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
:1. Introduction
2. Methods
2.1. Study Design and Data Collection
2.2. Qualitative Analysis
2.3. Ethics and Informed Consent
3. Results
3.1. Drug Administration Challenges
3.1.1. Dosage Form-Related Administration Challenges
3.1.2. Patient-Related Administration Challenges
3.2. Suitable Dosage Forms for Pediatrics
3.3. Factors Promoting Successful Drug Administration at Hospital Wards
3.4. Factors Promoting Successful Drug Administration after Patient Discharge
3.5. Roles and Cooperation of Healthcare Professionals
4. Discussion
4.1. Main Findings
4.2. Strengths and Limitations
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Themes |
---|
Suitability of orally administered dosage forms to pediatric patients of different age
|
Manipulation of drugs prior administration |
Risks associated with pharmaceutical excipients |
Variable | Physicians (n) | Nurses (n) | Pharmacists (n) |
---|---|---|---|
Gender | |||
Female | 4 | 5 | 6 |
Male | 4 | 0 | 0 |
Total | 8 | 5 | 6 |
Age | |||
20–34 | 0 | 1 | 0 |
35–49 | 6 | 2 | 5 |
>50 | 2 | 2 | 1 |
Dosage Form | Citations |
---|---|
Orodispersible | Some children take an orodispersible tablet directly into the mouth, afterwards rinsing with water or milk |
You can give orodispersible tablets to babies who eat purees | |
Orodispersible tablets are of course probably relatively pleasant to take | |
Liquid or suspension | You can administer different doses of oral liquids or suspensions |
It is easy to adjust the dose | |
A liquid is the best alternative for the smallest children |
Professional skills of the nurse | Skillful administration techniques |
Knowledge about useful manipulation methods | |
Knowledge about the preferences of each individual child | |
Firm guidance | |
Manipulation of drug products | Cutting a tablet into smaller pieces |
Crushing of tablets | |
Covering a bad taste of drug with juice or juice concentrate, glucose solution, water with added lemon concentrate, milk, fruit purees or jam (especially raspberry jam is good if the drug is in small pieces) | |
Ex tempore manufacturing of dose powders from commercial drug products | |
Dispersing of (crushed) tablets and dose powders before administration | |
Use of administration aids | Coating (Medcoat®) with good taste to cover the drug and facilitate swallowing of tablets, as a whole or in halves or pieces, or capsules. |
Consulting different sources of information | Transferring information amongst nurses |
Consulting a clinical pharmacist | |
Consulting the hospital pharmacy | |
Reading the package information leaflet or summary of product characteristics | |
Selecting the most appropriate drug product for the child | Ex tempore manufacturing of oral liquids or suspensions |
Choosing the more viscous alternative of two liquid formulations | |
Considering the total volume of liquid formulations to be administered | |
Using orodispersible tablets and dispersing them with water in a small spoon | |
Taking into account possible risks with respect to excipients |
Profession | Role |
---|---|
Physician | Prescribes the active pharmaceutical ingredient, dose and route of administration. Does not intervene in the choice of dosage form. |
Physician and nurse decide the route of administration together | |
Nurse | Informs physician which oral dosage form an individual child can take |
Decides which oral dosage form to administer to the child | |
Consults physician if problems occur | |
Knows what gimmicks to use in drug administration | |
Gives feedback to physician about medication administration | |
Clinical pharmacist | Discusses choice of dosage form with nurse |
Gives advice in drug manipulation and administration matters |
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Rautamo, M.; Kvarnström, K.; Sivén, M.; Airaksinen, M.; Lahdenne, P.; Sandler, N. A Focus Group Study about Oral Drug Administration Practices at Hospital Wards—Aspects to Consider in Drug Development of Age-Appropriate Formulations for Children. Pharmaceutics 2020, 12, 109. https://doi.org/10.3390/pharmaceutics12020109
Rautamo M, Kvarnström K, Sivén M, Airaksinen M, Lahdenne P, Sandler N. A Focus Group Study about Oral Drug Administration Practices at Hospital Wards—Aspects to Consider in Drug Development of Age-Appropriate Formulations for Children. Pharmaceutics. 2020; 12(2):109. https://doi.org/10.3390/pharmaceutics12020109
Chicago/Turabian StyleRautamo, Maria, Kirsi Kvarnström, Mia Sivén, Marja Airaksinen, Pekka Lahdenne, and Niklas Sandler. 2020. "A Focus Group Study about Oral Drug Administration Practices at Hospital Wards—Aspects to Consider in Drug Development of Age-Appropriate Formulations for Children" Pharmaceutics 12, no. 2: 109. https://doi.org/10.3390/pharmaceutics12020109
APA StyleRautamo, M., Kvarnström, K., Sivén, M., Airaksinen, M., Lahdenne, P., & Sandler, N. (2020). A Focus Group Study about Oral Drug Administration Practices at Hospital Wards—Aspects to Consider in Drug Development of Age-Appropriate Formulations for Children. Pharmaceutics, 12(2), 109. https://doi.org/10.3390/pharmaceutics12020109