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Alessandrini E, Gonakova M, Batchelor H, Gizurarson S, Iurian S, Klein S, Schaufelberger D, Turner R, Walsh J, Tuleu C. Colour of Medicines and Children's Acceptability? A Systematic Literature Review of Children's Perceptions about Colours of Oral Dosage Forms. Pharmaceutics 2023; 15:1992. [PMID: 37514178 PMCID: PMC10384887 DOI: 10.3390/pharmaceutics15071992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 07/18/2023] [Accepted: 07/19/2023] [Indexed: 07/30/2023] Open
Abstract
The colour of a product plays an important role in consumer experiences, and in the context of pharmaceutical products, this could potentially affect a patient's expectations, behaviours, and adherence. Several studies have been conducted on adults, but little is known about children's opinions on colours of medicines and to what extent medicines' colour affects their acceptability. To address this gap, a systematic search in PubMed, Scopus, MEDLINE, and Web of Science was conducted. Two authors independently screened the titles, abstracts, and references of all articles and selected studies conducted on children (0-18 years old), assessing children's preferences or opinions about colour of oral dosage forms as either a primary or secondary objective or as an anecdotal record. A total of 989 publications were identified and, after screening, 18 publications were included in the review. Red and pink were the most liked colours and there appeared to be a relationship between the colour of a medicine and expected taste/flavour. The review also highlighted a scarcity of information, usually collected as an anecdotal record. Several gaps in the current knowledge were underlined, emphasizing the need of patient-centred studies to understand if the use of certain colours can improve or worsen the acceptability of a paediatric medicine. This will help inform pharmaceutical manufacturers and regulators on the role and need of colours in children's medicines beyond quality purposes.
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Affiliation(s)
- Elisa Alessandrini
- Department of Pharmaceutics, University College London School of Pharmacy, London WC1N 1AX, UK
| | - Milena Gonakova
- Department of Pharmaceutics, University College London School of Pharmacy, London WC1N 1AX, UK
| | - Hannah Batchelor
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow G4 0RE, UK
| | - Sveinbjorn Gizurarson
- Faculty of Pharmaceutical Sciences, University of Iceland, IS-107 Reykjavik, Iceland
- Pharmacy Department, Kamuzu University of Health Sciences, Blantyre P.O. Box 360, Malawi
| | - Sonia Iurian
- Department of Pharmaceutical Technology and Biopharmacy, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Sandra Klein
- Department of Pharmacy, University of Greifswald, 17489 Greifswald, Germany
| | - Daniel Schaufelberger
- School of Medicine, Neurology, Johns Hopkins All Children's Hospital, St. Petersburg, FL 33701, USA
| | - Roy Turner
- Idorsia Pharmaceuticals Ltd., 4123 Allschwil, Switzerland
| | - Jennifer Walsh
- Jenny Walsh Consulting Ltd., East Midlands Chamber, Nottingham NG1 1GF, UK
| | - Catherine Tuleu
- Department of Pharmaceutics, University College London School of Pharmacy, London WC1N 1AX, UK
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Alessandrini E, Walsh J, Salunke S. Usability of administration devices for oral and respiratory medicines: views from a UK primary school. Eur J Pharm Biopharm 2022; 178:150-158. [PMID: 35987466 DOI: 10.1016/j.ejpb.2022.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 08/12/2022] [Indexed: 11/28/2022]
Abstract
The correct use of medicine administration devices is pivotal for optimal drug therapy in children. Little is known about end users' perspectives on administration device use. Thus, the aim of this study was to conduct a survey to gain information and opinions from caregivers and children regarding the usability of paediatric medicine administration devices. A survey was conducted at a primary school in the United Kingdom in children aged 10-12 years and their caregivers. It focused on oral and respiratory devices and comprised two identical parts: 1) for the caregivers, 2) for the children with parental consent. Ethics approval (REC4612-016) was obtained. A total of 57 caregiver-child pairs accessed the survey and it was completed by parents only (n=4), children only (n=31) or jointly (n=22). Most participants (65%) had taken liquid dosage forms (e.g., syrups/suspensions) compared to solid dosage forms (34%). Oral devices most frequently used were oral syringes (42%), measuring spoons (22%), and household spoons (18%), with parents most frequently demonstrating device use to their children. Respiratory devices were used less frequently, and pressurised metered-dose inhalers with/without spacer (pMDIs) were the most commonly used devices (11/13). Instructions on use were provided by healthcare professionals to both caregivers and children. Generally, oral and respiratory devices were considered easy to use and instructions were clear. However, for both oral and respiratory devices, some suggestions for device improvement were provided by participants. Education/training by healthcare professionals and clear supplier instructions (e.g., pictograms) may be especially effective in ensuring that caregivers and children are able to use administration devices appropriately and receive sufficient information on their correct use.
