Problems with oral formulations prescribed to children: a focus group study of healthcare professionals

Abstract

Background There is evidence to suggest that adherence with prescribed medication is lower amongst adolescents and children than in adults (1). Medication adherence rates between 11% and 93% in paediatric patients have been reported (2). More research needs to be carried out in order to understand why medicines adherence is low and how adherence can be improved in children with long-term conditions. Personal communication with paediatricians in secondary care has highlighted that problems are most likely to be encountered by parents, carers, nurses and children themselves when administering medicines for prevalent long-term childhood conditions. Objective To explore problems with oral medicines prescribed to paediatric patients from the perspectives of medical practitioners, pharmacists and nurses. Setting Two NHS trusts in the West Midlands, UK Method Four focus groups (FG) were conducted. 5 nurses, 8 medical practitioners and 6 pharmacists participated in focus groups.. The themes explored were problems experienced when prescribing, dispensing and administering oral medicines for children. Ethical approval was granted by the South Birmingham Research Ethics Committee (REC), UK. Main outcome measure Themes evolving from Healthcare professionals reports on problems with administering medicines to paediatric patients. Results Two main themes: sensory and non-sensory emerged from the data. Included within these were taste, texture, colour, smell, size, swallowing, quantity, volume and manipulation with food. Taste was the most commonly reported barrier to medicines administration. Texture was reported to be a significant problem for the learning disability population. Medicines manipulation techniques were revealed across the groups, yet there was limited knowledge regarding the evidence base for such activity. Problems surrounding the supply of Specials medicines were discussed in-depth by the pharmacists. Conclusion Organoleptic and physical properties of medicines were identified as key barriers to medicines administration. A robust scientific evidence-based approach is warranted to inform standardised protocols guiding healthcare professionals to support safe and effective medicines manipulation across all settings. Pharmacists' knowledge of Specials medicines needs to be recognised as a valuable resource for doctors. Findings of this study should help to optimise paediatric prescribing and direct future formulation work. Keywords: pediatrics;healthcare professionals;medicines administration;medicines adherence;prescribing.  A large number of issues are perceived by healthcare professionals to cause problems when administering oral medicines to children. Taste was highlighted as the most significant issue.  Nurses had the greatest knowledge of bedside issues, whilst pharmacists understood the consequences of certain manipulations; wider sharing of this knowledge can help to ensure appropriate medicines are prescribed to minimise issues with administration.  The scientific evidence base for medicines manipula...

Acceptability of Anti‑Tuberculosis Compounded Medicines at a Hospital in Bandung

“…2,3 Beberapa penelitian terdahulu menyimpulkan bahwa bentuk sediaan menjadi salah satu masalah dalam pemberian obat pada anak. 4 Sediaan untuk anak harus diformulasikan secara khusus untuk meningkatkan daya terima anak terhadap obat. Daya terima didefinisikan sebagai kemampuan dan kemauan pasien untuk menggunakan obat sehingga tercapai tujuan penggunaan.…”

“…Daya terima pasien anak terhadap obat sangat memengaruhi kepatuhan konsumsi obat, yang pada akhirnya dapat memengaruhi keberhasilan terapi TB. 4,5 Sulitnya administrasi obat pada anak mengakibatkan tingginya angka ketidakpatuhan konsumsi obat pada anak. Ketidakpatuhan konsumsi OAT adalah faktor terbesar penyebab kegagalan terapi dan resistensi TB.…”

“…4 Di sisi lain, perlu dipertimbangkan pula resiko penolakan dan ketidakpatuhan pasien anak, terutama apabila tidak ada bukti yang kuat mengenai interaksi makanan-obat yang menyebabkan efek klinis yang signifikan.…”

“…Hal ini sesuai dengan penelitian lainnya yang menyatakan bahwa daya terima pasien anak sangat berkaitan dengan kepatuhan konsumsi obat, sehingga meningkatkan keberhasilan terapi. 4,5,11,14,15 Ketika wawancara berlangsung, diketahui bahwa orang tua pasien sudah mendapatkan edukasi yang cukup dari petugas kesehatan mengenai penyakit dan terapi TB sehingga kepatuhan konsumsi obat menjadi tinggi.…”

Use of Adult Sensory Panel to Study Individual Differences in the Palatability of a Pediatric HIV Treatment Drug

“…Because taste is the key problem in children’s acceptance of medicine 2,3,20,21 , authorities recommended that “palatability” assessments involve children whenever possible or taste-screening approaches (e.g., adult panels), provided the alternative method is examined for result transferability to children 2,22–26 .…”