Audrey and Theodor Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA.
PLoS One. 2013;8(3):e58303. doi: 10.1371/journal.pone.0058303. Epub 2013 Mar 6.
The dearth of age-appropriate formulations of many medicines for children poses a major challenge to pediatric therapeutic practice, adherence, and health care delivery worldwide. We provide information on current administration practices of pediatric medicines and describe key stakeholder preferences for new formulation characteristics.
We surveyed children aged 6-12 years, parents/caregivers over age 18 with children under age 12, and healthcare workers in 10 regions of Tanzania to determine current pediatric medicine prescription and administration practices as well as preferences for new formulations. Analyses were stratified by setting, pediatric age group, parent/caregiver education, and healthcare worker cadre.
Complete data were available for 206 children, 202 parents/caregivers, and 202 healthcare workers. Swallowing oral solid dosage forms whole or crushing/dissolving them and mixing with water were the two most frequently reported methods of administration. Children frequently reported disliking medication taste, and many had vomited doses. Healthcare workers reported medicine availability most significantly influences prescribing practices. Most parents/caregivers and children prefer sweet-tasting medicine. Parents/caregivers and healthcare workers prefer oral liquid dosage forms for young children, and had similar thresholds for the maximum number of oral solid dosage forms children at different ages can take.
There are many impediments to acceptable and accurate administration of medicines to children. Current practices are associated with poor tolerability and the potential for under- or over-dosing. Children, parents/caregivers, and healthcare workers in Tanzania have clear preferences for tastes and formulations, which should inform the development, manufacturing, and marketing of pediatric medications for resource-limited settings.
许多儿童适用剂型缺乏，这对全球儿科治疗实践、用药依从性和医疗保健服务提供构成了重大挑战。我们提供了有关儿科用药现行管理实践的信息，并描述了利益相关者对新剂型特征的偏好。
我们在坦桑尼亚的 10 个地区调查了 6-12 岁的儿童、18 岁以上有 12 岁以下儿童的家长/照顾者以及卫生保健工作者，以确定当前儿科药物处方和管理实践，以及对新配方的偏好。分析按环境、儿科年龄组、家长/照顾者教育程度和卫生保健工作者职级分层。
共有 206 名儿童、202 名家长/照顾者和 202 名卫生保健工作者提供了完整的数据。整个吞咽口服固体制剂或压碎/溶解它们并与水混合是最常报告的两种给药方法。儿童经常报告不喜欢药物的味道，许多人还吐过药。卫生保健工作者报告药物的可获得性对处方实践的影响最大。大多数家长/照顾者和儿童更喜欢有甜味的药物。家长/照顾者和卫生保健工作者更喜欢为幼儿提供口服液体制剂，且对不同年龄的儿童能接受的最大口服固体制剂数量有类似的阈值。
有许多障碍会影响儿童对药物的可接受和准确管理。目前的做法与较差的耐受性和潜在的剂量不足或过量有关。坦桑尼亚的儿童、家长/照顾者和卫生保健工作者对口味和剂型有明确的偏好，这应能为资源有限环境中的儿科药物的开发、制造和营销提供信息。
