Assessing the expectations associated with pharmaceutical pill colour and shape

Effect of packaging label color on consumer perception of Greek protected designation of origin table olives "Kalamata"

Kalamata table olives are a widely exported Greek protected designation of origin (PDO) product with distinct organoleptic profile. This study aimed to evaluate the effect of label color on the flavor perception of pasteurized and unpasteurized Kalamata PDO olives. Consumer perception was assessed in two studies. First, four packaged products with green, blue, red, and purple labeling were assessed by participants (n = 106) for preference using rating scales, and emotional profiles were obtained using a check-all-that-apply list of 33 emotions developed in language native to the participants (Greek). The green label resulted to more positive emotion profiling of olive products (i.e., "healthy," "pleased," and "satisfied" with mean scores correspondingly equal to 2.99, 2.95, and 2.87), and red labeled olives resulted to willingness to pay more. In the second study, unpasteurized and pasteurized olives in red and green labeled glass jars were sensorially assessed by participants (n = 124) using rating scales, showing that green labeled products are liked most (mean scores; 5.12 and 5.12), whereas red labeled was scored less (mean scores; 4.96 and 4.67), along emotion profiles with emojis. Principal component analysis of emotional reactions revealed grouping of samples based only on pasteurization/no pasteurization, without been affected by the color of the label, and did not relate to the liking scores. The results showed that sensory perception of olives is significantly affected by the color of packaging (p-value <0.05) due to emotional reactions and color of packaging can enhance the perception of olives' quality as improvement of the processing is limited by the PDO status.

Changes in Tablet Color Due to Light Irradiation: Photodegradation of the Coating Polymer, Hypromellose, by Titanium Dioxide

The color of the tablets and capsules produced by pharmaceutical companies is important from the perspectives of product branding and counterfeiting. According to some studies, light can change tablet color during storage. In this study, tablets comprising amlodipine besylate (AB), a well-known light-sensitive drug, were coated with commonly used coating materials and exposed to light. Compared to the tablets that were not exposed to light, the color of those exposed to light changed over time. In fact, a faster and more pronounced color change was observed in the tablets exposed to light; however, the amount of AB did not decrease significantly in these tablets. The coating materials and their amounts were varied to clarify the materials involved in the color change. Based on the results, titanium dioxide and hypromellose may be involved in the color change process. As titanium dioxide is a photocatalyst, it may induce or promote chemical changes in hypromellose upon light irradiation. Overall, care should be exercised during selection of the coating polymer because titanium dioxide may promote photodegradation of the coatings while protecting the tablet's active ingredient from light.

Understanding Color Associations and Their Effects on Expectations of Drugs’ Efficacies

Colors influence our daily perceptions and expectations that manifest in a variety of ways. This research has three main objectives: to demonstrate the relationship between the colors of pills and their expected efficacies, to test this effect on a wide variety of demographics, thereby demonstrating their influence on choices made by participants. Finally, to understand the reasoning behind the choices made by participants, and the color associations exhibited. The results of a series of surveys showed clear similarities and differences across various demographics. The strongest and most consistent color associations were those of white with pain relief and red with stimulant efficacies. The color associations found were red with aggression and power, blue with calmness and serenity, white with calm and purity, yellow with energy, and green with environment and health. The findings of this study can help pharmaceutical companies, and medical practitioners, to better make, market, and prescribe pills, depending on the geographical location, ethnicity, and age group of the patient. This may also strengthen the perceived effects of the pills on patients overall by increasing their compliance rates.

An Oral 3D Printed PLGA-Tocopherol PEG Succinate Nanocomposite Hydrogel for High-Dose Methotrexate Delivery in Maintenance Chemotherapy

