Evaluation of the difficulties associated with the administration of pediatric drugs delivered to outpatient

4 octobre 2023

A. Caldas, M. Royer, F. Marçon
Centre Hospitalier Universitaire d’Amiens, France

In paediatrics, the acceptability of treatments can influence compliance. Caregivers often employ various strategies to facilitate drug administration. This issue is especially pertinent to paediatric medications, whether they are custom pharmaceutical preparations or commercial drugs, dispensed in hospital pharmacies. The objective of this study was to evaluate the challenges faced by caregivers when administering and compounding paediatric drugs provided by our hospital’s pharmacy.

Materials and methods
Over a 4-month period, we distributed a questionnaire in our hospital pharmacy to caregivers of children under 12 years old. The goal was to pinpoint challenges related to the administration and compounding of non-ready-to-use drugs.

During the data collection period, 54 questionnaires were collected. More than half (59%) of our population was under 6 years old. Among children under 6 years old, 72% of treatments delivered were liquid forms and 6% were monolithic forms (capsule or tablets). Pharmaceutical preparations (powder packaged in openable capsules) accounted for 22% of dispensed medicines. Nearly a quarter (26%) of the drugs prescribed required an additional compounding step before the administration (opening capsules or tablets for oral suspension). Over a third of caregivers (37%) regularly used food to administer the drugs. No respondent reported crushing tablets and only 3 reported opening capsules of commercial drugs on the advice of their healthcare professional. Among caregivers, 81% felt well informed overall about the compounding and the administration of the drugs.

Discussion and Conclusion
This survey explores the perception of caregivers. It revealed that using food to administer medication was a common practice, which did not systematically benefit pharmaceutical support. Food interactions altering bioavailability need to be anticipated as the literature suggests [1]. This practice also reveals that the acceptability of pharmaceutical forms is not optimal, and could lead to dose errors, as reported in the literature [2]. It therefore seems essential to reinforce the pharmacist’s counsel role with caregivers, to ensure the safe administration of drugs, particularly those that are not ready-to-administer and require an additional step of dispersion in food, which can influence drug bioavailability.

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[1Martir J, Flanagan T, Mann J, Fotaki N. Recommended strategies for the oral administration of paediatric medicines with food and drinks in the context of their biopharmaceutical properties : a review. J Pharm Pharmacol. 2017 ;69:384-397.

[2Boztepe H, Özdemir H, Karababa Ç, Yıldız Ö. Administration of oral medication by parents at home. Journal of Clinical Nursing. 2016 ;25:3345-3353.

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