Solid oral medications' suitability for use in enteral feeding tubes

Abstract

Background: There is a lack of specific data about the efficacy and safety of medications administered via feeding tubes, although there is a general awareness that not all drug formulations are suitable.Aims and objectives: To overview the current situation with solid medications administered through feeding tubes in the Tartu University Hospital intensive care units. To evaluate the availability of information on the suitability of drug formulations for administration via feeding tubes.Design: This was a descriptive retrospective document analysis study.Methods: During visits to the intensive care units, medication data for current patients were collected from paper medical charts and nurses. In addition, package information leaflets, summaries of product characteristics, and two practical handbooks were used for evaluating the medicines' suitability for administration via feeding tubes. A request for information was also sent to manufacturers or marketing authorization holders.Results: In 3 months, data were collected from 113 intensive care patients' medical charts. A total of 306 medication administrations via feeding tubes were documented and analysed, 67% of which were solid oral dosage forms. Exactly 91.2% of these were conventional tablets. After the analysis of information availability, 88% of the medications were classified as suitable for administration via feeding tubes, but only 48% had the manufacturer-provided information. Conclusion:This study showed that the information about the suitability of formulations administration through a feeding tube is not readily available for almost half of the medications. The manufacturers seem to have the relevant information, but it is not always added to their medications' official information, putting these patients at higher risk for errors.Relevance to Clinical Practice: This study shows that if there is no clear statement about administration through feeding tubes on official manufacturers' information,

Development of an Administration Guideline of Oral Medicines to Patients with Dysphagia

“…This project aimed to develop an easy-to-use tabular guideline for HCPs presenting all relevant information for oral medications used by patients with dysphagia. A small local study in TUH [5] and an additional literature review have demonstrated the need for the guideline described above.…”

“…There is a lack of clear and readily available information from drug manufacturers on ways to administrate medications to patients with dysphagia [4,5]. Although some handbooks and databases provide guidelines about medication management for these patients, much such information is unavailable [5][6][7][8][9].…”

“…There is a lack of clear and readily available information from drug manufacturers on ways to administrate medications to patients with dysphagia [4,5]. Although some handbooks and databases provide guidelines about medication management for these patients, much such information is unavailable [5][6][7][8][9]. Besides legal issues, medication alterations can lead to several problems, like changes in absorption and effects, recurrent adverse drug reactions, FT blockages and drug loss, or an unpleasant taste that can cause reluctance to take the medicines [10][11][12].…”

Spotlight on the first joint BACCN/IACCN conference

“…The other papers in this issue focus on pain intensity during treatment and care procedures 11 and after discharge from ICU 12 ; enteral nutrition practices by ICU nurses 13 ; medication administration through enteral feeding tubes 14 ; the development of an oral care frequency assessment scale 15 ; and ICU nurses' knowledge and practice regarding maintaining arterial catheter patency 16 …”

“…Guner and Kutluturkan's randomized controlled trial adds to the growing body of evidence about the optimum angle of the head of bed elevation that is safe and effective in the prevention of ventilator-associated pneumonia, 9 while Burey et al investigated the feasibility of alveolar collapse analysis by measuring lung impedance distribution by nurses caring for patients with acute respiratory distress syndrome. 10 The other papers in this issue focus on pain intensity during treatment and care procedures 11 and after discharge from ICU 12 ; enteral nutrition practices by ICU nurses 13 ; medication administration through enteral feeding tubes 14 ; the development of an oral care frequency assessment scale 15 ; and ICU nurses' knowledge and practice regarding maintaining arterial catheter patency. 16 The authors of these papers employed various quantitative and qualitative methodologies, varying from randomized controlled trials and prospective observational studies to cross-sectional studies and survey design, and from document analysis and retrospective service evaluation to narrative inquiry.…”