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Affiliation(s)
| | - Jennifer Walsh
- Jenny Walsh Consulting Ltd., BioCity Nottingham, Nottingham, UK
| | - Smita Salunke
- University College London School of Pharmacy, London, UK
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Saito J, Nakamura H, Walsh J, Yamatani A, Salunke S. A Survey to Understand Parent/Caregiver and Children's Views on Devices Used for the Administration of Oral Pediatric Medicines in Japan. Children (Basel) 2022; 9:children9020196. [PMID: 35204916 PMCID: PMC8869804 DOI: 10.3390/children9020196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 01/31/2022] [Accepted: 02/02/2022] [Indexed: 11/22/2022]
Abstract
Administration devices are crucial for the correct dosing of medicines to children. In countries outside Japan, oral droppers and syringes are reported to be preferred for the administration of oral liquid medicines to neonates and infants, whilst spoons and cups are more frequently used for older children. However, in Japan the majority of oral medicines are powders and the use of dosing devices in each pediatric age group is not well known. This study was performed as an observational anonymous questionnaire survey on devices for oral medicines in children aged 10 to less than 18 years and parents/caregivers on behalf of children aged from birth to less than 18 years. The results from 336 respondents showed that powders were most frequently prescribed in children aged less than 10 years old followed by liquids. Unlike previous reports, droppers were most frequently used in patients less than 12 months old, while household spoons were most frequently used in older children. Oral syringes were perceived as easy to use, which was in line with previous studies. Further cross-regional multi-countries study for establishment the guidelines on the choice of device will be needed.
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Affiliation(s)
- Jumpei Saito
- Department of Pharmacy, National Center for Child Health and Development, Tokyo 157-8535, Japan;
- Correspondence: ; Tel.: +81-3-3416-0181
| | - Hidefumi Nakamura
- Department of Research and Development Supervision, National Center for Child Health and Development, Tokyo 157-8535, Japan;
| | - Jennifer Walsh
- Jenny Walsh Consulting Ltd., BioCity Nottingham, Pennyfoot Street, Nottingham NG1 1GF, UK;
| | - Akimasa Yamatani
- Department of Pharmacy, National Center for Child Health and Development, Tokyo 157-8535, Japan;
| | - Smita Salunke
- School of Pharmacy, University College London, 29-39 Brunswick Square, London WC1N 1AX, UK;
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de Souza ML, Dos Santos WM, de Sousa ALMD, Ferraz LRDM, da Costa LAG, Silva EO, Rolim Neto PJ. Cutaneous leishmaniasis: new oral therapeutic approaches under development. Int J Dermatol 2021; 61:89-98. [PMID: 34510406 DOI: 10.1111/ijd.15902] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 07/14/2021] [Accepted: 08/19/2021] [Indexed: 12/19/2022]
Abstract
The World Health Organization (WHO) classifies leishmaniasis as a disease for which the development of new treatments is a priority. Available drugs are not fully effective in all cases; they have parenteral administration and exhibit serious and common adverse effects. The only oral drug available (miltefosine) has shown resistance, is expensive, and is not available in many endemic countries. Thus, the development of an oral medicine may solve many of these issues. Based on that, this review aimed to investigate which therapeutic alternatives have been studied for the development of oral drugs for the treatment of cutaneous leishmaniasis. A literature search for keywords "leishmania and oral" was performed in PubMed and ScienceDirect, considering articles published in the last 5 years. The articles were selected based on the objective of the review. The main problem in the current treatment of leishmaniasis is the administration of injectables, since it requires patients to travel to health centers, hospitalization, and professional administration, conditions that are not adapted to the socioeconomic reality of patients. Therefore, many research studies have evaluated oral alternatives for the treatment of cutaneous leishmaniasis. The main tested approaches were obtaining new molecules, repositioning drugs, and new formulations of old drugs. The prospects are encouraging but still require more in vivo bioavailability and clinical trials.
