A Focus Group Study about Oral Drug Administration Practices at Hospital Wards—Aspects to Consider in Drug Development of Age-Appropriate Formulations for Children

Abstract

Oral drug administration to pediatric patients is characterized by a lack of age-appropriate drug products and the off-label use of medicines. However, drug administration practices at hospital wards is a scarcely studied subject. The aim of this study was to explore the oral drug administration practices at pediatric hospital wards, with a focus on experiences and challenges faced, methods used to mitigate existing problems, drug manipulation habits, perceptions about oral dosage forms and future needs of oral dosage forms for children. This was a qualitative study consisting of focus group discussions with physicians, nurses and clinical pharmacists in a tertiary university hospital with the objective of bringing forward a holistic view on this research topic. These healthcare professionals recognized different administration challenges that were classified as either dosage form-related or patient-related ones. A lack of depot formulations developed especially for children as well as oral pediatric dosage forms of drug substances currently available as intravenous dosage forms was recognized. The preferred oral dosage forms were oral liquids and orodispersible tablets. Patient-centered drug administration practices including factors facilitating drug administration both at hospital wards and at home after patient discharge were identified. Among all healthcare professionals, the efficient cooperation in drug prescribing and administration as well as in educating the child’s caregivers in correct administration techniques before discharge and improving the overall discharge process of patients was emphasized. This study complements the prevalent understanding that new dosage forms for children of varying ages and stages of development are still needed. It also brings a holistic view on different aspects of oral drug administration to pediatric patients and overall patient-centered drug administration practices.

Direct Powder Extrusion of Paracetamol Loaded Mixtures for 3D Printed Pharmaceutics for Personalized Medicine via Low Temperature Thermal Processing

“…Lately, 3D Printed (3DP) drugs have drawn attention as an alternative to improve the adherence to treatment, improving the organoleptic characteristics and facilitating identification by using different shapes and colors [7][8][9]. The use of 3D printing allows the personalization of the oral forms (3DP pills) not only to improve adherence, but to customize the drug dosage, which is of great interest in the definition of the prescription for adults and is critical in pediatrics [10][11][12][13].…”

“…Different 3D printing technologies have been described in the literature to prepare 3DP pills [14][15][16][17]. Fused deposition modelling (FDM) and Semi Solid Extrusion (SSE) are the most straightforward technologies to prepare different mixtures and combinations Pharmaceutics 2021, 13, 907 2 of 16 of drugs and excipients, where the active pharmaceutical ingredient (API) is directly blended with or impregnated in the excipient/carrier to subsequently be processed. Seoane-Viaño et al [18] did a thorough review of SSE, highlighting the numerous applications this technology has and discussing some of its drawbacks: post-printing drying process, complete solvent evaporation, risk of material collapse and loss of shape.…”

I Spy with My Little Eye: A Paediatric Visual Preferences Survey of 3D Printed Tablets

“…Oral administration remains the most convenient route for patients, although they can present limitations related to dose modification, ease of swallowing, taste masking, physical and chemical stability and packaging [ 21 ]. Due to the lack of appropriate dosage forms, existing products are often manipulated (e.g., crushing or tablet splitting) or formulations are extemporaneously prepared [ 22 ], which may compromise the safety and efficacy of the treatment [ 23 ]. Although oral liquids such as syrups are highly acceptable (if palatable) and easy to administer, their benefits are counterbalanced by a risk of dosing error, instability, safety of excipients and storage concerns [ 24 , 25 ].…”

Benefits and Prerequisites Associated with the Adoption of Oral 3D-Printed Medicines for Pediatric Patients: A Focus Group Study among Healthcare Professionals

“…Participation in the study was voluntary, and everyone gave their written informed consent before attending the interviews. The same healthcare professionals participated in our recent study on oral drug administration practices at hospital wards [32].…”