High-dose methotrexate (HDMTX) is one of the chemotherapeutic agents used to treat a variety of cancers in both adults and children. However, the toxicity associated with HDMTX has resulted in the spread of infections and treatment interruption. Further, poor bioavailability due to efflux pump activities mediated by P-glycoprotein has also been linked to poor therapeutic effects of methotrexate following oral administrations. D-α-Tocopheryl poly-ethylene glycol 1000 succinate (TPGS) is known to improve the bioavailability of poorly soluble drugs by inhibiting P-gp efflux activities, thus enhancing cellular uptake. Therefore, to achieve improved bioavailability for MTX, this study aimed to design and develop a novel drug delivery system employing TPGS and a biodegradable polymer, i.e., PLGA, to construct methotrexate-loaded nanoparticles fixated in alginate-gelatine 3D printable hydrogel ink to form a solid 3D printed tablet for oral delivery. The results indicated that high accuracy (>95%) of the 3D printed tablets was achieved using a 25 G needle. In vitro, drug release profiles were investigated at pH 1.2 and pH 7.4 to simulate the gastrointestinal environment. The in vitro release profile displayed a controlled and prolonged release of methotrexate over 24 h. The in silico modeling study displayed P-gp ATPase inhibition, suggesting enhanced MTX absorption from the gastrointestinal site. The 3D-printed hydrogel-based tablet has the potential to overcome the chemotherapeutic challenges that are experienced with conventional therapies.

Physical, Emotional, and Social Pain During COVID-19 Pandemic-Related Social Isolation

The socio-emotional condition during the COVID-19 pandemic subsidises the (re)modulation of interactive neural circuits underlying risk assessment behaviour at the physical, emotional, and social levels. Experiences of social isolation, exclusion, or affective loss are generally considered some of the most “painful” things that people endure. The threats of social disconnection are processed by some of the same neural structures that process basic threats to survival. The lack of social connection can be “painful” due to an overlap in the neural circuitry responsible for both physical and emotional pain related to feelings of social rejection. Indeed, many of us go to great lengths to avoid situations that may engender these experiences. Accordingly, this work focuses on pandemic times; the somatisation mentioned above seeks the interconnection and/or interdependence between neural systems related to emotional and cognitive processes such that a person involved in an aversive social environment becomes aware of himself, others, and the threatening situation experienced and takes steps to avoid daily psychological and neuropsychiatric effects. Social distancing during isolation evokes the formation of social distress, increasing the intensity of learned fear that people acquire, consequently enhancing emotional and social pain.

The Mystery of "Metal Mouth" in Chemotherapy

Of all the oral sensations that are experienced, "metallic" is one that is rarely reported in healthy participants. So why, then, do chemotherapy patients so frequently report that "metallic" sensations overpower and interfere with their enjoyment of food and drink? This side-effect of chemotherapy-often referred to (e.g., by patients) as "metal mouth"-can adversely affect their appetite, resulting in weight loss, which potentially endangers (or at the very least slows) their recovery. The etiology of "metal mouth" is poorly understood, and current management strategies are largely unevidenced. As a result, patients continue to suffer as a result of this poorly understood phenomenon. Here, we provide our perspective on the issue, outlining the evidence for a range of possible etiologies, and highlighting key research questions. We explore the evidence for "metallic" as a putative taste, and whether "metal mouth" might therefore be a form of phantageusia, perhaps similar to already-described "release-of-inhibition" phenomena. We comment on the possibility that "metal mouth" may simply be a direct effect of chemotherapy drugs. We present the novel theory that "metal mouth" may be linked to chemotherapy-induced sensitization of TRPV1. Finally, we discuss the evidence for retronasal olfaction of lipid oxidation products in the etiology of "metal mouth." This article seeks principally to guide much-needed future research which will hopefully one day provide a basis for the development of novel supportive therapies for future generations of patients undergoing chemotherapy.

Acceptability of generic versus innovator oral medicines: not only a matter of taste

Optimum use of generic products would require equivalence, not only in terms of quality, safety, and efficacy in clinical studies, but also patient acceptability to not jeopardize treatment success because of non-adherence which would de facto limit the potential cost saving anticipated by their use. Although acceptability is a requirement for the authorization of pediatric innovator products, a survey of European Union (EU) regulatory authorities showed that few have a formal process for assessing patient acceptability of generic products during the registration processes. The current International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) focus on unifying guidance for the development and scrutiny of generics but should include acceptability alongside the other factors being considered for harmonization.

