USP Survey on Tablet/Capsule Identification
Detailed Results
The data below were collected from 1,021 surveys of health care professionals representing six health profession associations. Respondents are represented as follows (base is 1021):
| 47.5 % |
ASHP |
(485) |
| 23.8 % |
APhA |
(243) |
| 12.5 % |
AAPCC |
(128) |
| 8.5 % |
AAMC |
(87) |
| 5.9 % |
AAFP |
(60) |
| 1.8 % |
AONE |
(18) |
1-A. Are you a... (CHECK ONE) (base is 1,021)
| 1.0 % |
Nurse |
(10) |
| 89.7 % |
Pharmacist |
(916) |
| 4.4 % |
Physician |
(45) |
| 0.0 % |
Physician's assistant |
(0) |
| 0.2 % |
Nurse Practitioner |
(2) |
| 4.7 % |
Other* |
(48) |
* Under the "Other" category, the most frequent responses were from professionals in the fields of research, poison control and toxicology.
1-B. How long have you practiced? (CHECK ONE) (base is 1,021)
| 1.5 % |
Less than 1 year |
(15) |
| 17.3 % |
1 – 5 years |
(177) |
| 7.8 % |
6 – 10 years |
(80) |
| 13.8 % |
10 – 15 years |
(140)
|
| 59.6 % |
More than 15 years |
(609) |
1-C. What type of practice? (CHECK ALL THAT APPLY) (base is 1,021)
| 47.2 % |
Hospital – Inpatient |
(482) |
| 16.0 % |
Hospital – Outpatient |
(164)
|
| 4.1 % |
Hospital Emergency Room |
(42) |
| 3.2 % |
Office-based |
(33) |
| 20.9 % |
Outpatient Clinic |
(213) |
| 7.0 % |
Long-term Care Facility |
(71) |
| 4.6 % |
Poison Control Center |
(47) |
| 9.6 % |
Drug Information Center |
(98) |
| 18.6 % |
Independent Community Pharmacy |
(190) |
| 10.4 % |
Chain Pharmacy |
(106) |
| 30.8 % |
Hospital Pharmacy |
(315) |
| 15.3 % |
Other (Specify): |
(156) |
*Of those responding to "Other," the most frequent practices were private industry, research facilities and government, including the Veteran's Administration.
2. How often in your practice are you called upon to identify a tablet or capsule outside its original packaging, utilizing the current scheme based on manufacturers' company-specific imprint codes plus other physical characteristics (color, shape, etc.)? [CHECK ONE] (base is 1,021)
| 5.0 % |
Never |
(52) |
| 21.5 % |
Less frequently than once a month |
(218) |
| 19.9 % |
Once a month |
(204) |
| 19.9 % |
2 to 3 times per month |
(204) |
| 10.7 % |
Once a week |
(109) |
| 13.8 % |
2 to 3 times per week |
(141) |
| 9.2 % |
*More than 3 times per week |
(94) |
*For the 94 respondents who had incidents of more than three times a week, there was an average of 52.5 incidents per day and the highest incident rate was reported at over 700 per day by a (presumably national) poison control center.
NOTE: 52 (5.0%) health care professionals participating in the survey never had occasion to identify a tablet or capsule outside of its original packaging. Therefore, the numbers and percentages following do not include their answers. (Base is 969)
3. Do you make identifications personally 868 (92.1%), or are they normally done by someone else 74 (7.9 %). Note: 27 respondents did not answer. (Base is 942.)
4. When confronted with the need to identify tablets or capsules, how easy is it for you to identify them? (CHECK ONE) (base is 964 – 5 did not respond)
| 2.9 % |
Always easy |
(28) |
| 33.7 % |
Usually easy, but occasional problems |
(325) |
| 44.6 % |
Sometimes difficulties |
(430) |
| 16.8 % |
Often difficulties |
(162) |
| 2.0 % |
Always a problem |
(19) |
5. What resources, if any, have you utilized in identifying the tablets or capsules? (CHECK ALL THAT APPLY) (base is 969)
| 17.3 % |
Pharmacist at your institution |
(168) |
| 7.0 % |
Community pharmacist |
(74) |
| 16.5 % |
Poison control center |
(150) |
| 15.6 % |
Drug Information center |
(151) |
| 12.5 % |
Manufacturer or manufacturer's representative |
(121) |
| 15.6 % |
Product package insert |
(151) |
| 9.7 % |
USP DI (USP Drug Information) |
(94) |
| 20.2 % |
PDR (Physicians' Desk Reference) |
(196) |
|
Ident-A-Drug |
|
| 19.4 % |
Book |
(188) |
| 17.2 % |
Online |
(167) |
| 3.0 % |
Both |
(29) |
| 45.6 % |
Identidex |
(442) |
| 16.9 % |
Other online databases (Specify): |
(164) |
| 9.9 % |
Other resources (Specify): |
(96) |
6. What would you say is your success rate for identification of an individual tablet or capsule? (CHECK ONE IN EACH COLUMN)
| On your own (base is 963) |
|
After consulting other resources (base of 945) |
| (6 didn't answer or stated "n/a") |
(24 didn't answer or stated "n/a") |
| 1.4 % |
100 % |
(14) |
11.2 % |
100 % |
(106) |
| 14.0 % |
96 % – 99% |
(134) |
35.7 % |
96 % – 99% |
(337) |
| 15.0 % |
90 % – 95% |
(144) |
20.2 % |
90 % – 95% |
(191) |
| 15.7 % |
85 % – 89% |
(151) |
11.5 % |
85 % – 89% |
(109) |
| 15.9 % |
75 % – 84% |
(153) |
10.5 % |
75 % – 84% |
(99) |
| 10.1 % |
50 % – 74% |
(98) |
8.1 % |
50 % – 74% |
(77) |
| 27.9 % |
less than 50% |
(269) |
2.8 % |
less than 50% |
(26) |
