Evaluation of patient-reported outcome measurements as a reliable tool to measure acceptability of the taste of paediatric medicines in an inpatient paediatric population

Abstract

ObjectiveTo evaluate the age appropriateness and suitability of patient-reported outcome measures to assess the acceptability of the taste of oral liquid medicines in children.Design and settingAn observational mixed-methods study involving children aged 2–16 years taking oral liquid medicine in paediatric inpatient wards across the West Midlands (UK). Assessment tools included patient-reported scores on the taste of medicines via a five-point Facial Hedonic Scale; a Visual Analogue Scale (VAS); a question, ‘Did you think the medicine tasted OK?’ and researcher observations of facial expressions and behaviours immediately before, during and after administration.Results611 children participated. The percent unable to complete the scales was 7% (n=46) for the VAS; 2% (n=15) for the hedonic scale and 1% (n=7) for the question about taste. Significant correlations (Spearman’s r) were observed between the patient-reported outcome measures: 0.80 and 0.78 for the taste question and hedonic and VAS, respectively, and 0.84 for the hedonic and VAS. Researcher observations demonstrated the ability of the patient to take the medicine as intended but did not provide sensitive measures of taste. 5% of administrations were not taken as intended by the children. Medicines known to have poor taste (clarithromycin and prednisolone) showed mean hedonic and VAS scores of ≥3.5 and >65 mm, respectively.ConclusionsPatient-reported outcome measures correlate with each other and are a useful means to assess the taste (and acceptability) of medicines. Hedonic scales are better understood by children and should be the first choice tool in the assessment of medicines taste.

Delay of Gratification Predicts Eating in the Absence of Hunger in Preschool-Aged Children

“…Mothers had indicated which foods their child should not eat due to allergies beforehand; children performed their taste test using only the foods that were permitted by their mothers (total N = 1; removed red/pink Starburst containing red food dye). Consistent with the original paradigm used in the proposed age range (Cutting et al, 1999 ; Fisher and Birch, 1999 ), children were instructed to taste each of the foods and provide a rating from 1 to 5 using a smiling-face scale where 1 = “very tasty” and 5 = “not very tasty” validated for use in the assessment of taste in pediatric populations (Mistry et al, 2018 ). Children were encouraged to complete the taste test within 5 minutes, and were then told that they had to remain in the room while their mother completed her surveys.…”

Can children swallow tablets? Outcome data from a feasibility study to assess the acceptability of different-sized placebo tablets in children (creating acceptable tablets (CAT))

“…3 Liquid medicines have long been considered the most appropriate oral dosage form for children and young people (CYP); however, support is increasing for solid dosage forms to be used more frequently due to their better stability profile, suitability for coating to taste mask and the inclusion of a lower number of excipients. 5 There is increasing evidence to show that tablets are an acceptable dosage form and a suitable alternative to liquids which can overcome the challenges associated with liquid medicines. [6][7][8][9] The ability of CYP to swallow tablets is of importance to the pharmaceutical sector, healthcare professionals and patients themselves.…”

A Novel Oral Syringe for Dosing and Administration of Multiparticulate Formulations: Acceptability Study in Preschool and School Children

“…Hedonic scores were used as an indicator of acceptability. Criteria to demonstrate acceptability was defined as a hedonic score ≤3 (neutral or positive face) [25]. Acceptable/unacceptable hedonic scores were then tested for association with other acceptability measures using Wilcoxon rank test.…”