Like many hospitals, one US-based Timestrip customer maintains a fleet of ambulances that serves the local community. Use of the pharmaceutical products carried by the ambulances is subject to rules laid down by the state Board of Pharmacy.

This is responsible for regulating the practice of pharmacy and the legal distribution and dispensing of prescription drugs and precursor substances.

One stipulation requires hospital-based ambulance services to monitor their drug kits for extreme temperatures while out in the field. So hospital medics turned to Timestrip monitoring devices to track the kits as they are stored and transported.

Timestrip liquid-based TTIs and Timestrip neo TT525-AB electronic indicators are placed on the drug kits before they are deployed in the field. In this way, the hospital receives a clear, irreversible visual alert if the drugs are exposed to conditions below freezing point or above 100ºF (48ºC).

Timestrip neo is a range of very small and light time and temperature indicators that provide a highly cost effective method of monitoring the conditions in which drugs and other products are kept.

Using the tiny Timestrip devices means the hospital can be sure whether the acceptable pharmaceutical temperature excursions of products has been breached or not. This safeguards the patients and means that medicines don’t have to be discarded unnecessarily.

Pioneers Sustainable Healthcare with Innovative Medicines Returns System

Radboud University Medical Center (Radboudumc), a leading institution in sustainable and innovative healthcare, and Timestrip UK, a leading supplier of time and temperature indicators. are spearheading a groundbreaking initiative to address challenges in re-allocating medicines returned unused from patients.

A panel of 14 hospitals across The Netherlands is implementing a system involving sealed bags containing oncology medicines and Timestrip neo indicators for drugs dispensed to patients. The neo indicators were selected for their clear irreversible alerts, small size and reliability.

Currently, unused medicines returned by patients are not re-dispensed, leading to wastage and potential delays in treatment. Recognizing the need for a more sustainable approach, researchers at Radboudumc have embarked on a trial to evaluate the practicality of a returns system that ensures the authenticity and proper storage conditions of returned medicines.

The panel of 14 hospitals that have been established to participate in the trial comprises six university hospitals, six teaching hospitals and two general hospitals.

When any of the drugs used in the trial are returned to the hospital pharmacy unused, the pharmacists can check that the package has not been interfered with, and that the temperatures incurred during storage and transport have not exceeded specified limits.

A custom neo indicator was developed to monitor three oncology medicine temperature ranges:
2ºC, 25ºC and 30ºC. A series of LEDs on the front of the indicator show clearly when certain temperature limits have been breached. The indicators also show the duration of exposure to 25ºC up to eight hours.

As the neo indicator alerts are clear and irreversible, clinicians can have confidence in the readings, and a further safeguard is included in the form of a QR code on each indicator that can be scanned to provide serial number data for traceability.

Shirley Xie MSc, the Investigator for the trial at Radboudumc, explains: “Using a temperature indicator is important in providing the evidence needed during the trial. We needed a simple yet effective device which gives us a visible confirmation of medicine quality.”

The ongoing trial is expected to demonstrate the cost-effectiveness of the proposed system for re-dispensing oncology (and potentially other) medicines, thereby reducing waste.

Miss Xie emphasizes the significance of the trial: "As well as the potential improvements in efficiency and patient care from re-dispensing unused drugs of good quality, there is a sustainability benefit associated with the reduced waste."

Radboudumc remains committed to making a significant impact on health and healthcare, and this initiative aligns with their broader mission of advancing healthcare practices for the benefit of patients and the environment.

Read more about our partnership with Radboudumc on oncology medicine temperature indicators.

Dr Carrie Milton is a veterinarian and adventure traveller. She speaks three languages well and is conversational in three more. In addition to practising veterinary medicine, she is an accredited copy-editor who provides proofreading and editing services to a range of clients.

Carrie is also a long-term sufferer of rheumatoid arthritis, and needs a regular supply of drugs to keep this painful condition at bay. However, she is determined not to let this setback spoil her chances of a full and active life, and one day came up with the idea of starting a travel blog, now called ‘Adventures with RA’.