7. Approximately what percentage of the tablets or capsules that you are unable to identify appear to be: (base is 969)
| 47.3 % |
Dietary/nutritional supplements |
| 32.7 % |
OTC pharmaceuticals |
| 19.3 % |
Tablets/capsules not manufactured in the United States |
| 0.7 % |
Other ("street drugs") |
8. What is the average time it takes you to identify the tablet or capsule? (CHECK ONE) (base is 969)
| 5.8 % |
Less than 1 minute |
(56) |
| 15.2 % |
1 but less than 2 minutes |
(148) |
| 29.9 % |
2 but less than 5 minutes |
(290) |
| 24.9 % |
5 but less than 10 minutes |
(241) |
| 12.3 % |
10 but less than 20 minutes |
(119) |
| 6.7 % |
20 but less than 30 minutes |
(65) |
| 5.2 % |
30 or more minutes |
(50) |
9. What factors contribute to any difficulties you have in identifying tablets or capsules in your practice? (CHECK ALL THAT APPLY) (Base is 969)
| 16.0 % |
Lack time to perform such identification |
(156) |
| 32.0 % |
No company logo on tablet/capsule |
(311) |
| 22.5 % |
Company logo hard to describe/identify |
(218) |
| 46.1 % |
No imprint code on tablet/capsule |
(447) |
| 25.5 % |
Unreadable/too small imprint code |
(247) |
| 37.3 % |
Multiple look-alike, similarly appearing tablets or capsules |
(361) |
| 5.5 % |
Not aware of any references/databases to permit identification |
(53) |
| 15.4 % |
No readily available references/databases |
(149) |
| 5.5 % |
Difficulty locating/using picture section of PDR |
(53) |
| 3.2 % |
Difficulty locating/using picture section of USP DI |
(31) |
| 4.0 % |
Difficulty using other references/databases |
(39) |
| 47.8 % |
Not finding the tablet/capsule in the references/databases |
(463) |
| 3.6 % |
Other (Specify): |
(35) |
10. On a scale from 1 (low) to 5 (high), how would you rate the adequacy of current printed resources for identifying individual tablets or capsules? (CHECK ONE) (base is 955 – 14 did not respond)
| 4.9 % |
1 |
(47) |
| 20.6 % |
2 |
(197) |
| 34.2 % |
3 |
(327) |
| 33.0 % |
4 |
(316) |
| 7.2 % |
5 |
(68) |
Why?
11. On a scale of 1 (low) to 5 (high), how would you rate the adequacy of current online databases for identifying individual tablets or capsules. (CHECK ONE) (base is 960 – 9 respondents didn't answer because they did not have access to databases.)
| 4.2 % |
1 |
(40) |
| 17.2 % |
2 |
(165) |
| 40.8 % |
3 |
(392) |
| 32.0 % |
4 |
(307) |
| 5.8 % |
5 |
(56) |
Why?
12. On a scale of 1 (low) to 5 (high), how would you rate the additional value of a standardized imprint code system? (See Survey Introduction) (CHECK ONE) (base is 949 – 20 respondents didn't answer)
| 0.8 % |
1 |
(8) |
| 2.2 % |
2 |
(21) |
| 12.9 % |
3 |
(122) |
| 28.9 % |
4 |
(274) |
| 55.2 % |
5 |
(524) |
13. We would welcome any additional observations or comments from you relevant to the objectives of this survey, especially comments regarding any clinical implications of difficulties in identifying unlabeled tablets and capsules.
- Standardization of codes may help to reduce overdose frequency, which often results from same entity in dissimilar dose forms.
- Require generic houses to promptly update the databases and any type of standardization would be helpful.
- Before a product should receive final approval for marketing, the marketer should be required to give specific product identification information to some entity with the capacity to immediately publish said information.
- A standardized imprint system may be useful in private pharmacy or emergency department settings. Almost all of the questions I get relate to dispensing different generic products of the same medication - the patients are simply looking for reassurance that they are receiving the same active ingredient and dose.
- The standardized approach would be an easy way to check if a different generic was used to fill a prescription. Looking up the code would give a description of all tablets for the same active ingredient and strength. This would be very helpful. A problem may be the length of the code for some of the smaller tablets or capsules. If they are too small they may be difficult to read.
- Standardization to include the same basic "code" on all products with the same active ingredient along with mfr info on other side of dosage form would be ideal and make drug ID much more efficient.
14. From your experience, which of the approaches referred to in the survey introduction do you consider to have the highest potential for providing the required tablet and capsule identification information rapidly and accurately? [CHECK ONE]
(base is 907 – 40 respondents checked more than one answer, and 22 respondents did not answer)
| 13.4 % |
Current approach |
(122) |
| 38.5 % |
Standardized approach |
(349) |
| 40.4 % |
Database approach |
(366) |
| 7.7 % |
Other approach (Specify): |
(70) |
|
