Barriers to administering non-oral formulations in a paediatric population: A semi-structured interview study

Int J Pharm. 2016 Jan 30;497(1-2):12-7. doi: 10.1016/j.ijpharm.2015.11.010. Epub 2015 Nov 28.

Abstract

There is a paucity of research exploring barriers to non-oral medicines administration in paediatric patients; however, these undoubtedly influence medicines adherence. Studies conducted with healthcare professionals have identified various issues with the administration and acceptance of non-oral medicines and devices (Venables et al., 2012; Walsh et al., 2015). EMA (2014) guidelines specify that formulation teams should demonstrate 'acceptability' of paediatric formulations when developing pharmaceutical formulations. Semi-structured interviews exploring barriers to administering non-oral medicines were conducted with young persons and the parents/legal guardians of children (0-17 years) with chronic conditions at the University Hospital of Coventry and Warwickshire, UK. 90 children prescribed a total of 148 non-oral medicines were recruited to the study; 88 barriers to administering non-oral medicines were reported. The most commonly reported barriers were: poor acceptance of face mask/difficulties with spacer for inhaled formulations (38% of reports); disliking parenteral/preferring alternative formulations (38% of reports); greasy texture of topical preparations; difficulty with administering an ocular ointment and the large dose volume of a nasal preparation. Formulation teams should consider the use of child-friendly, age-appropriate designs to improve usability and acceptance, thus medicines adherence. These findings should be used to inform future development of non-oral formulations and devices, suitable in terms of safety, efficacy and acceptability to paediatric patients.

Keywords: Acceptability; Barriers to administration; Device; Formulation; Medicine; Pediatric; Usability.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Cutaneous
  • Administration, Inhalation
  • Administration, Intranasal
  • Administration, Ophthalmic
  • Administration, Rectal
  • Adolescent
  • Child
  • Child, Preschool
  • Drug Implants
  • Female
  • Focus Groups
  • Health Knowledge, Attitudes, Practice*
  • Health Personnel / psychology
  • Humans
  • Infant
  • Injections / psychology
  • Interviews as Topic*
  • Male
  • Medication Adherence / psychology*
  • Parents / psychology
  • Pediatrics / methods*
  • Pharmaceutical Preparations / administration & dosage*
  • Self Report

Substances

  • Drug Implants
  • Pharmaceutical Preparations