“I wanted to promote an active lifestyle and to share my experiences in such a way that they may be encouraging and useful to others suffering from chronic illness”

Dr Carrie Milton

Traveling with fridge medicines

The nature of Carrie’s expeditions means that her drug supply is in danger of being exposed to harsh environmental conditions and since this can lead to a loss of efficacy, she needs a way to monitor for temperature breaches during storage and transport.

Carrie discovered Timestrip neo – at that time a newly introduced product that, when activated, provides constant confirmation that conditions have remained within expected limits.

Small, very light and low cost, the neo indicators are now popular in industries that work with foodstuffs and pharmaceuticals, where they can be attached to products at unit or batch level.

Any breach of temperature is shown clearly using LED lamps, along with the cumulative duration of the breach.†

Carrie was so impressed with the Timestrip neo that she took to LinkedIn to exclaim:

"I'm excited about using the Timestrip neo to monitor my biologic medication. What a mission it is to travel with fridge meds, never mind to simply look after them during power cuts in South Africa! Thank you, @timestripukltd, for making it a little easier and a little less stressful!"

As she continues on her mission to promote an adventurous and healthy lifestyle, we wish Carrie all the best using her new travel companion: the Timestrip neo!

† Carrie used a neo TT525-AB, but other products are available to cover different temperature and time ranges.

Timestrip smart indicators were used in a study by academics at Reading School of Pharmacy, part of The University of Reading, into people’s confidence in the quality of medicines.

The study focused on the potential re-use of returned medicines. It found that participants’ intention to take part in medicines re-use increased with the presence of the Timestrip^® Plus temperature sensors on the packaging. The perceived social pressure to accept the medication also increased. The effect of the indicators was even greater than the promise of pharmacist visual checking of the medicines.

Although medicines re-use is not at present allowed in the UK, the presence of Timestrip indicators on packaging is understood to be a marker of their quality.

Ref: Lam, Y.; McCrindle, R.; Hui, T.K.L.; Sherratt, S.; Donyai, P. The Effect of Quality Indicators on Beliefs about Medicines Reuse: An Experimental Study. Pharmacy 2021, 9, x. https://doi.org/10.3390/xxxxx. Read more here:  https://www.mdpi.com/2226-4787/9/3/128

Whether in a major teaching hospital, a walk-in clinic or a doctor’s surgery, any type of healthcare boils down to two broad objectives: improved patient outcomes and the best possible use of resources.

Although historically reconciling patient health and the harsh realities of budgetary constraints have at times led to difficult choices, the fact is that by integrating technology and innovation into decision making around resource allocation, both objectives can be achieved at the same time.

Indeed, thanks to its high tech / low cost Time and Temperature Indicator labels, Timestrip® is able to provide healthcare providers and the pharmaceutical sector with a broad range of practical, user-friendly solutions that:

✔ Ensure product quality

✔ Reduce product waste

✔ Ensure regulatory compliance

✔ Reduce time and temperature monitoring costs

But what does this look like in practice?

Improving quality control and efficiency

Tenet Healthcare is US healthcare provider that faced the challenge of needing to effectively manage how it processed bags of whole blood. On the one hand, it faced the need to comply with local regulatory requirements related to the use of effective temperature monitoring for blood products; and on the other, it had to discard any bag of blood that had been exposed to a temperature above 10°C for more than 30 minutes.

The company needed to be absolutely certain that any unused bag of whole blood was 100% safe to be returned to storage for future use. It had also noted ongoing difficulties in using other blood temperature indicators. Potentially, the latter could lead to doubts about product safety, which in turn would require that bag of blood to be discarded, possibly unnecessarily.

Its use of Timestrip® Blood Temp 10 – 10°C Blood Irreversible Transit Temperature Indicator noted the following advantages:

✔ Improved quality of care

✔ Improved workflow efficiency

✔ Maintenance of quality control during transportation and storage

✔ Support in complying with regulatory guidelines

Cost-effective regulatory compliance

Marathon Distributors is a pharmaceutical and healthcare logistics services provider in Cyprus and is involved in the distribution of pharmaceutical products throughout the island. The main cold chain management issue it faced was around compliance with local and EU regulations, specifically the country’s Law on Human Pharmaceuticals 70(I) 2001 and the EU guidelines on Good Distribution & Manufacturing Practices. These mandated the company to ensure that the pharmaceuticals it delivered were not exposed to a temperature above 8°C for more than 8 hours during transportation.

