans and technologies are impacted by each other. I work closely to the people that really get affected in their lives by the new technologies, such as older people, their relatives, homecare staff, technology providers, and municipalities. I apply participatory approaches and inclusive design principles to really understand the roles of technology in relation to people’s needs and contexts. I also try to bring insights from the research to the lecture hall, in courses I teach, for instance, Interaction Design.

What challenges do you see patients facing with today’s pharmaceutical packaging?

Packaging has several roles to fulfill, for instance, protect the product inside, give information to the end-user about the product, help with storage, transportation, and use of the product. For consumer products and over-the-counter products, packaging might also help to sell the product. However, for prescribed medication, the situation is fairly different. Medication packaging should help patients to be correctly informed about dosing, about how to take the medication, about identifying the medicine. In my previous research, I have seen that these aspects are not entirely fulfilled. Many similar packaging make it difficult to differentiate between medications or their strengths.

Another significant problem is the difficulty to open some packages, which require a lot of wrist strength, this affects a lot, for instance, older patients, especially older women. In one my interview studies, done some years ago, older female patients reported exactly on this: the need to ask for help to their male partners to open medication packages for them.

One older woman showed all the tools she needed to be able to open her medication packaging. I remember her commenting that for each package, she needed one tool, and that would be nice if the tools already come with the packaging. That was an eye-opener to me.

Why is further research into pharmaceutical packaging needed, and what patient safety risks do you identify when medicine packaging is difficult to open?

One of the things we can think about difficult-to-open medication packaging is that people/patients might adapt coping strategies, i.e. strategies to go around difficulties. Imagine someone that needs to take 10 different medications a day.

Packaging should communicate and help with the overall experience of taking medication easier. However, that is not what happens many times. So, to cope, people will, for instance remove pills from their original packaging to other containers that might not give them the right information about the dosing or the medication and that can easily get messed up. In the case of child-resistant packaging, people might leave them” half-open” which also removes the whole point of child-resistant packaging, because these packaging can only protect young children from accessing medication if the packaging is properly closed. People can also get so frustrated that they might avoid taking their medication altogether, which has even more severe implications.