I was in a car accident that hurt the ligaments for my thumb, so I couldn't pinch my thumb together to use a regular pen. The hand doctor recommended a pen like this. It didn't help me, since you do need some thumb involvement to use it. I ended up getting a gel pen that flowed really well and holding it using my pointer, middle, and ring fingers.I probably could have used it if it either flowed better or came with a little velcro strap to affix it to my finger. Now that I think about it I could have just gotten some of my double sided velcro and made it work myself.I'm back to real pens and using my thumb a bit more, and I'll have this fifteen dollar mistake of a purchase to remind me of my car accident.So comfortable to hold and use. Saves me a lot of pain from arthritis.Ink and refills leak every timeThis pen is great. It takes pressure off my hands and wrists when I write, but it doesn't seem to write as smooth as previous versions of this product that I've used in the past.This was a big hit when trying to teach some older kids how to hold a pencil correctly. Great OT tool to keep on hand.This is the only pen that my stepfather is able to use because of arthritic hands. He has used this style for a few years now.Easy to holdEasy to use. Good to write when you have tremors.