The Social and Material Life of Antimicrobial Clay: Exploring Antimicrobial Resistance, Medicines' Materiality, and Medicines Optimization

While sociologists have made significant theoretical contributions to the antimicrobial resistance (AMR) debate, little attention has been given to the antimicrobial products themselves. Here we advocate a significant new direction which centers on the social and material life of antimicrobials, specifically on what they are made from and how this affects their use. This focus is timely because, in the context of declining efficacy of biomedical antibiotics, diverse materials are increasingly taking center stage in research and drug discovery as potential agents for new antimicrobial treatments. Of particular significance are natural antimicrobials, such as plants, honey and clay, whose antimicrobial potential is well-documented and which are increasingly moving into mainstream antimicrobial research. Alongside this biomedical focus, we suggest that the social and material lives of these antimicrobial materials require attention to (i) highlight the ways they have been, and continue to be, used in diverse cultures globally, (ii) explore ways we might theorize these materials within wider AMR debates, and (iii) examine the impact of antimicrobials' materiality on their use by patients. This article takes the example of clay, whose antimicrobial properties are well-established and which has been used to treat wounds and gastrointestinal problems for millennia. We first locate clay as an exemplar of a wider shift toward natural products drug discovery in pharmaceutical science and antimicrobial research. We then offer a number of theoretical "ways in" for sociologists to begin making sense of clay as it comes under the western biomedical gaze. We map these conceptual lenses on to clay's physical and symbolic mobility from its use in the global south into western biomedical research and commercialization. We particularly concentrate on post-colonial theory as a means to understand clay's movement from global south to north; laboratory studies to examine its symbolic transformation to a black-boxed antimicrobial artifact; and valuation practices as a lens to capture its movement from the margins to the mainstream. We finish by reflecting on the importance of materiality in addressing optimal use of medicines and by advocating an interdisciplinary approach to AMR which positions sociology as a key contributor to AMR solutions.

Tablet Scoring: Current Practice, Fundamentals, and Knowledge Gaps

Oral solid dosage formulations and/or tablets have remained the preferred route of administration by both patients and health care practitioners. Oral tablets are easy to administer, they are non-invasive and cause less risk adversity. Because of the lack of commercially available tablet dose options, tablets are being split or partitioned by users. Tablet scoring refers to the breakage of a tablet to attain a desired efficacy dose and is an emerging concept in the pharmaceutical industry. The primary reason for the tablet scoring practice is to adjust the dose: dose tapering or dose titrating. Other reasons for tablet partitioning are to facilitate dose administration, particularly among the pediatric and the geriatric patient population, and to mitigating the high cost of prescription drugs. The scope of this review is to: (1) evaluate the advantages and inconveniences associated with tablet scoring/portioning, and (2) identify factors in the formulation and the manufacturing of tablets that influence tablet splitting. Whereas tablet partitioning has been a common practice, there is a lack of understanding regarding the fundamentals underpinning the performance of tablets with respect to splitting. Several factors can influence tablet partitioning: tablet size, shape, and thickness. A requirement has recently been set by the European Pharmacopoeia and the U.S. Food and Drug Administration for the uniformity of mass of subdivided tablets. For breaking ease, an in-vivo reference test and a routinely applicable in-vitro test need to be established.

Functional and structural basis of the color-flavor incongruency effect in visual search

We conducted a functional magnetic resonance imaging (fMRI) study and a voxel-based morphometry (VBM) study to investigate the functional and structural basis of how visual search for flavor labels in packaging is influenced by the color of the packaging. The participants were cued by a flavor word before searching for a package with this flavor label. The behavioral results of both studies revealed that the participants were slower to find the target when its color was incongruent with the flavor label in terms of color-flavor associations than when it was congruent with the flavor label, which is indicative of a color-flavor incongruency effect in the reaction times. The fMRI results revealed that this behavioral effect was associated with enhanced activation in the right putamen. The VBM results further revealed a significant positive correlation between the magnitude of the behavioral effect and volume of gray matter in the right putamen. Taken together, these findings suggest that the color-flavor incongruency effect may be attributed to the violation of color expectation in the incongruent condition and that the putamen may be one of the important areas for processing events in violation of expectation.