Although other products helped achieve regulatory compliance, the company began using Timestrip® PLUS™ 8°C 8 Hrs (TP065) Irreversible Time and Temperature Indicators because they were much more competitively priced.

Overall the company reported:

✔ Timestrip Indicators were 50% cheaper

✔ Delivery costs were 50% lower

✔ Delivery times were faster

✔ Positive end-user feedback around ease of use

Easy temperature monitoring for vaccine transport

Cambridgeshire Community Service NHS Trust is a UK healthcare provider in south-east England. Part of its work is the delivery of school-age immunisations to schools in its area. This includes for instance flu nasal immunisations for primary schools and HPV vaccinations and Meningitis ACWY and TdIPV for secondary schools.

For the delivery of vaccines, electric Labcold Portable Vaccine Carriers and pharmaceutical-grade vaccine carriers are used. In order to maintain the efficacy of the various transported vaccines, two different temperature ranges need to be managed: 2°C to 8°C and -25°C to 25°C.

In order to ensure the delivery of viable, unspoiled vaccines, the Trust thus had a requirement for a dual, low-cost solution for use by its delivery teams.

To achieve this, two Timestrip products have been used in each vaccine carrier:

● a Timestrip® PLUS (TP 065) to indicate if the temperature went above 8°C

● a Timestrip® PLUS (TP 217) to indicate if the temperature exceeded 25°C, and if so, for how long

The feedback from the delivery teams has been extremely positive, specifically around:

✔ Easy to read visual data

✔ Ease of use

✔ Reliability

Reliable test kit time data

Clinical Innovations is a US maker of obstetrics devices that wanted to develop a non-invasive test kit for the diagnosis of any rupture of membranes (ROM). Although treatable, spontaneous ROM is a serious medical condition and a major cause of preterm births. Thus, an accurate diagnosis of ROM can be a key factor in determining timely and appropriate medical intervention. Similarly, a false diagnosis of ROM can lead to unnecessary hospitalisation, medication and even induced premature delivery.

Timestrip was able to provide Clinical Innovations with Time Indicators for its ROM Plus® self-contained test kit. These give clinicians the essential and immediate data they need to reduce the dangers of any premature ROM for expectant mothers and their babies.

The test kit uses Timestrip technology with an in-built 20-minute time monitoring indicator that generates the required data within 5-20 minutes, with 5,10 and 20 minutes clearly indicated on the Timestrip. Its key benefits are:

✔ Clear visual data

✔ Ease of use

✔ Improved health outcomes

Hygienic healthcare environment

Beyond pharmaceuticals and blood products, healthcare also involves various types of disposable items that need replacing regularly. Especially for the sick, hygiene in the clinical environment is an essential aspect of patients being able to make a full recovery. Timestrip indicators make excellent cleaning reminders for surfaces, filters and instruments.

Assuming the absence of any complications, catheters for instance need to be replaced every 30 days for Foley catheters and every 60-90 days for silicone catheters. Catheter bags however need to be replaced every 5-7 days. If these items are not replaced at appropriate intervals, opportunities are created for harmful pathogens to develop.

Unsurprisingly, this has also been shown to be the case for hospital privacy curtains. Dr Kevin Shek was the lead study author into the rate of contamination of hospital privacy curtains in a burns/plastic ward. In a report about the study findings in Nursing Times, he said:

“We know that privacy curtains pose a high risk for cross-contamination because they are frequently touched but infrequently changed. The high rate of contamination that we saw by the fourteenth day may represent an opportune time to intervene, either by cleaning or replacing the curtains."

Especially in busy hospital departments such as Accident & Emergency and ICU, hospital privacy curtains can quickly become contaminated with bacteria such as methicillin-resistant S. aureus (MRSA) and Clostridium difficile (C. diff). Thanks to Timestrip® Time Monitoring Indicator panels that change color after a set period of time, clinical staff are alerted when a privacy curtain needs to be changed. They help a hospital achieve:

✔ Best use of resources with a low-cost solution

✔ Compliance with guidelines around frequency of change

✔ Less time needed to monitor when that change needs to occur

✔ Hygienically clean hospital environment for patients