Walch A C, Henin E, Berthiller J, Dode X, Abel B, Kassai B, Lajoinie A
Clinical Investigation Centre CIC-INSERM 1407, EPICIME, Department of Clinical Pharmacology, Hospices Civils de Lyon, France.
Clinical Investigation Centre CIC-INSERM 1407, EPICIME, Department of Clinical Pharmacology, Hospices Civils de Lyon, France; UMR CNRS 5558, Laboratoire de Biométrie et Biologie Evolutive LBBE, Equipe Evaluation et Modélisation des Effets Thérapeutiques EMET, University Claude Bernard Lyon 1, France.
Int J Pharm. 2016 Sep 25;511(2):855-63. doi: 10.1016/j.ijpharm.2016.07.076. Epub 2016 Aug 2.
The purpose of this study was to interview paediatric nurses on administration issues using extemporaneous capsules and marketed capsules and tablets in children younger than 6 years old, based on most frequently administered drugs in six participating wards. The 59 responding nurses estimated respectively at 7.7±1.7 and 7.3±1.8years the age from which children would properly swallow extemporaneous capsules and marketed solids, with 33% and 37% of nurses considering that children under 6 would not get their prescribed treatment using these dosage forms. Refusal of the child to take the solid was the first reason to explain administration failure (85% of nurses for extemporaneous capsules, 89% for marketed solids). Although type of formulation and requirement of chewing were factors influencing the age at which children would take solid from nurses' experience, size of conventional tablets was not among these factors. All respondents use to crush tablets in children unable to swallow whole solids; 37% of nurses systematically split the tablets to ease the swallowing in children able to swallow. Only 11 nurses had an information tool at their disposal to guide manipulation of solids, with 7 of them using it in their daily practice. Providing specific-ward questionnaires, this study gives factual information on administration practices, perceptions and issues faced by paediatric nurses.
本研究的目的是就6岁以下儿童使用临时配制胶囊以及市售胶囊和片剂的给药问题，对儿科护士进行访谈，所依据的是六个参与病房中最常用的药物。59名回复的护士分别估计儿童能够正确吞咽临时配制胶囊和市售固体剂型的年龄为7.7±1.7岁和7.3±1.8岁，33%和37%的护士认为6岁以下儿童无法使用这些剂型接受规定的治疗。儿童拒绝服用固体剂型是导致给药失败的首要原因（85%的护士认为是临时配制胶囊，89%的护士认为是市售固体剂型）。尽管从护士的经验来看，剂型类型和咀嚼要求是影响儿童服用固体剂型年龄的因素，但常规片剂的大小并不在这些因素之列。所有受访者都会给无法吞咽整片固体的儿童碾碎片剂；37%的护士会有系统地将片剂掰开，以便能吞咽的儿童更容易吞咽。只有11名护士有可用的信息工具来指导固体剂型的操作，其中7人在日常工作中使用了该工具。通过提供特定病房的调查问卷，本研究给出了关于儿科护士给药实践、认知和所面临问题的实际信息。
