Consumer experiences and perception with reclosable pharmaceutical child resistant closures in Ghana, West Africa

Child resistant closures (CRCs) are an effective deterrent in preventing inadvertent poisoning in young children. Nevertheless, investigations since their debut have shown that users in different parts of the world do not embrace this safety package due to their opening mechanism. In this study, consumers who have interacted with pharmaceutical CRCs in Ghana within the West African sub-region were interrogated to assess their experiences and perception. The assessments centred on consumer attitudes towards using CRCs generally, as well as their understanding of and importance for CRCs, the types that are available, observed cases of unintended medicinal child poisoning, ease of opening and injuries/accidents caused by them. The two observed CRCs used in the region were push and turn and squeeze and turn closures, with the former being the most popular. Regardless of educational level, consumers within the region had little understanding of how CRCs worked and how important they were. Due to their imprecise instructions and unpleasant opening mechanisms, CRCs were generally assessed by consumers as being challenging to open. Consumers unable to open CRCs employed their teeth, knives and sharp objects, resulting in injuries and casualties such as cuts and scratches. To maintain safe containment and limit children's exposure to medications, consumers identified CRCs as their top choice for pharmaceutical packaging. In conclusion, consumers oppose changing the design of CRCs but advocate for better opening instructions and pharmacist education for correct use.