Are Blue Pills Better Than Green? How Treatment Features Modulate Placebo Effects

Treatment-related expectations are important predictors for placebo effects in various medical conditions. They are formed by verbal and nonverbal cues during the administration of treatments, such as verbal suggestions, conscious and unconscious associations with previous treatments, characteristics of patients and health-care providers as well as perceptual characteristics of the treatment. This review provides an overview of studies that aimed to elucidate the impact of treatment characteristics on expectations and placebo effects. Results show that high price, brand label, the use of invasive placebos and high placebo dose increase the expectations toward the beneficial effect of a placebo treatment, which in turn boost the placebo effect. Neuroimaging studies provide first insights into the neurobiological mechanisms underlying these differential placebo effects.

Influence of drug colour on perceived drug effects and efficacy

A drug's physical characteristics, such as colour, could be factors influencing its therapeutic effects. It is not well understood whether people's expectations on drug effects and efficacy are affected by colour, especially among Chinese population. This study was conducted to examine people's expectations on drug effects and efficacy on the basis of drug colour, and to reveal possible gender differences in colour-related drug expectations. Participants (n = 224) were asked to classify seven single-coloured and six two-coloured capsules into one of four categories of drug effects, and to indicate the strength of drug efficacy. It is found that all the coloured capsules yielded non-chance distributions in classifications of drug effects, with six single-coloured and four two-coloured capsules associated with specific drug effects. Colour also conveyed differential strengths of drug efficacy in general and in relation to specific drug effects. There were gender differences in drug expectations for some colours and colour combinations. Practitioner Summary: Drug colour was found to have impacts on perceived drug effects and efficacy. The findings from the present study can be used by ergonomics practitioners to design appropriate drug colours in support of drug differentiation, therapeutic effects and medication adherence.

Patient acceptability of 3D printed medicines

Patient-centric medicine is a derivative term for personalised medicine, whereby the pharmaceutical product provides the best overall benefit by meeting the comprehensive needs of the individual; considering the end-user from the beginning of the formulation design process right through development to an end product is a must. One way in which to obtain personalised medicines, on-site and on-demand is by three-dimensional printing (3DP). The aim of this study was to investigate the influence of the shape, size and colour of different placebo 3D printed tablets (Printlets™) manufactured by fused deposition modelling (FDM) 3DP on end-user acceptability regarding picking and swallowing. Ten different printlet shapes were prepared by 3DP for an open-label, randomised, exploratory pilot study with 50 participants. Participant-reported outcome (PRO) and researcher reported outcome (RRO) were collected after picking and swallowing of selected printlet geometries including sphere, torus, disc, capsule and tilted diamond shapes. The torus printlet received the highest PRO cores for ease of swallowing and ease of picking. Printlets with a similar appearance to conventional formulations (capsule and disc shape) were also found to be easy to swallow and pick which demonstrates that familiarity is a critical acceptability attribute for end-users. RRO scores were in agreement with the PRO scores. The sphere was not perceived to be an appropriate way of administering an oral solid medicine. Smaller printlet sizes were found to be preferable; however it was found that the perception of size was driven by the type of shape. Printlet colour was also found to affect the perception of the end-user. Our study is the first to guide the pharmaceutical industry towards developing patient-centric medicine in different geometries via 3DP. Overall, the highest acceptability scores for torus printlets indicates that FDM 3DP is a promising fabrication technology towards increasing patient acceptability of solid oral medicines.

Using Single Colors and Color Pairs to Communicate Basic Tastes

Recently, it has been demonstrated that people associate each of the basic tastes (e.g., sweet, sour, bitter, and salty) with specific colors (e.g., red, green, black, and white). In the present study, we investigated whether pairs of colors (both associated with a particular taste or taste word) would give rise to stronger associations relative to pairs of colors that were associated with different tastes. We replicate the findings of previous studies highlighting the existence of a robust crossmodal correspondence between individual colors and basic tastes. However, while there was evidence that pairs of colors could indeed communicate taste information more consistently than single colors, our participants took more than twice as long to match the color pairs with tastes than the single colors. Possible reasons for these results are discussed.