Patient preference and acceptability of calcium plus vitamin D3 supplementation: a randomised, open, cross-over trial

Abstract

Preference for a drug formulation is important in adherence to long-term medication for chronic illnesses such as osteoporosis. We investigated the preference for and acceptability of chewable tablet containing calcium and vitamin D (Calci Chew D3, Nycomed) compared to that of a sachet containing calcium and vitamin D3 (Cad, Will-Pharma). This open, randomised, cross-over trial was set up to compare the preference and acceptability of two calcium plus vitamin D3 formulations (both with 500 mg calcium and 400/440 IU vitamin D3), given twice a day in patients with osteoporosis. Preference and acceptability were assessed by means of questionnaires. Preference was determined by asking the question, which treatment the patient preferred, and acceptability was measured by scoring five variables, using rating scales. Of the 102 patients indicating a preference for a trial medication, 67% preferred the chewable tablet, 19% the sachet with calcium and vitamin D3, and 15% stated no preference. The significant preference for Calci Chew D3 (p < 0.0001) was associated with higher scores for all five acceptability variables. The two formulations were tolerated equally well. A significant greater number of patients considered the chewable tablet as preferable and acceptable to the sachet, containing calcium and vitamin D3. Trial registration: Current Controlled Trials ISRCTN18822358.

Patient-Centered Pharmaceutical Design to Improve Acceptability of Medicines: Similarities and Differences in Paediatric and Geriatric Populations

“…Sachet was considered to be more time-consuming and more difficult to take than chewable tablets [ 132 , 133 ] Children and adults with phenylketonuria (aged 8–49 years) 11 of 12 participants preferred a ‘ready to drink’ liquid protein substitute formulation over powder. The liquid formulation was considered easy to take and more convenient to use in different environments than the powder [ 132 , 133 ] Dispersible and effervescent tablets Infants and children (aged 3 months to 5 years) 90 % of caregivers reported that zinc dispersible tablets were as acceptable to their children, or more so, as other medicines, while 84 % were willing to use the medicine again in the future [ 134 ] Children (aged 0–5 years) Acceptability and adherence to diarrhoea treatment was more favourable using zinc dispersible tablets. Almost 90 % of children received 10 days’ treatment and two-thirds completed the full 14 days, while only 6.5 % of caregivers reported administration problems (4 % reported vomiting and 2.5 % refusal to take) [ 135 ] Children (aged 4–8 years) A citrus-flavoured effervescent tablet was preferred over peppermint-flavoured syrup by more than two-thirds of the children and their caregivers [ 136 ] Parkinson’s disease patients with dysphagia The acceptability of a dispersible tablet containing levodopa-benserazide was considered advantageous with regard to ease of administration [ 137 ] ODTs Children (aged 6–11 years) More than 90 % of the children preferred strawberry-flavoured lansoprazole ODTs over peppermint-flavoured ranitidine syrup [ 138 ] Children (aged 5–11 years) The taste of the ondansetron ODTs scored lower than placebo; however, none of the children rejected or spat out the tablet and 87 % were reportedly willing to take it again in the future [ 139 ] Children (aged 6 months to 10 years) A randomised clinical trial involved administration of ondansetron ODTs or placebo to chi...…”

Compliance Of Calcium+Vitamin D Treatment Among Elderly

“…Meta-analyses have also reported that compliance is also associated with insufficient social support, depression, and hopelessness. [5][6][7][8][9][10] In our study, no correlation was seen between regular use of Ca+vitD and age, perception of health state, level of activity, education, diagnosis of osteoporosis, osteoporosis treatment, or fracture history.…”

“…were reported to be the most common side effects. [8,9] Brunner et al found that only 23% of the female patients adhered to Ca+vitD treatment in the first year of osteoporosis treatment.…”

Phase IV randomized preference study in patients eligible for calcium and vitamin D supplementation

“…Previous studies have demonstrated that the currently approved formulation of Calcichew D3 is preferred to Adcal-D3, a chewable tablet competitor product 24 , and it is also preferred to effervescent powder formulations 25,26 . However, since long-term adherence to supplements is generally low, new formulations are constantly needed.…”

“…Non-adherence is linked to an increased fracture risk 7,22 and doubling of the cost per quality-adjusted life year (QALY) 23 . The formulation, size and taste of the supplement affects patients adherence 24 and therefore long-term clinical benefits to patients 25 .…”