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Published on: November 17, 2018
Challenges prescribing and dispensing oral antibiotics with poor palatability for paediatric patients: A qualitative
Ayat Elgammal1,2, Joseph Ryan3, Colin Bradley3
1Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Ireland.
Insights
Poorly palatable liquid antibiotics lead to children not finishing treatment, risking disease recurrence and antimicrobial resistance. Improving antibiotic flavor and awareness among healthcare providers and parents is crucial for better adherence.
Area of Science:
- Pharmacology and Pharmaceutics
- Pediatric Medicine
- Health Services Research
Background:
- Poor palatability of oral liquid antibiotics in children is a significant barrier to treatment adherence.
- Non-adherence due to taste issues can lead to treatment failure, disease relapse, and increased antimicrobial resistance.
- Understanding healthcare professionals' perspectives on prescribing and dispensing challenges is vital.
Purpose of the Study:
- To investigate the experiences and challenges of general practitioners (GPs) and community pharmacists with oral liquid antibiotics for children.
- To explore the impact of poorly palatable antibiotic formulations on pediatric patients and the healthcare system.
- To identify strategies for overcoming palatability challenges in pediatric antibiotic therapy.
Main Methods:
- Semi-structured interviews were conducted with general practitioners (GPs) and community pharmacists.
- Interviews were facilitated via an online video-conferencing platform.
- Qualitative data were analyzed using thematic analysis.
Main Results:
- Three main themes emerged: challenges faced by prescribers/dispensers, the impact of poor palatability, and strategies to overcome these issues.
- Challenges included factors influencing antibiotic selection, discussions with parents, and formulation characteristics.
- Impacts spanned patient outcomes (non-adherence, recurrence) and health system consequences, with awareness and counseling identified as key solutions.
Conclusions:
- Enhanced palatability awareness among healthcare professionals and parents is essential for improving antibiotic adherence.
- Development of more palatable oral liquid antibiotic formulations is recommended.
- Improved prescribing and medicine-taking practices can result from addressing palatability concerns.
Background:
Poor palatability of antibiotics is a key cause for non-adherence to antibiotic treatment among children. Failure to complete antibiotic treatment because of poor palatability can cause disease recurrence and may contribute to increasing rates of antimicrobial resistance. The aim of this study was to investigate the experience and challenges faced by general practitioners (GPs) and community pharmacists regarding prescribing and dispensing oral liquid antibiotics for children and the impact of poorly palatable antibiotic formulations on patients and the health-system.
Methods:
One-to-one semi-structured interviews with GPs and pharmacists were conducted via an online video-conferencing platform. Data were analysed using thematic analysis.
Results:
Twenty participants (7 GPs and 13 pharmacists) were interviewed. Three main themes and eight subthemes were identified. Theme 1: challenges reported by GPs and pharmacists included four subthemes; (i) factors affecting prescribing and dispensing antibiotics, (ii) reasons to select poorly palatable antibiotics, (iii) palatability discussion with parents, and (iv) formulation factors affecting oral liquid antibiotic acceptability. Theme 2: the impact of prescribing or dispensing poorly palatable oral liquid antibiotics encompassed two sub themes; (i) patient impact and (ii) health-system impact. Theme 3: overcoming palatability challenges involved two subthemes; (i) raising awareness of flavour and palatability issues among healthcare professionals and (ii) counselling parents while prescribing and before dispensing.
Conclusions:
There is a need to increase palatability awareness among healthcare professionals and parents. The development of more palatable oral liquid formulations can play a role in improving prescribing and medicines taking practices.
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