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Affiliation(s)
- Myla Lôbo de Souza
- Laboratory of Drug Technology, Department of Pharmaceutical Sciences, Federal University of Pernambuco, Av. Prof Artur de Sá, S/N, Recife - Pernambuco, Brazil
| | - Widson Michael Dos Santos
- Laboratory of Drug Technology, Department of Pharmaceutical Sciences, Federal University of Pernambuco, Av. Prof Artur de Sá, S/N, Recife - Pernambuco, Brazil
| | - André Luiz Moreira Domingues de Sousa
- Laboratory of Drug Technology, Department of Pharmaceutical Sciences, Federal University of Pernambuco, Av. Prof Artur de Sá, S/N, Recife - Pernambuco, Brazil
| | - Leslie Raphael de Moura Ferraz
- Laboratory of Drug Technology, Department of Pharmaceutical Sciences, Federal University of Pernambuco, Av. Prof Artur de Sá, S/N, Recife - Pernambuco, Brazil
| | - Lucas Amadeu Gonzaga da Costa
- Laboratory of Drug Technology, Department of Pharmaceutical Sciences, Federal University of Pernambuco, Av. Prof Artur de Sá, S/N, Recife - Pernambuco, Brazil
| | - Emerson Oliveira Silva
- Laboratory of Drug Technology, Department of Pharmaceutical Sciences, Federal University of Pernambuco, Av. Prof Artur de Sá, S/N, Recife - Pernambuco, Brazil
| | - Pedro José Rolim Neto
- Laboratory of Drug Technology, Department of Pharmaceutical Sciences, Federal University of Pernambuco, Av. Prof Artur de Sá, S/N, Recife - Pernambuco, Brazil
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Abstract
OBJECTIVE Oral medicines are frequently modified (eg, tablets crushed) for older adults. However, these modifications can have clinical, legal and/or ethical implications. Nurses bear responsibility for medicine administration and hence, perform these modifications. The aim of this study was to investigate the knowledge, attitudes and beliefs of nurses about oral medicine modification for older adults. DESIGN A qualitative study was conducted using semi-structured, face-to-face interviews with nurses providing care to older adults in acute and long-term care settings. Interviews were audio-recorded, transcribed verbatim and analysed thematically. SETTINGS Sixteen purposively selected care settings; 4 acute-care and 12 long-term care settings were included. Nurses were recruited by convenience sampling at these sites. PARTICIPANTS Eighteen nurses participated (83% female, 67% long-term care, 33% acute-care, median age (IQR) 38 years (32.5-52.0)). RESULTS Three major themes: modifying-a necessary evil, nurses' role as patient advocate and modifying-we are working very much as a team and two minor themes: fractional dosing, and covert administration emerged from the data. Nurses viewed oral medicine modifications as being a routine and necessary occurrence in geriatric patient care due to limitations of available formulations and the presence of age-related challenges in drug administration. Nurses' knowledge of residents' requirements ensured that they advocate for those with individualised formulation needs, however, nurses rely on pharmacists for information about modifications. Nurses expressed a desire for supports including increased education and ward-specific, pharmacist-developed recommendations on common modifications. CONCLUSIONS This study has provided useful insights into the views of nurses regarding oral medicine modification for older adults. The unique and varied formulation requirements of older adults must be acknowledged. Increased engagement by healthcare professionals, the pharmaceutical industry, regulatory agencies and policy-makers is required to facilitate the development of age-appropriate formulations. In the interim, practical interventions, informed by the findings of this study, are required.
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Affiliation(s)
- Aoife Mc Gillicuddy
- Pharmaceutical Care Research Group, School of Pharmacy, University College Cork National University of Ireland, Cork, Republic of Ireland
| | - Abina M Crean
- Synthesis and Solid State Pharmaceutical Centre, School of Pharmacy, University College Cork, Cork, Republic of Ireland
| | - Maria Kelly
- Pharmaceutical Care Research Group, School of Pharmacy, University College Cork National University of Ireland, Cork, Republic of Ireland
| | - Laura Sahm
- Pharmaceutical Care Research Group, School of Pharmacy, University College Cork National University of Ireland, Cork, Republic of Ireland
- Pharmacy Department, Mercy University Hospital, Cork, Republic of Ireland
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Brindley J. Undertaking drug calculations for oral medicines and suppositories. Nurs Stand 2017; 32:56-63. [PMID: 29094541 DOI: 10.7748/ns.2017.e10953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2017] [Indexed: 06/07/2023]
Abstract
Nurses are required to demonstrate knowledge and competence in undertaking drug calculations as part of their practice. This article aims to assist nurses in identifying their competence in undertaking drug calculations for oral medications and suppositories. Although nurses enter their professional register with an assessed level of medicines competence, nursing is a dynamic profession and competency can decrease over time, with literature demonstrating that nurses often have suboptimal drug calculation skills. This article enables nursing students to continue to enhance their knowledge and understanding of drug calculations, and registered nurses to revisit this element of an essential nursing skill. It provides examples of drug calculations, alongside methods and formulas that should be used. It also discusses issues that potentially compromise safe practice, and relates drug calculations to the professional standards outlined in UK nurses' code of practice.
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Affiliation(s)
- Jane Brindley
- School of Nursing, Canterbury Christ Church University, Canterbury, England
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