Objectives The purpose of this article was to present an original standardized tool assessing the medicine's acceptability whichever their characteristics and the patient features. Methods An acceptability map was built with objective measures from medicine use assessments collected in real-life conditions. Multiple correspondence analysis (MCA) was used for the mapping process. Hierarchical classification on the principal components (HCPC) of the MCA was performed for the clustering process corresponding to distinct acceptability profiles. Key findings The results presented here focus on 234 evaluations issued from the paediatric population and gathered in four clusters: 'well-accepted' (50%), 'accepted' (19%), 'poorly accepted' (25%) and 'not accepted' medicines (6%). The first one was characterized by a dose fully taken, in a short time, with a patient's positive reaction; the second by a longer administration time, a neutral reaction and the use of methods to achieve administration (reward, divided dose). Differentiation between the two last clusters was, respectively, originated by a required dose partially taken or not taken. Conclusions The acceptability profile of each medicine can be evaluated with the map position of the related patient's assessments barycentre. This tool should satisfy expectations in terms of methods for appropriate acceptability evaluation and standardized comparison among medicines.
Presenting many advantages, solid oral dosage forms (SODFs) are widely manufactured and frequently prescribed in older populations regardless of the specific characteristics of patients. Commonly, patients with dysphagia (swallowing disorders) experience difficulties taking SODFs, which may lead to non-adherence or misuse. SODF characteristics (e.g., size, shape, thickness) are likely to influence swallowability. Herein, we used the acceptability reference framework (the ClinSearch acceptability score test (CAST))—a 3D-map juxtaposing two acceptability profiles—to investigate the impact of tablet size on acceptability. We collected 938 observer reports on the tablet intake by patients ≥65 years in hospitals or care homes. As we might expect, tablets could be classified as accepted in older patients without dysphagia (n = 790), while not in those with swallowing disorders (n = 146). However, reducing the tablet size had a significant impact on acceptability in this subpopulation: tablets <6.5 mm appeared to be accepted by patients with swallowing disorders. Among the 309 distinct tablets assessed in this study, ranging in size from 4.7 to 21.5 mm, 83% are ≥6.5 mm and consequently may be poorly accepted by institutionalized older people and older inpatients suffering from dysphagia. This underlines the need to develop and prescribe medicines with the best adapted characteristics to reach an optimal acceptability in targeted users.
ObjectivesOur novel tool to standardise the evaluation of medicine acceptability was developed using observational data on medicines use measured in a paediatric population included for this purpose (0–14 years). Using this tool, any medicine may be positioned on a map and assigned to an acceptability profile. The present exploration aimed to verify its statistical reliability.MethodsPermutation test has been used to verify the significance of the relationships among measures highlighted by the acceptability map. Bootstrapping has been used to demonstrate the accuracy of the model (map, profiles and scores of acceptability) regardless of variations in the data. Lastly, simulations of enlarged data sets (×2; ×5; ×10) have been built to study the model's consistency.Key findingsPermutation test established the significance of the meaningful pattern identified in the data and summarised in the map. Bootstrapping attested the accuracy of the model: high RV coefficients (mean value: 0.930) verified the mapping stability, significant Adjusted Rand Indexes and Jaccard coefficients supported clustering validity (with either two or four profiles), and agreement between acceptability scores demonstrated scoring relevancy. Regarding enlarged data sets, these indicators reflected a very high consistency of the model.ConclusionsThese results highlighted the reliability of the model that will permit its use to standardise medicine acceptability assessments.
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